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Motor Insurance

Provide financial protection against physical damage and bodily injury resulting from traffic collision liability that could also arise therefrom.

Please provide your details.
Our representative will call you for your queries and policy details.

Required Details

Policy required

Vehicle Details

Cubic Capacity
Current Insurer
Car Registratuion No.*
Date of First registration*
Policy Expiry Date*

If additional accessories added in policy (Optional)

Please Provide Details below
Electrical Access.
Non-Electrical Access.
Bi-fuel CNG/LPG Kit

Do you want additional Coverage (Optional)

Legal liability to paid driver
Un-named passenger PA cover

Details of Expiring Policy

Claim Made*
No claim Bonus in %*

Personal Details

First Name* Last Name*
Email* Contact No*
City Occupation



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