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Receive free quotations...

All you have to do is complete the applicable sections for House, Car, Health and Travel and then click the 'Send' button at the bottom of the form.

Full Name
Street
District
Town
Region / County
Country
Postcode
Telephone
Mobile
Fax
Email
Construction Year
Enter Personal Details (required)
Household Insurance (optional)
Car Insurance (optional)
Rental Property
Unoccupied Days per annum:
Burglar Alarm
24 hour security
Steel reinforced doors
Window Bars
Property has shutters
Doorman
Other Security? (please specify):-
Valuations (please indicate currency)
Security / Protection
Date Insurance Required from:-
Re-build Value
Contents Value
Electrical Risk
Earthquake Cover NOT Required
Other Special Requirements:-
Year + Month Manufactured:-
Make
Model
Capacity CC
No. of Seats
No. of Doors
Garaged
Country of reg.
Vehicle Reg.No
Driver Details
Claim Free Years (NCB)
Marital Status
Cover Required
Value of Vehicle (please specify currency):-
Date of Birth
Driving Since Year
Date Insurance Required
Special Requirements:-
Fuel
Health Insurance (optional)
(required)
(required)
(required)
Cabriolet
Kms Driven p.a.
For Portugal, Spain and UK registered vehicles
Rural Property
Property Type:-
Travel Insurance (optional)
Policy Type
Area of Travel
Country of Residence
Insurance start date
No.of Days (if not all year)
Winter Sports Option
Enter no. of people travelling in the different age groups:-
Aged 17 or less
18 - 65 yrs
66 - 70 yrs
71 - 75 yrs
76 - 80 yrs
81 - 85 yrs
To increase this to max.100 days per trip, tick this box
Max. 50 days per trip.
Upto 65 years:-
Over 65 years:-
Max. 35 days per trip (cannot be extended).
Notes:
For maximum age 85 Years
Insurance accepted subject to health declaration
Location (town):-
(Please be aware that Portugal has
been seriously affected by earthquakes
in the past)
Tick this Box if you are interested in Health Insurance

 

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