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*
—Valitse vaihtoehto—GasolineDieselOther
Number of doors*
Year of manufacture*
Engine horsepower
Plate number*
Number of seats?*
Your current insurance company?*
Bonuses Spain / home country*
Required insurance coverage
—Valitse vaihtoehto—Third partyThird party,- fire- and theftComprehensive
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.
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Seguria S.L. 2024