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Vehicle Insurance

Contact Information

Please provide your contact details so we can reach you for any follow-up or additional information needed.
First Name
Last Name
Company
Email
Phone Number (whatsApp)

Vehicle Details

Please provide detailed information about your vehicle. This will help us better understand your needs and tailor the insurance coverage to your specific situation.
Vehicle brand and model ?
What is the function of this vehicle ?
STNK of the vehicle
Pictures of the vehicle's sides
Please provide clear and high-quality pictures of both sides of the vehicle. Ensure the entire side of the vehicle is visible in each photo

Front

Back

Left

Right

Chassis

The chassis number is a long number that is crucial for identifying your vehicle. For cars, it is usually located on the front part near the engine. For motorbikes, it is typically found under the seat.

Machine

The machine number is a short number that is crucial for identifying your vehicle. For cars, it is usually located on the front part near the engine. For motorbikes, it is typically found under the vehicle near the back wheel.

Owner's identity
Please provide the vehicle owner's identity. Passeport, KTP or NPWP.
Current market value of the vehicle
This should be an accurate estimate based on recent market trends, vehicle condition, and comparable sales in IDR

Insurance History

In this section, please provide details about the insurance history of your vehicle.
Do you currently have active insurance coverage on this vehicle?

Has the vehicle had any insurance claims in the past five years?