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Car Insurance Application

Protect your ride for less than 1% of its value with reliable and affordable coverage.

As an expat living in Bali, it’s now possible and super easy to get insured.
Fill out the form below to get started and receive your personalized proposal!

Enjoy your ride with peace of mind!

Contact Information

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Car Details

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Is this car new?

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Is this car new?

A

Yes

B

No

License or Temporary Plat Number

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Engine Number /VIN (Vehicle Identification Number)

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Chassis Number /VIN (Vehicle Identification Number)

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Car's price

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Car Pictures

Front

Size limit: 10 MB

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Back

Size limit: 10 MB

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Left

Size limit: 10 MB

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Right

Size limit: 10 MB

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Who is the registered owner of the car (as listed in the BPKB)

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In Indonesia, the owner of a car is listed inside the "Buku Pemilik Kendaraan Bermotor" (BPKB), commonly known as the "Blue Book".

Who is the registered owner of the car (as listed in the BPKB)

A

Personal - Indonesian

B

Personal - Expat

C

Business (PT - Company Owned)

What is the purpose of your car?

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What is the purpose of your car?

A

Personal use (Used for private, non-commercial purposes)

B

Business use (Used for rental, delivery, taxi, or other commercial services)

C

Company use (Owned by a company and used by employees for work-related activities)

Do you have active insurance on this car?

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Do you have active insurance on this car?

A

yes

B

no

Any insurance claims on this car in the past 2 years?

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Any insurance claims on this car in the past 2 years?

A

yes

B

no