LuCUSS Login

Please register your details below and agree to the declaration statements below. We will be in contact to confirm your application as soon as possible.

SECTION 1 - COMPANY INFORMATION

Full Name:

Full name, including any trading name(s)

Contact Name:

Holding Company Name:

Registered Office

Number / Street:

Area:

Town / City:

County:

Postcode:

Company Reg. Number:

Main Email:

Telephone:

Your Web Address:

Year Established:

Num of Staff Employed:

Total number of staff employed, including directors, principals and partners

Billing Address:

Tick if your billing address is different to your contact details above.

Add Secondary Contact

We recommend providing a secondary contact to cover annual leave or sickness.

Add Secondary Contact?

Please upload your list of sub agents here. If you do not have a file containing this information then please use our template. (Excel format - link to download template).

Upload Related Sub Agent Details:

Has your firm ever had an agency revoked or an agency application declined, or accepted on special terms?:

Has your firm been involved in any legal disputes with any insurers or clients during the last 3 years?:

Next Step

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SECTION 1 - COMPANY INFORMATION

Registered Office

Add Secondary Contact

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