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Overseas Motor Insurance Proposal Form

By completing this Proposal Form you are stating your demands and needs as those of a motor vehicle owner who wishes to insure against loss of or damage to motor vehicles caused by accidental or malicious damage or vandalism, fire, lightning, explosion, theft or attempted theft.

Please note our policies exclude Third Party Liability Insurance, which should be arranged locally.

Please state the date you wish the insurance to commence

1

PROPOSER'S DETAILS

Address where vehicle will be stored in the country you are seeking insurance for
2

ADDITIONAL DRIVER'S DETAILS

3

ACCIDENTS / CLAIMS

4

VEHICLE/S TO BE INSURED

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