Private Motor Insurance | Car Insurance in Singapore

• Applicable to first time car owners and renewal • 30% discount based on basic premium excluding GST

Please complete the form below for a quote and our friendly staff will get back to you as soon as possible. Thank you.

1. Coverage and Vehicle Details

Choice of Coverage *

Vehicle Number *

Vehicle Make and Model *

Off-peak car? *

Private Hire Use?
YESNONot Sure

2. Proposer (Vehicle Registered Owner Only)

Full Name (As per NRIC) *

Date of Birth *

NRIC Number *

Licence Passing Date *

Email *

Contact No. *

Previous Insurer (Optional)

NCD (Optional)

3. Claim Experience

Any claims for past 3 years ? *

Suspension of Driving *

4. Additional Information

Promotional Code (Optional)

Attachment (Optional)

(Please attach your renewal notice/log card/driving licence & etc. If more than 1 file, zip it before attaching. Max allowed file size is 10MB.)

How Did You Hear of Us/Find Us? *

Remarks (Optional)

I/we hereby understand that I/we need to disclose our personal data in order for Assure (Singapore) Pte Ltd to generate a quotation for me/us. I/we have read the Privacy Policy and I/we consent to the collection and use of my/our personal data in accordance with its terms and conditions. I/we agree and understand that accuracy of quotation premium is solely reliant on information provided by me/we only.

*indicates required field. By clicking Submit, you agree to our Privacy Policy.

	November 2024
M	T	W	T	F	S	S
				1	2	3
4	5	6	7	8	9	10
11	12	13	14	15	16	17
18	19	20	21	22	23	24
25	26	27	28	29	30