Vehicle Insurance Enquiry

If you would like a quote for your new or existing car insurance, kindly fill-up the form completely, cut and paste the following template and email to . Please note that we are able to process your request within 1-2 working day.

Personal Information
Owner Name:
Postal Code:
Contact Number:
Email Address
The Name Driver
Marital Status:
Date Of Birth:
Driving Experience:
No of Cliams in last 3 years:
Claim Amount:
Safty Driver Discount: Yes / No
NCD Discount: 10 / 20 / 30 /40/50
Previous Insurer:
Vehicle Number:
Vehicle Information
Make Model:
Normal Private Vehicle / Off Peak Car:
Vehicle Registration Number:
Year of Manufacture:
Chassis Number:
Engine Number:
Name Of Finance Company:
Period Of Coverage: