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Application

Motor Insurance

Whether it is your prized luxury car or the trusty commercial vehicle that serves your business’ transportation requirements, rest assured that you are protected by reputable insurers with a comprehensive range of solutions. You can drive with confidence knowing that you are well protected against unfortunate events. What’s more, you also stand to enjoy timely motor and car insurance renewal reminders and support for your claims process when you insure with us!

We’d be happy to assist you with your requirements through the following channels:

1)      Complete the online form and click “Submit” for us to process your request.
2)      Speak to us at 6411 7047 (weekdays 8.30am to 6.00pm) if you need additional assistance.

Policyholder's Details

Owner's Name (Company/Individual):*
UEN/NRIC:*
Nature of Business:*
Existing Insurer:*
No Claims Discount (NCD) (Upon renewal):*
Existing Customer:*
Claims Experience (Past 3 years)
Any Claims?*
$
$
$

Main Driver's Details

Name (as per NRIC):*
Date of Birth:*
Not 18 years old.
Gender:MaleFemale*
Marital Status:Single Married*
Occupation:*
Driving Experience:**

Vehicle Details

Vehicle Registration Number:*
Make:*
Model:*
Attachment(s):
NACanopy/Hood

Box

Refrigerator/Freezer

Power Tailgate

Crane

Cement Mixing Equipment

Others (to specify)

Coverage Details

Coverage Type: *
Policy Start Date:*

Contact Details

Salutation:*
Name:*
Contact Number:*
Email:
Referred By (indicate “NA” if none):*
Promo Code (if any):
I understand and agree that by requesting for an insurance quotation, the information collected will be disclosed to insurers in order to process and respond to my request. The information collected is also subject to the uses as indicated in ABWIN’s Privacy Policy. Read more about our Privacy Policy here.

Policyholder's Details

Salutation*
Name (as per NRIC):*
NRIC:*
Date of Birth:*
Not 18 years old.
Gender:Male Female*
Marital Status:Single Married*
Occupation:*
Driving Experience:**
Existing Insurer:*
No Claims Discount (NCD) (Upon renewal):*
Certificate of Merit:Yes No NA*
Existing Customer:*
Claims Experience (Past 3 years)
Any Claims?*
$
$
$
Was your license revoked?*

Vehicle Details

Vehicle Registration Number:*
Make:*
Model:*
Seating Capacity (Inclusive of driver):*
Additional Accessories Details (Include if you require accessories to be insured)
$
$
$

Coverage Details

Coverage Type: *
Policy Start Date:*

Contact Details

Salutation:*
Name:*
Contact Number:*
Email:
Referred By (indicate “NA” if none):*
Promo Code (if any):
I understand and agree that by requesting for an insurance quotation, the information collected will be disclosed to insurers in order to process and respond to my request. The information collected is also subject to the uses as indicated in ABWIN’s Privacy Policy. Read more about our Privacy Policy here.

Your enquiry is currently receiving our attention. Please be assured that we will contact you shortly. Thank you.
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