Motor Insurance Quotation

* Policy Start Date   
* No of years holding the driving license
* New/Used Vehicle
     New     Used    
Is vehicle under comprehensive coverage
     No     Yes    
Registration No
Chassis No
* Type of Vehicle
* Type of Body
* Make of Vehicle
* Model of Vehicle
* Model Year
* No. of Cylinders
* Seating Capacity
* Heavy/Light Vehicle
* Registration Month
Vehicle Replacement Days for small car
(For medium car please contact TIC office)
* Vehicle Value
* No Claim Discount
(subject to submission of proper document)
   Other Information
* Will a trailer be used
     No     Yes    
* Is the vehicle attached with any plant or Tool for carrying out any work
     No     Yes    
* Do you undertake cartage for others
     No     Yes    
* Do you undertake carrying passengers
     No     Yes    
* Will Vehicle be used for carrying Passenger for hire or reward
     No     Yes    
   Cover Selection
  Third Party
  Third Party Fire & Theft
  Comprehensive(OD Only)
  Comprehensive Plus
  Comprehensive Silver
  Comprehensive Gold
  Comprehensive Platinum
   Additional Covers
  Personal Accident Benefit
  Riot and Strike
  Storm and Flood
  Wind Screen Coverage
  Road Assist
Note: Comprehensive covers (Plus,Silver,Gold,Platinum) includes car replacement (small-7 days) + Road Assist.(cover details)
Insured Detail
*CPR No.
*Confirm CPR No.
*First Name
*Last Name
*Date of Birth
*Gender Male Female
Flat No
Building No
Road No
Block No
PO Box No
Mobile No
Phone No
Email Id