Motor Insurance Private Enquiry

LTM Inspires & Consulting

Private Motor Vehicle

Mobile Number *

Email *

Name of Insured *

NRIC / FIN *

Date of Birth *

Gender *

Nationality *

Marital Status *

Occupation *

Nature of Business *

Driving Experience *

Claims Information

Claims Experience for Past 3 Years*

Vehicle Registration Number *

Type of Coverage *

Any Workshop or Authorised Workshop *

No Claim Discount (On Renewal) *

Reason *

NCD Protector*

Additional Named Driver*

Existing Insurer *

Renewal Premium Inclusive GST *

Vehicle Make / Model *

Year Of Manufacture *

Registration Date *

Vehicle Body Type *

Parallel Import *

Off Peak Car *

Yes
No

Cubic Capacity (cc) *

Period Of Insurance

From *

To *

Good Driver Discount (5%) *

Yes
No
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