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About Us
Products
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Contact Us
Apply for Insurance
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Activa
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Vehicle Information
Model
*
Activa
Dio
Variant
*
Registration Number
*
Year of Manufacture
*
Select year
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
Month of Manufacture
*
January
February
March
April
May
June
July
August
September
Octobor
November
Decemebr
Type of Vehicle Ownership
*
Individual
Corporate
Insurance Company
*
Insurance Policy Type
*
Third Party
Comprehensive
No
Insurance Expiry Date
*
Vehicle Requirement
*
No Lien
Hypothecation
Hire Purchase
Lease
Other
Current Premium
*
Insured Value
*
Customer Information
First name
*
Last name
*
Email
*
Phone
*
Street address
*
Town / City
*
Postal Code
*
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