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Motor Vehicle Comprehensive Insurance

Name  
Email  
Phone  
What is the $ value of insured item  
     
Make of vehicle (Mazda, Toyota, Ford etc)  
     
Model of vehicle (Yaris, Ranger, 320 etc)  
     
What is the registration of vehicle you
wish to get insured ?
 
     
For what purpose will the vehicle be used?   Private
Taxi
Minibus
Bus
Business
Others
Others (Please Specify)
     
Have you or anyone who will be driving the insured car has had an accident in the past 3 years?
(If so, please provide details)
 

Yes
If Yes Please Provide details below:

     
What is your preferred excess/deductible level? (excess is a $ amount that an insured has to bear in the event of an insurance claim; standard excess level for a private motor vehicle insurance is $500, however if you volunteer to increase this amount, it may reduce your insurance premium)  
     
Standard coverage is provided for 12 months from inception of cover, please advise if your require coverage for less than 12 months with exact dates of coverage?  
     
Full Comprehensive covers include damage to your vehicle and damage to Third Party Vehicles. However in order to opt for a lower premium, you may opt for a limited cover which shall cover damage to Third Party vehicles only. Do you require Full Comprehensive cover or limited Third Party Property Damage Cover?   Full Comprehensive cover Third Party Property Damage Cover
     
As part of our standard coverage for Private vehicles, a Third Party Damage is limited to $100,000 whilst Passenger Risk Coverage is limited to $100,000. If you require covers at higher values, please state your required sums?  
     
Do you require ferry crossing coverage?   Yes
     
Do you require a rental cover? (covers for rental vehicle hire whilst your vehicle is being repaired as a result of an insurance claim)   Yes
     
Our standard deductible for windscreen damage is 10% of the Loss, Minimum $100 or do you require this excess to be waived with a $100 charge?   Yes