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Personal Insurance Quotation

Personal Quote Request

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Personal Information

Contact Details
Credit Check Consent
Can we perform a credit rating (ITC check)? *

Insurance History

Declarations
Has any application for insurance been declined, cancelled, renewal refused, special conditions imposed, or any judgements against your name? *
Been convicted of any offence or involved in any civil/criminal litigation in the past 3 years? *
Previous Claims / Losses
Please tell us about any previous claims or losses in the past 5 years, even if not claimed — windscreen claims included.
No file selected

PDF only, maximum 10 MB. The file will be attached to your quote request.

Type of LossAmount (R)YearInsurerPolicy No

Contents & Homeowners

Do you require Contents / Homeowners cover? *
Property 1
Risk Address
Sums Insured
Do you have a solar geyser?
Residence
Is the residence within 500m of a shoreline, river, lake or dam?
Occupancy Details
Will the residence be unoccupied for more than 7 consecutive days in first 30 days of cover?
Will the residence be left unoccupied during working hours?
Will the residence be unoccupied for more than a total of 60 days per year?
Will the residence be hired or let out?
Security Details
Are all opening windows burglar barred (or ground floor windows if multi-storey)?
Are all access doors fitted with security gates?
Does any outbuilding or garage adjoining the main residence have an inter-leading door?
Is the perimeter walled/fenced with a wall or steel fence of at least 1.8m?
Is the perimeter wall fitted with razor/barbed wire or electric fence?
Is the property a full security complex/estate with electric fence and 24-hour guards?
Is there 24-hour access control to your property?
Is your home protected with an approved SAIDSA alarm system linked to a 24-hour control room with armed response?

Motor Vehicle

Do you require Motor Vehicle cover? *
Vehicle 1
General Detail
Excess Waiver?
Car Hire?
Do you require Credit Shortfall cover?
Vehicle Details
Existing damages?
Is the registered owner the insured or spouse?
List of Extras That Is Not Standard
DescriptionReplacement Value (R)
Vehicle Security Details
Tracking and recovery system?
Regular Driver Details
Named Drivers
NameID Number

Motorcycle

Do you require Motorcycle cover? *
General Detail
Motorcycle Details

Watercraft

Do you require Hull / Vessel cover? *
Hull / Vessel Details
Engine Details

Caravan / Trailer

Do you require Caravan / Trailer cover? *

All Risks

Do you require All Risks cover? *
General All Risks covers unspecified personal belongings. Minimum sum insured R15,000. Specified All Risks covers individually listed high-value items.
Specified All Risks – Individual Items
DescriptionReplacement Value (R)

Review & Submit

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