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  • Car Insurance Application Form

  • To get car insurance, just fill out this form.

  • Customer information

  • Give your information.

  • For corporate customers only.

  • Previous period of insurance.

  • Current period of insurance.

  • Claims lodged during the preceding year number.

  • Coverage Information

  • Personal Accident Cover for Owner Driver is compulsory in the Package policies. Please give details of nomination: