Motor Policy

Basic Information

Customer Information

Business Channel

Source of Business

Customer

Insured Group

Sub Agent/RM

Relationship Officer/CRO

Insured Information

Insured Name

Mobile Number

E-mail Address

Vehicle Information

Vehicle Make

Vehicle Model

Body Type

Model Year

Value of Vehicle
Vehicle Value is required for Motor Corprehensive Insurance. Kindly ensure insured value falls within the average market value of the vehicle details entered. In case of any accident occurs during the policy period, insurance company will consider the market value of the vehicle. For Third party Policies Insured Value will be Zero (0).

Registered Vehicle Yes/No

Date of First Registration
Please enter Date of First Registration as per the Vehicle Registration card.
First Registration date cannot be more than one year prior to the Model year.

Vehicle Age

Vehicle Usage

No. of Cylinders

CampaignCode

PlanDetails

AdditionalDetails

Insured Information

Policy Start Date

Policy End Date

DOB

P.O.Box Number

Qatar ID Number

Nationality

Referral Code

Insured Address

Mortgage Bank / Financed By

Driver Information

Driver Name

Driving License No(Driver)

Driver Age

Vehicle Information

Vehicle Plate Type

Vehicle Plate Number

Chassis Number

No. of Seats (Incl. Driver)

Engine Number

Vehicle Color

Territory Limit

Previous Insurance Details

Sharq Previous Policy No

Policy Remarks

FileUpload

Mulkiya Front

Mulkiya Back

Qatar ID Front

Qatar ID - Back

Driving License Front

Driving License Back

Trading License

Motor Policy

Basic Information

PlanDetails

AdditionalDetails

Summary

Additional Documents

Premium Summary

Commission Summary

Information Summary