motor

Motor Insurance Quotation For Private Vehicle

Important Notice:
This online form does not constitute acceptance of a contract of insurance. It is intended only for the collection of data to be used to generate quotation of the insurance policy based on the factual information provided by the applicant. In preparation of the quotation, we have assumed and relied on the accuracy and completeness of the information supplied to us.

Please refer to the policy contract for the policy terms, conditions and exclusions.

Insured Details

* Indicates required field

Name of Insured *

NRIC No. *

Gender *

Date of Birth *

Marital Status *

Occupation *

Driving Experience *

Coverage Details

Type of Cover *

Comprehensive Third Party, Fire & Theft Third Party Only

Vehicle No. *

Current Insurance Company *

No Claim Discount (NCD) *

Insurance Commencement Date *

Claim Details

Any Claims for the past 3 years *

Yes No

If Yes, Indicate Date of Claim *

Own Claim Amount *

Third Party Claim Amount *

Contact Details

Contact Person Name *

Email *

Contact No. *

Submit