Intermediary Application Form - Directly Authorised Firms


Welcome to the application form for Directly Authorised firms (including Principals of a Network)

Before you begin the application process we would ask you to read Bupa’s Standard Terms of Business, as you'll be asked to confirm you have read and will adhere to these before you can proceed with your application 

If you have any questions about the application process please email 

If you are an Appointed Representative of a Principal or Network please Click Here

If you wish to enter in to any other form of third party relationship with us please email and a Bupa representative will be in touch to discuss your requirements

All questions marked with an asterisk * must be answered before you can proceed to the next page

1. Please confirm you have read Bupa’s Standard Terms of Business and agree to adhere to them *

2. Please confirm you are a Principal of business or Network as defined within the Financial Conduct Authority (FCA) Handbook *

3. Please confirm you are directly regulated by the FCA *

4. Please confirm you have the appropriate permissions for the activities you propose to carry out *

5. Please confirm you are a business registered in the UK (England, Wales, Scotland or Northern Ireland, Channel Islands, or the Isle of Man) *

6. Please confirm you or your directors are not subject to any sanctions *

7. Please confirm you hold £500,000 or over in Annual Premium Income (API) for Private Medical Insurance (PMI) for Business Products *

If you do not meet any of the eligibility criteria above you will be unable to progress with your application.

Should you wish to discuss any elements of this further please email: and a Bupa representative will be in touch


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