Vehicle insurance

The fields with asterix (*) are obligatory.

Policyholder's name*

NIE-number*

Address in Spain*

Postal code and city*

Date of birth*

Citizenship*

Date of issue of 1. driving license and country of issue of your present licence*

Telephone number*

E-mail*

Details of the vehicle (make, model, e.g. Skoda Rapid Spaceback 1,2 TSI Ambiente DSG)*

Fuel*

Number of doors*

Year of manufacture*

Engine horsepower

Plate number*

Number of seats?*

Your current insurance company?*

Bonuses Spain / home country*

Required insurance coverage

Number of claims under the last 5 years*

Vehicle owner's name, address and NIE number, if different than the policyholder

Bank account number (IBAN) for direct debits

Please note! Our insurance include car windows, 24h road assistance, replacement car and accident insurance for passengers and optionally for the driver.

Seguria 2018