Motor Insurance Quotation Form

Name
NRIC
Gender
Address
Occupation
Marital Status
Contact Number
D.O.B
Driving Experience
Vehicle Make and Model
Engine Capacity
Vehicle Number
Date of Registration
*off Peak Car
No. of Claims
Claim Amount
NCD
Private Car 10% 20% 30% 40% 50%
Commercial Car 10% 15% 20%
Motorcycle 10% 15% 20%
Previous Insurance Company
   
 

Don’t know how much NCD you have got?
Please provide your previous car number and insurance company to allow us to verify and check you NCD status.
We served both new cases and renewals.
We promised to provide the best deals in town that we can!
We Hope to serve you better.
Thanks!

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