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Please submit commercial vehicle's quotation request below and we will respond to you with the most competitive quotations within 2 working days.

* For motor cars, please submit the request from here.

Quotation Request Form (for Commercial Vehicle):

* Fields marked with (*) are compulsory.

Company & Vehicle Information:

Company Name:* :

Registration Number:

Business Description*:

Vehicle Number.*:

Vehicle Type*:

Usage of the Vehicle*:

Type of Insurance Cover Require*:

Insurance Expiry Date:

(DD/MM/YYYY) *Click here if you are not sure

No Claim Discount (upon renewal)*:

Current Insurer:

Number of claims
(in past 3 years)*:

Date of Last Claim:

(DD/MM/YYYY)

Total Claim Amount:

Contact Person*:

Contact Number*:

Email Address*:

Remarks:

Main Driver (Optional)

Full Name*:
NRIC/ID Number*:
Gender*:
Date of Birth*:	(DD/MM/YYYY)
Marital Status*:
Occupation*:
Job Type*:
Driving License Pass Date*:	(DD/MM/YYYY)
Number of claims (in past 3 years)*:
Date of Last Claim:	(DD/MM/YYYY)
Total Claim Amount:

*CONSENT TO USE OF PERSONAL DATA

I have acknowledged and confirmed that I authorize, agree and consent to allow CIA adviser(s), its agents and third party service providers to collect, use, disclose, transfer, and process all my Personal Data provided by me now, or subsequently provided by me from time to time. I understand that I am entitled to withdraw my consent for the collection, use and disclosure of my Personal Data at any point in time by notifying the CIA advisers in writing. I have been advised and understand that my withdrawal of consent may cause CIA advisers to be unable to provide me services which CIA may be contractually obliged to provide. I also authorize, agree and consent to allow CIA, its adviser, representatives, agents and business partners to send me marketing, advertising and promotional materials and/or documents relating to services offered by CIA adviser(s) or its business partners through the following modes of communication: • Postal mail and /or electronic transmission to my email address; and • To my telephone contact number(s) by way of voice, text (SMS/MMS), fax, VOIP-based smart phone application such as Whatsapp. Viber, etc

FAST AND EASY QUOTE

You can also request for quotations via Email or SMS. Simply email the following information to motor.new.q@gmail.com, Name, NRIC No., Gender, Date of Birth, Maritial Status, Occupation, Nature of Job (Indoor or Outdoor), License Issue Date, Vehicle No., NCD, Current Insurer, Claim History>.

We are able to provide quotes for: