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Apply for an Agency

We welcome applications from quality brokers of all sizes, whether you place large volumes of business or have occasional need to access a particular market.

Applying for an agency is simple. Simply enter your details into the form below, ensuring all required fields are completed.

Click here for Bollington Underwriting’s Terms of Business Agreement

Is your company registered with the FCA?
Yes No
FCA Number
Please explain why
Brokerage Name
Brokerage Address
Telephone
Email
Website address
Main Contact Name

Director Details

Full Name
Date of Birth
Date Appointed as Director
Insurance Qualifications
Date Obtained

Have you (or any Director or Partner):

Ever been involved in bankruptcy, liquidation or receivership or ever made any composition or entered into any Deed of Arrangement with creditors?
Yes No
Ever been convicted of a criminal offence?
Yes No
Been found professionally negligent by any supervisory or regulatory authority. For any transactions undertaken?
Yes No
Ever been notified of a compliance feature or had your authorisation suspended by FCA or any other regulatory body?
Yes No
Have you (or any Director/Partner) had an insurance agency or insurance agency declined, terminated or restricted?
Yes No
Do you have Professional Indemnity insurance?
Yes No
Do you hold client money?
Yes No
By submitting this application, I understand that I accept the terms of business.
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