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Immediate Quote
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25 min activation
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Personal Broker
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Near Instant Documentation
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Direct pricing
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Privacy Policy
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Free Tracking devices
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Claims submission
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FAIS Act Compliant
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Business Insurance
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Car & Household Insurance Quote

   
 
Personal/Driver Details
Title
Name
Surname
I.D Nr.
Drivers Age
Mobile Phone Nr.
Work Tel. Nr.
Email Address
Marital Status
Suburb name
Area Code
Click here for area code
Vehicle Details
How many years have you had your drivers licence ?
Type of Licence Code
Code 10
Vehicle Year
Make (to be popluated from cvs file once Year is selected)
Model (to be popluated from cvs file once Make is selected)
Are you currently comprehensively insured ?
Yes
No
If yes, how many claim free years?
Date of last claim
Overnight parking
Use of vehicle
Sound System cover ? ( max R6000 )
Is there a tracking device installed?
Yes
No
Note: Vehicle values over R200,000, tracking compulsory.
Car hire (extra R50/m) Yes
No
Household Quote (Optional)
Value of house Contents ?
( minimum R150 000 )
Do you have Burglar bars on all opening windows ?
Yes
No
Do you have Security Gates on all exterior leading doors ?
Yes
No
Do you have a Linked alarm system ?
Yes
No
 
 
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