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28 April 2024, Sunday
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Get a Quote Online
Online Casco (Motor Own Damage) Insurance Proposal Form
INFORMATION OF THE INSURED
Name / Title *
Turkish Identity Number / Tax Number *
Gender *
Select
Mr.
Mrs.
Date of Birth *
Occupation *
Phone *
E-Mail *
Address *
VEHICLE INFORMATION
Class *
Select
Private
Pick-up Truck
Mini-bus
Type of Usage *
Select
Private
Commercial
Official
Make *
Select
Alfa Romeo
Audi
BMC
BMW
Buick
Cadillac
Chevrolet
Chrysler
Citroen
Daewoo
Daihatsu
Dodge / USA
Ferrari
Fiat
Ford
Ford / Otosan
Honda
Isuzu
Lada
Lancia
Lincoln
Maserati
Mazda
Mercedes
Mercury
Mitsubishi
Nissan
Opel
Peugeot
Peugeot / Karsan
Pontiac
Porsche
Range Rover
Renault
Rolls-Royce / Bentley
Rover
Saab
Seat
Skoda
SSangYong
Subaru
Suziki
Tata
TofaÅŸ / Fiat
Toyota
Volkswogen
DiÄŸer
Model *
The value of Casco Insurance
Year of the Model *
Select
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
Value of the Vehicle *
TL
The value of Casco Insurance
License Plate Number *
COVERAGE INFORMATION
Voluntary Financial Responsibility (Ä°MM) *
Select
Option One: 25.000-75.000-25.000
Option Two: 30.000-90.000-30.000
Option Three: 50.000-150.000-50.000
Option Four: 50.000
Option Five: 100.000
Option Six: 2.500.000
TL
Personal Accident Coverage *
Select
Option One: 5.000-5.000
Option Two: 10.000-10.000
Option Three: 15.000-15.000
TL
Treatment Coverage *
Select
Yes
No
*
( Required fields to be filled )
Online Traffic Insurance Proposal Form
INFORMATION OF THE INSURED
Name / Title *
Turkish Identity Number / Tax Number *
Gender *
Select
Mr.
Mrs.
Date of Birth *
Occupation *
Phone *
E-Mail *
Address *
VEHICLE INFORMATION
Class *
Select
Private
Pick-up Truck
Mini-bus
Type of Usage *
Select
Private
Commercial
Official
Make *
Select
Alfa Romeo
Audi
BMC
BMW
Buick
Cadillac
Chevrolet
Chrysler
Citroen
Daewoo
Daihatsu
Dodge / USA
Ferrari
Fiat
Ford
Ford / Otosan
Honda
Isuzu
Lada
Lancia
Lincoln
Maserati
Mazda
Mercedes
Mercury
Mitsubishi
Nissan
Opel
Peugeot
Peugeot / Karsan
Pontiac
Porsche
Range Rover
Renault
Rolls-Royce / Bentley
Rover
Saab
Seat
Skoda
SSangYong
Subaru
Suziki
Tata
TofaÅŸ / Fiat
Toyota
Volkswogen
DiÄŸer
Model *
The value of Casco Insurance
Year of the Model *
Select
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
Value of the Vehicle *
TL
The value of Casco Insurance
License Plate Number *
Registration License Number *
*
( Fields required to be filled )
Online Homeowner (Residential) Insurance Proposal Form
INFORMATION OF THE INSURED
Name / Title *
Turkish Identity Number / Tax Number *
Phone *
E-Mail *
INFORMATION OF THE RESIDENCE
Type of Construction *
Select
Steel
Reinforces Concrete Frame Structures
Masonry Stone Structures
Other
Construction Type *
Select
Lux
1. Type
2. Type
Age of Property *
Select
0-15
Over 16
Type of Property *
Select
Apartment
Detached Building
Other
Owner/ Renter *
Select
Owner
Renter
Type of Usage *
Select
Permanent Residence
Summer House
Other
Cost of Building *
TL
Building (m2) *
Cost of Furniture *
TL
Cost of Glass *
TL
Electronic Equipment Insurance
TL
Valuables
TL
DASK *
Select
Yes
No
Open Address of the Property *
*
( Fields required to be filled )
Online WorkPlace Insurance Proposal Form
INFORMATION OF THE INSURED
Name / Title *
Turkish Identity Number / Tax Number *
Phone *
E-Mail *
INFORMATION OF THE WORKPLACE
Type of Business *
Building Layout *
Select
Apartment
Passage
Industrial Estate
Mall
Detached/Private Building
Depot
Other
Construction Year *
Owner / Renter *
Select
Owner
Renter
Office Space (m2) *
Cost of Building *
TL
Cost of Decoration *
TL
Cost of Machine *
TL
Inventory Stock *
TL
Cost of Goods *
TL
Cost of Glass *
TL
Workplace Security Measures
Open address of the Business *
*
( Fields required to be filled )
Online Health Insurance Proposal Form
INFORMATION OF THE INSURED
Name *
Turkish Identity Number *
Gender *
Select
Mr.
Mrs.
Size *
cm
Weight *
kg
Daily Cigarette Usage *
Select
Non smoker
Less than 20
Between 20 and 30
Over 30
Alcohol Consumption *
Select
Not Used
Used
Medications Taken Daily
Current and Past Health Conditions
Date of Birth *
Place of Residence *
Solicited Coverage *
Select
%100 Inpatient Treatment
%100 Inpatient Treatment plus + %80 Outpatient Treatment
%100 Inpatient Treatment plus + %100 Outpatient Treatment
Phone *
E-Mail *
Previous Health Insurance *
Select
Yes
No
Address *
*
( Fields required to be filled )
Online Travel Health Insurance Proposal Form
INFORMATION OF THE INSURED
Name *
Turkish Identity Number *
Phone *
E-Mail *
Date of Birth *
Gender *
Select
Mr.
Mrs.
Country to be visited *
Travel Departure Date *
Travel Return Date *
Address *
*
( Fields required to be filled )
Online DASK Proposal Form
INFORMATION OF THE INSURED
Name / Title *
Turkish Identification Number *
Phone *
E-Mail *
PROPERTY INFORMATION
Type of Construction *
Select
Steel
Reinforces Concrete Frame Structures
Masonry Stone Structures
Other
Age of Property *
Select
After 2000
1997 - 1999
1976 - 1996
Prior to 1975
Usage Type of the Property *
Select
Apartment
Detached Building
Other
Damage Condition of Property *
Select
Without Damage
Slightly Damaged
Moderately Damaged
Usage Type of the Property *
Select
Residential
Office
Business
Other
Gross Square Meter of Property M2 *
City Block, Map Section, Parcel
Full address of the Property *
*
( Fields required to be filled )
