Insurer have the rights to decline claim if accident is not reported within 24 Hrs. Please click on the link for more info http://www.gia.org.sg/pdfs/Industry/Motor/Final%20Brochure_9%20May%2008.pdf
Name of Insured (as in NRIC):
NRIC:
Occupation:
Driving Experience:
Sex:
Date of Birth:
dd mm yyyy
Contact No.:
Email:
Vehicle No:
Make & Model of Vehicle:
cc:
Year of Registration:
Current Insurance Co:
Policy No:
No Claim Discount:
Any claims within past 3 years?
- Select - Yes No If 'yes', please state amount
Parallel Import?
- Select - Yes No
100 Jalan Sultan #02-15 Sultan Plaza S’pore 199001 Tel: 6295 6108 Fax: 6295 6107 Email: sales@i-n-s.com.sg