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This service is only for
vehicle insurance
renewal
Fill up the below form, and we will respond back to you with 3 of the most competitive quotations for insurance
renewal within 3 working days.
Request for Quotation
This service is only for vehicle insurance renewal.
attn: fields marked with (*) are compulsary to be filled in.
Personal Information
Full name
*
:
NRIC/Passport No.
*
:
Home Address:
Vehicle No.
*
:
Gender
*
:
Please Select
Male
Female
No Claim Discount (upon renewal)
*
:
Please Select
0%
10%
20%
30%
40%
50%
OFD (Offence Free Discount)
*
:
Please Select
No
Yes
Claim Experience
*
:
Claims made from
13-Mar-09 to
13-Mar-10
Please Select
No
First Car, no
1
2
3 or more
claims totalling $
Claims made from
13-Mar-08 to
13-Mar-09
Please Select
No
1
2
3 or more
claims totalling $
Claims made from
13-Mar-07 to
13-Mar-08
Please Select
No
1
2
3 or more
claims totalling $
Driving License Date
*
:
(dd.mm.yyyy) Click
here
if you are not driving
Date of Birth
*
:
(dd.mm.yyyy)
Maritial Status
*
:
Please Select
Married
Single
Occupation
*
:
Please Select
Academic, Educator
Actor, Actress, Entertainer
Aircraft Pilot/Cabin Crew
Banker, Accountant, Fund Manager
Clerical, Administrative
Computer Engineer, Technician
Computer Engineer, Technician (Outdoor)
Construction, Supervisor, Worker (Indoor)
Contractor, Subcontractor
Doctor, Medical or Lab Staff
Executive, Managerial
Hawker
Homemaker
Housewife
Insurance, Property Agent
Lawyer, Legal Profession
Management, Director, CEO
Mechanic
Military, Police, Civil, Defence, etc
News Reporter, Journalist
Other, Technician, Engineer
Others, Indoor
Others, Outdoor
Professional
Renovation, Contractor
Retiree
Sales, Marketing, Service, Surveyors, Valuers
Self, Employed, Own, Company
Service, Customer, Support, in, house
Student
Unemployed
Job Type
*
:
Please Select
Indoor
Outdoor
Contact No.
*
:
Email
*
:
Vehicle Information
Date of Registration
*
:
(dd.mm.yyyy)
Make & Model
*
:
Capacity (cc):
Vehicle Type:
Please Select
Hatchback
Sedan
Luxury Sedan
Coupe
Sports
SUV
MPV
Commercial
OPC (Off Peak Car)
*
:
Please Select
Yes
No
Current Insurer
*
:
Named Driver (1)
click to show / hide
Full name:
Claim Experience
*
:
Claims made from
13-Mar-09 to
13-Mar-10
Please Select
No
First Car, no
1
2
3 or more
claims totalling $
Claims made from
13-Mar-08 to
13-Mar-09
Please Select
No
1
2
3 or more
claims totalling $
Claims made from
13-Mar-07 to
13-Mar-08
Please Select
No
1
2
3 or more
claims totalling $
Driving License Date
*
:
(dd.mm.yyyy)
Date of Birth
*
:
(dd.mm.yyyy)
Marital Status
*
:
Please Select
Married
Single
Gender
*
:
Please Select
Male
Female
Relationship with:
Policy Holder
Occupation
*
:
Please Select
Academic, Educator
Actor, Actress, Entertainer
Aircraft Pilot/Cabin Crew
Banker, Accountant, Fund Manager
Clerical, Administrative
Computer Engineer, Technician
Computer Engineer, Technician (Outdoor)
Construction, Supervisor, Worker (Indoor)
Contractor, Subcontractor
Doctor, Medical or Lab Staff
Executive, Managerial
Hawker
Homemaker
Housewife
Insurance, Property Agent
Lawyer, Legal Profession
Management, Director, CEO
Mechanic
Military, Police, Civil, Defence, etc
News Reporter, Journalist
Other, Technician, Engineer
Others, Indoor
Others, Outdoor
Professional
Renovation, Contractor
Retiree
Sales, Marketing, Service, Surveyors, Valuers
Self, Employed, Own, Company
Service, Customer, Support, in, house
Student
Unemployed
Named Driver (2)
click to show / hide
Full name:
Claim Experience
*
:
Claims made from
13-Mar-09 to
13-Mar-10
Please Select
No
First Car, no
1
2
3 or more
claims totalling $
Claims made from
13-Mar-08 to
13-Mar-09
Please Select
No
1
2
3 or more
claims totalling $
Claims made from
13-Mar-07 to
13-Mar-08
Please Select
No
1
2
3 or more
claims totalling $
Driving License Date
*
:
(dd.mm.yyyy)
Date of Birth
*
:
(dd.mm.yyyy)
Marital Status
*
:
Please Select
Married
Single
Gender
*
:
Please Select
Male
Female
Relationship with:
Policy Holder
Occupation
*
:
Please Select
Academic, Educator
Actor, Actress, Entertainer
Aircraft Pilot/Cabin Crew
Banker, Accountant, Fund Manager
Clerical, Administrative
Computer Engineer, Technician
Computer Engineer, Technician (Outdoor)
Construction, Supervisor, Worker (Indoor)
Contractor, Subcontractor
Doctor, Medical or Lab Staff
Executive, Managerial
Hawker
Homemaker
Housewife
Insurance, Property Agent
Lawyer, Legal Profession
Management, Director, CEO
Mechanic
Military, Police, Civil, Defence, etc
News Reporter, Journalist
Other, Technician, Engineer
Others, Indoor
Others, Outdoor
Professional
Renovation, Contractor
Retiree
Sales, Marketing, Service, Surveyors, Valuers
Self, Employed, Own, Company
Service, Customer, Support, in, house
Student
Unemployed
Contact Us
Address
:
20A Smith Street
Singapore 058934
Phone
:
6225 4711
Fax
:
6225 4133
Email
:
aaplonline@A-Assurance.com
Please call us for enquiries only. We do not entertain call-in quote requests. Use the online quotation form instead
F.A.Q
view more
Who do I pay my car insurance premium to?
How will my road tax be renewed?
What is excess?
How will it affect my premiums?
Why should there be an excess?
What to do after a motor accident under MCF?
What is the premium difference without COE?
What are the factors affecting your premium?
view more
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