Health Insurance Quotation Form

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Motor Insurance Quotation

Motor Insurance Quotation Form

Do you live on the Maltese Islands on a permanent bases or is your entity registered in Malta?

Are you the owner or intend to own a motor vehicle registered in the Maltese Islands?

Do you have a valid European driving licence?

Do you need insurance protection for your motor vehicle and/or cover for third party liability?

Name and Surname

Mobile No:

ID Card Number

Cover Required

Vehicle Registration Number

Make and Model

Engine CC

Your estimated value of the car

Who will be driving the vehicle?

Youngest driver's Age

Have you made a claim in the last 5 years?

Name of current Insurance Company:

Or call us on +356 21339110

Travel Insurance Quotation

Travel Insurance Quotation Form

Do you live in the Maltese Islands on a permanent basis?

Are you travelling or intend to travel from the Maltese Islands and returning to the Maltese Islands within a specified period?

Are you travelling for pleasure and/or business purposes?

Do you require insurance protection for a single trip not exceeding 180 days?

Name and Surname

ID Card Number

Mobile No:

How many persons, ordinarily resident in Malta, are travelling? (Age 0-69)

Where to and for how long are you travelling?

From:

From Month

From Year

To:

To Month

To Year

Which cover do you want:

Or call us on +356 21339110

Business Insurance Quotation

Or call us on +356 21339110

Professional Indemnity Insurance Quotation

Professional Indemnity Insurance Quotation Form

Do you live on the Maltese Islands on a permanent bases or is your entity registered in Malta?

Do you hold a valid qualification and/or warrant and/or licence?

Do you practice your profession or business operation solely in the Maltese Islands?

Do you require insurance protection for sums which you may become legally liable to pay, arising from a claim made against you by reason of any negligent act,error or omission, occurring or committed in good faith in connection with your profession or business operation?

Name and Surname

ID Card Number

Telephone/Mobile No:

Comments/Suggestions

How did you hear about us?

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