AIG Motor Insurance

Your Details

- Name Title* Forenames* Surname* Please enter your title, firstname and surname.
- Date of Birth* Please enter your date of birth, E.G. 11/09/1960.
- Gender*
  
  Female Male
  
  This will not affect the pricing of your policy
- Licence Type* Please tell us the licence type on your Driving Licence?
- Licence Country of Issue Please select the country where your driving license was issued.
- How long have you held this licence?* Please tell us the number of years that you have held your licence.
- Employment status* Please tell us your current employment status?
- Occupation. (Type the first two letters of your occupation and select from the list) Don't worry if your precise Job Title isn't listed. Simply select the occupation that most closely resembles your job.
- No. of Years driving on the left hand side of the road* Please choose the number of years driving on the left hand side of the road
- - County* Please select a County from the drop down list.
- - Area* Please select a city/town from the Area drop down list.
- - Address line 1* What is the number or name of your house. Insert in this field (i.e. No: 15 Main Street, should be inserted as 15 Main Street)
- - Address Line 2 The second line of your address
- Email address* Please tell us your e-mail address so we can e-mail you your quote and for policy administration purposes.
- Contact Telephone number* Please tell us your preferred mobile or phone number e.g. 087 123 4567 or 01 123 4567.
  
  This is so we can contact you about your quote/ policy OR if we need to update you on any policy changes.
- Medical Condition Details Please select a medical condition from the list options
- Do you have any penalty points?* YesNo If you need to check how many penalty points are on your driving licence, you can contact the Road Safety Authority on 1890 41 61 41, quoting your driving licence number.
- List and describe all Penalty Points which currently apply to this driver.
  Date* The date on which the Penalty Points were received
  Offence* Please select the penalty points offence from the drop down list .
  Number of Points* Please enter the number of points.
- How many cars are in your household?* Please tell us the number of cars in your Household?

Additional Drivers

List the main driver and any additional named drivers
- Name Title* Forenames* Surname* Please enter the title, firstname and surname of this driver.
- Date of Birth* Please enter a date of birth for this driver, E.G. 11/09/1960.
- Gender*
  
  Female Male
  
  Please choose the Gender of this driver.
- Employment status* What is the current employment status of this driver, please choose from the list?
- Occupation Start by typing the job title of the driver into the Occupation field and select from the choices listed.
- Licence Type* What type of licence does this driver currently hold?
- Licence Country of Issue The country from where this driver's driving licence was issued.
- No. of Years Licence Held* Please choose the number of years that the driver has held their current Licence.
- No. of Years driving on the left hand side of the road.* Please choose the number of years driving on the left hand side of the road.
- Medical Condition Details Please select a medical condition from the list options
- Penalty Points* YesNo Does this driver have any Penalty Points?
  If you need to check how many penalty points are on your driving licence, you can contact the Road Safety Authority on 1890 41 61 41, quoting your driving licence number.
- List and describe all Penalty Points which currently apply to youor any person who will drive.
  
  Date* The date on which the Penalty Points were received
  
  Offence* Please select the penalty points offence from the drop down list .
  
  Number of Points* Please enter the number of points.
- Relationship to Proposer* What is the relationship to the Proposer of the policy? Please select from the drop down list.

No Claims Details

Your current NCD* To get a discount on your car insurance, please let us know how many years no claims discount you are presently entitled to on your car policy. Please select a number from the menu. Proof of No Claims Discount will be required within 7 days. If your NCD was earned outside the Republic of Ireland, please call us.

Claim Free Driving Experience* Do you have any claim free driving experience?

Who is your current insurer? Who is your current Insurer?

Car Details

Establish details of your Vehicle.
- Please input your Vehicle Reg and click 'Find Car'* We need your registration so that we can find your exact car and give you our most accurate quote.
Is this your car ?
- Is there a registration match This is a hidden field not displayed on screen

Select the Details of your Vehicle Manually Enter the details of your Vehicle and choose a Model from the list of models displayed.

Make What is the make of your vehicle?

Model Name Choose the Vehicle Model from the list

Year of Manufacture When was your vehicle Manufactured

Fuel Type Is your vehicle a Petrol, Diesel or Electric model? Please select from drop down list.

Transmission Is your vehicle Manual or Automatic?

No. of Doors Hatchbacks or Estates have either 3 or 5 doors, Saloons and other vehicles normally have either 2 or 4 doors

Vehicle Body Type Is the body shape of your vehicle a saloon, hatchback, estate etc. Please choose from the list.

Engine size What is the engine size/cc of your vehicle?

Vehicle Value* Please try and get the value of your car as close as possible to the market value. In the event of a claim we will cover the replacement or market value of your car, which may not equal the value you enter here.

Annual Mileage/Kilometres* How many miles/kilometres do you drive per year. Please choose from the list where KM represents Kilometres and mi represents the equivalent value in miles

Cover Details

When should your policy start?* From what date do you wish this insurance to start? (DD/MM/YYYY)

What type of cover would you prefer?*

Comprehensive Third Party, Fire And Theft

Comprehensive - covers you for accidental damage, fire damage, theft of your car and claims made by third parties.

Third party fire and theft - covers you for fire damage and theft of your car and claims made by third parties.

What do you use the car for?* Social Domestic and Pleasure
Social Domestic and Pleasure purposes including commuting between your home & your permanent place of business (providing that business calls are not made on the journey), excluding the carriage of goods and samples and/or commercial travelling, hiring, racing, pace making, speed testing or any purpose in connection with the motor trade.
Class 1, Business use
Social Domestic and Pleasure purposes including commuting between your home & your permanent place of business and use by the policyholder in person in connection with his/her business or profession, excluding the carriage of goods and samples and/or commercial travelling, hiring, racing, pace making, speed testing or any purpose in connection with the motor trade.
Class 2, Business use
Social Domestic and Pleasure purposes including commuting between your home & your permanent place of business and use in connection with the policyholder�s business or profession, including the carriage of goods but excluding commercial travelling, hiring, racing, pace making, speed testing or any purpose in connection with the motor trade.
Please note that where an �Indemnity to Employer� is required, you will need to contact us.

Other Information

Is there any Additional Material Information that you wish to bring to our attention?* YesNo Is there any additional information you wish to bring to our attention regarding the risk being proposed that might be considered material by the insurer? Failure to disclose a material fact may result in; your policy being cancelled; a claim under your policy not being paid; difficulty in obtaining insurance elsewhere, and in the case of property insurance breach of the conditions of any loan secured on the property.

Do you currently have a household policy? YesNo Do you currently have a household policy?

Promotional Code Offer? Please enter any applicable promotional code to avail of special discounts. If you do not have a promotional code, please leave blank

How did you hear about us?

Your quote and cover are based on a number of Assumptions and we may offer you a telematics quotation.
Please Confirm You Have Read And ACCEPT the
Assumptions, Terms of Business and Privacy Statement before proceeding: *

Assumptions

Terms and Conditions

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Terms of Business

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Privacy Statement

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Data Protection - From time to time AIG or its agents and business partners may want to keep you informed about special offers, discounts, products and services that may be of interest to you by post, telephone, email and SMS. If you do not wish your information to be used for these purposes please tick here

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	Exact Model	Body Type	Capacity	Doors

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Your Details

Additional Drivers

No Claims Details

Car Details

Is this your car ?

Cover Details

Other Information