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Request for Motor Car Insurance Quotations

Step 1: Fill in the form below and submit.
Step 2: Quotations will be emailed to you at the earliest opportunity.
Step 3: Once you decided on the insurer, the application forms will be mailed/courier to you.
Step 4: Sign and return the forms and we will process the rest. The insurance policy document will be sent to you once approved.

Get a free ebook “The Ultimate Guide to Car Insurance” when you request for quotes! It is non-obligatory!

Car insurance yet to expire? Leave your contact here and you will receive the ebook too!

Full Name
Contact No.
Email
Gender
NRIC No.
Date of Birth (dd/mm/yyyy)
Marital Status
Occupation
Nature of Occupation
Driving Experience (no. of years)
Car Make and Model (e.g. Toyota Altis)
Engine Capacity (e.g. 1.6L)
Car Modification if any (e.g. bodykit, exhaust)
Car Registration No.
Car Registration Date (dd/mm/yyyy)
Any claims for past 3 years? If yes, how much?
No Claim Discount on next renewal
Current Insurer
Renewal Date
Expected Renewal Premium
Remarks

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