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MOTOR CAR INSURANCE for Business

Insured Perils:

Third Party

Fire

Theft

Damage

Comprehensive

YES

YES

YES

YES

Third Party, Fire & Theft

YES

YES

YES

NO

Third Party Only

YES

YES

NO

NO

Vehicle Use

Business Goods

People for Reward

Visit Business Clients

To/From Work

Private

Commercial

YES

YES

YES

YES

YES

Business

NO

NO

YES

YES

YES

Private

NO

NO

NO

YES

YES

Extensions: [Optional]

Loss of use
Credit shortfall
Contingent liability
Loss of keys

Important:

Audio equipment is not covered unless specified
Vehicle value [including extras]
Vehicle security - Insurance company warranty (Certificate required)

Exclusions:

Carrying of fare paying passengers
Hire
Speed contests

ADDITIONAL OPTIONAL RISK INSURANCE CAR INSURANCE
Please Answer ALL Questions
PERSONAL DETAILS
Surname	x
Initial
Title	Required Fields = x
ID Number	x
Residential Suburb and town. eg. Morningside Johannesburg	x
Postal code	x
Tel no & code	x
Cellphone	x
E-mail	x
Marital status
Do you currently have CAR INSURANCE ?
Have you had CAR INSURANCE during the last 30 days
Current or previous CAR INSURANCE companies
How long in total?
Did you have any claims in the last 5 years
Details of CLAIMS (if any) CAR INSURANCE
Security at your house
Type of residence
Construction of the walls of the home
Type of roof
Burglar bars in front of all opening windows
Safety gates at all outside doors, sliding doors included
Alarm system with armed response by a professional security company
Alarm system linked to a monitoring room of a security company with no armed response
Is the perimiter walls secured with electric fencing
Do you stay in a complex with 24 hr security guards on the premises, a boomed entrance with security checking and electric fencing on the perimiter walls
Date you moved in at this address
How many years have you stayed at this addres without a claim ?
CARAVAN INSURANCE
MAKE and MODEL YEAR of MANUFACTURE	Make model Year
VALUE
MOTORCYCLE INSURANCE
MAKE and MODEL YEAR of MANUFACTURE	Make model Year
VALUE
Roadside Assistance-option .....learn more
Medical Assistance-option ...learn more
INSURE the Difference between the MARKET VALUE and the OUTSTANDING amount of FINANCE CHARGES	Difference in Value
Car Hire (when your vehicle is Damaged under a CLAIM-FREE CAR HIRE)-option ...learn more
CAR INSURANCE
VEHICLE NO.1-MOTORCAR INSURANCE
Make of motorcar
Model description eg. Toyota Corolla 160i GLE with aircon
Year of manufacture
Value
Overnight parking
Vehicle cover
Private/Business Use
Radio cover :Is the car radio factory fitted
Value of radio
Factory fitted Immobiliser
Vesa approved gearlock
Is the vehicle equipped with a anti hi-jacking device
Is the vehicle equipped with a tracking device
If yes, what type or trademark eg. Tracker
Details of the most regular driverInitials, surname and date-of-birth
When was this person issued with a drivers license? provide rough estimate !!
Claim-free years of this vehicle
VEHICLE NO.2-MOTORCAR INSURANCE
Make of motorcar
Model description eg. Toyota Corolla 160i GLE with aircon
Year of manufacture
Value
Overnight parking
Vehicle cover
Private/Business Use
Radio cover :Is the car radio factory fitted
Value of radio
Factory fitted Immobiliser
Vesa approved gearlock
Is the vehicle equipped with a anti hi-jacking device
Is the vehicle equipped with a tracking device
If yes, what type or trademark eg. Tracker
Details of the most regular driver Initials, surname and date-of-birth
When was this person issued with a drivers license? provide rough estimate !!
Claim-free years of this vehicle
ADDITIONAL INFORMATION :
please provide notes of any extra items or maybe there is more information that you might think is relevant to this quotation

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Motor Car Insurance-business