Car Insurance Quote

Information needed

In accordance with the European directive on Insurance MiFID and the new European regulation GDPR we are required by Belgian and European legislation to register all pre-contractual actions, to document personal details and keep these available for review by the appointed authority FSMA. This means we are obliged to ask you to complete the below form completely and correctly before we can offer you a quote or personal advice.

Tarification assurance véhicule EN
  • Policy Holder
  • Main Driver
  • Vehicle
  • Insurance quote requested

Policy Holder

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