Private Car - All Cars	* Indicates compulsory fields
New vehicle policy	Policy renewal of old vehicles
City where Car is Registered (RTO)* :		Loading...
Manufacturer Name* :	Select Manufacturer
Model* :	Select Model
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Vehicle CC * :	Select CC less than 1000 1000 to 1500 above 1500
Date of First Purchase / Registered (refer to your RC book)* :	(DD/MM/YYYY)
Name of the Current Insurer* :	Select Bajaj Allianz General Insurance Co. Ltd. ICICI Lombard General Insurance Co. Ltd. IFFCO Tokio General Insurance Co. Ltd. National Insurance Co.Ltd. The New India Assurance Co. Ltd. The Oriental Insurance Co. Ltd. Reliance General Insurance Co. Ltd. Royal Sundaram Alliance Insurance Co. Ltd. Tata AIG General Insurance Co. Ltd. United India Insurance Co. Ltd. Cholamandalam MS General Insurance Co. Ltd. HDFC/ERGO General Insurance Co. Ltd. Universal Sompo General Insurance Co. Ltd. Future Generali India Insurance Co. Ltd. Bharti AXA General Insurance Co. Ltd. Shriram General Insurance Co. Ltd.
Is the current policy in your name ?* :	Yes No
No Claims Bonus as per current policy* :	(Please look at your current policy for this information)
Have you filed any claim in Expiring Policy* :	Yes No
Current Policy expiry date* :	(DD/MM/YYYY)
Do you want to transfer your NCB from Old vehicle to New vehicle?* :	Yes No Tell me more about this...
Enter NCB value of old vehicle's insurance policy* :
Vehicle Owned By* :	Individual company
Does the owner have a valid drivers license ?* :	Yes No
Additional Covers
Value of Electrical / Electronics Accessories : Value of Non-Electrical Accessories : Is Fibre glass fuel tank fitted? : Yes No LPG/CNG Kit Cover Type : -- Select -- LPG CNG Value : Passenger Seating Capacity(as per RC) : -- Select -- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Passenger Sum Insured : -- Select -- 10000 20000 30000 40000 50000 60000 70000 80000 90000 100000 110000 120000 130000 140000 150000 160000 170000 180000 190000 200000 Legal liability cover for paid driver(Rs. 25/-) : Yes No
Discounts
ARAI approved anti-theft device installed? : Yes No Automobile association membership? : Yes No Enter Membership Id : Voluntary deductibles : -- Select -- 2500 5000 7500 15000 Is Vehicle altered for handicapped person? : Yes No