Driver's Insurance Plan

IMPORTANT INFORMATION

THE LIABILITY OF THE COMPANY DOES NOT COMMENCE UNTIL THIS APPLICATION IS ACCEPTED AND THE PREMIUM IS PAID IN ACCORDANCE WITH SECTION 50(1) OF THE INSURANCE ACT 2003

This policy pays compensation to the drivers or their beneficiaries in the event of road traffic-related accidents which may result in loss of life, permanent disability, or bodily injury

Kindly fill the form in block letters, tick ( ) the boxes as appropriate
Attach your means of Identification and driver’s license

Personal Information


















Other Requirement











Declaration