Motor Enquiry
Motor Insurance
Contact No. *
Email *
Name of Insured *
NRIC/FIN/ROC *
Date of Birth
Gender
Select gender
Male
Female
Nationality
Select nationality
Afghan
Albanian
Algerian
American
Andorran
Angolan
Anguillan
Argentine
Armenian
Australian
Austrian
Azerbaijani
Bahamian
Bahraini
Bangladeshi
Barbadian
Belarusian
Belgian
Belizean
Beninese
Bermudian
Bhutanese
Bolivian
Botswanan
Brazilian
British
British Virgin Islander
Bruneian
Bulgarian
Burkinan
Burmese
Burundian
Cambodian
Cameroonian
Canadian
Cape Verdean
Cayman Islander
Central African
Chadian
Chilean
Chinese
Citizen of Antigua and Barbuda
Citizen of Bosnia and Herzegovina
Citizen of Guinea-Bissau
Citizen of Kiribati
Citizen of Seychelles
Citizen of the Dominican Republic
Citizen of Vanuatu
Colombian
Comoran
Congolese (Congo)
Congolese (DRC)
Cook Islander
Costa Rican
Croatian
Cuban
Cymraes
Cymro
Cypriot
Czech
Danish
Djiboutian
Dominican
Dutch
East Timorese
Ecuadorean
Egyptian
Emirati
English
Equatorial Guinean
Eritrean
Estonian
Ethiopian
Faroese
Fijian
Filipino
Finnish
French
Gabonese
Gambian
Georgian
German
Ghanaian
Gibraltarian
Greek
Greenlandic
Grenadian
Guamanian
Guatemalan
Guinean
Guyanese
Haitian
Honduran
Hong Konger
Hungarian
Icelandic
Indian
Indonesian
Iranian
Iraqi
Irish
Israeli
Italian
Ivorian
Jamaican
Japanese
Jordanian
Kazakh
Kenyan
Kittitian
Kosovan
Kuwaiti
Kyrgyz
Lao
Latvian
Lebanese
Liberian
Libyan
Liechtenstein citizen
Lithuanian
Luxembourger
Macanese
Macedonian
Malagasy
Malawian
Malaysian
Maldivian
Malian
Maltese
Marshallese
Martiniquais
Mauritanian
Mauritian
Mexican
Micronesian
Moldovan
Monegasque
Mongolian
Montenegrin
Montserratian
Moroccan
Mosotho
Mozambican
Namibian
Nauruan
Nepalese
New Zealander
Nicaraguan
Nigerian
Nigerien
Niuean
North Korean
Northern Irish
Norwegian
Omani
Pakistani
Palauan
Palestinian
Panamanian
Papua New Guinean
Paraguayan
Peruvian
Pitcairn Islander
Polish
Portuguese
Prydeinig
Puerto Rican
Qatari
Romanian
Russian
Rwandan
Salvadorean
Sammarinese
Samoan
Sao Tomean
Saudi Arabian
Scottish
Senegalese
Serbian
Sierra Leonean
Singaporean
Slovak
Slovenian
Solomon Islander
Somali
South African
South Korean
South Sudanese
Spanish
Sri Lankan
St Helenian
St Lucian
Stateless
Sudanese
Surinamese
Swazi
Swedish
Swiss
Syrian
Taiwanese
Tajik
Tanzanian
Thai
Togolese
Tongan
Trinidadian
Tristanian
Tunisian
Turkish
Turkmen
Turks and Caicos Islander
Tuvaluan
Ugandan
Ukrainian
Uruguayan
Uzbek
Vatican citizen
Venezuelan
Vietnamese
Vincentian
Wallisian
Welsh
Yemeni
Zambian
Zimbabwean
Marital Status
Select marital status
Single
Married
Widowed
Divorced/Separated
Occupation
Nature of Business
Driving Experience *
Select driving experience
Less than 1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
More than 10 years
No License
Claims Information
Claims Experience for Past 3 Years *
Please Select
Yes
No
Date of Accident
Nature Of Claim
Claim Amount
Own Damage
Third Party Damage
Other
Vehicle Registration Number *
Type of Coverage *
Select type of coverage
Comprehensive
TPFT
TPO
Any Workshop or Authorised Workshop *
Select workshop
Any Workshop
Authorised Workshop
No Claim Discount (On Renewal) *
Select claim discount
0%
10%
15%
20%
30%
40%
50%
60%
Reason for 0% NCD / How many years have you enjoyed 50% No Claim Discount
NCD Protector
Please Select
Yes
No
Additional Named Driver
Please Select
Yes
No
Driver Name
NRIC No
Gender
Select gender
Male
Female
Date of Birth
Driving Experience
Select driving experience
Less than 1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
More than 10 years
No License
Occupation
Relationship
Other
Existing Insurer
Renewal Premium (incl. GST)
Vehicle Make / Model
Vehicle Type
Year of Manufacture
Registration Date
Laden Weight
Unladen Weight
Vehicle Body Type
Select Vehicle Body Type
CRV
Coupe
High Performance
SUV
Saloon
Station Wagon
MPV
Others
Parallel Import
Please Select
Yes
No
Vehicle Usage
Select Vehicle Usage
Private Use
Private and Business Use
Private Hire
Private Use (Off Peak Car)
Private and Business Use (Off Peak Car)
Business Use
Cubic Capacity (cc) / Tonnage
Good Driver Discount (5%) *
Please Select
Yes
No
Period of Insurance *
to
Remarks
Captcha
Refresh
Enter the text you see above:
Terms & Conditions
I have read and agree to the Terms and Conditions
Please read our
Terms & Conditions
before submitting this form.