Motor Cycle Insurance- Insurancesave

INSURANCESAVE.CO.NZ

BEST RATES BEST COVER

GET A QUOTE NOW

AND SAVE ONLINE WITH

INSURANCESAVE.CO.NZ




Become an agent

HAVE YOU OR ANY PROPOSED RIDER OF THE MOTORCYCLE:

Been convicted for driving under the influence of drugs or alcohol?

Been convicted for negligent, dangerous or reckless driving?

Had their drivers licence suspended or cancelled for any other reason than above?

Had insurance declined or cancelled or had a claim refused for fraud?

Had any non-traffic criminal convictions?

The answer to all of the above questions is “Never, or over 5 years ago”

The answer to at least one of the questions is “Yes”

PERSONAL DETAILS

Title*

First Name*

Last Name*

Date of Birth*

Gender*

Male

Female

CONTACT DETAILS

Street*

Suburb*

Postcode

Town/City*

Mobile Phone Contact*

Land Line Phone Contact*

Contact Email*

VEHICLE DETAILS

Make*

Model*

Off Road Motorcycle*

Yes

Engine Capacity*

Year*

Registration*

Purchase Price*

Confirm the total value of non-standard accessories (i.e. Panniers, Windscreens, Driving Lights etc) *

Sum Insured Value*

Area of Garaging*

Does any party have a financial interest in this motorcycle?*

Yes

If so whom? (List person or finance company here)*

% Rider uses motorcycle*

% (i.e. 95%)

SECONDARY RIDER
("Named Drivers over 25 will reduce the Insurance Premium" )

Title

First Name

Last Name

Date of Birth

Gender

Male

Female

License Class

Country License Issued In

License Number

License Number Version

% Rider uses Motorcycle

% (i.e. 5%)

The number of accidents the
Rider has had in the last 5 years

The number of at fault
accidents the Rider has had
in the last 5 years

Terms & Conditions