Motor Insurance Form

Fill up the form below to get your quote.

Name of Insured

NRIC No

Handphone

Email

Nationality

Gender

Date of Birth

Marital Status

Occupation

Plan Type

Years of Driving Experience

Vehicle Number

Effective Date of Insurance

Number of Claim Records (Past 3 years)

NCD Entitlement (%)

Other Named Drivers (below 25 years old or above 70 years old or driving experience less than 2 years)

Other Named Drivers

Referred By