Quote for Bike Insurance

Personal Details

First Name

Last Name

Company Name (optional)

Email Address

Consider using a personal email address as your work email address can change

Phone Number

A preferred number for us to call you on between the hours of 9am & 5pm

Date of Birth

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First Name

Last Name

Email

Phone

Do you already have an existing policy with CG?

YES

NO

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Quote for Bike Insurance

Riding Experience

How long have you been a licensed bike rider?

years

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First Name

Last Name

Email

Phone

Do you possess a valid motorbike license?

Yes, Learner

Yes, Full

NO

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First Name

Last Name

Email

Phone

Have you had any riding accidents, claims, or losses in the last 5 years?

Yes

NO

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First Name

Last Name

Email

Phone

Have you been convicted of any traffic offences in the last five years?

YES

NO

Do you have any current or past medical conditions that affect your ability to drive?

Yes

NO

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First Name

Last Name

Email

Phone

Quote for Bike Insurance

Bike Details

Estimated Value

How much the bike is worth now, rather than the cost when you purchased it.

$

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First Name

Last Name

Email

Phone

Make

Model

Year

Additional Information

Selected Cover

Price paid

$

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First Name

Last Name

Email

Phone

Is your bike subject to a loan?

YES

NO

Which bank provided you with the loan?

Date of Purchase

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First Name

Last Name

Email

Phone

Registration No.

The registration number is found on the number plate on the bike

Engine Capacity (optional)

The official documents for your bike will likely indicate the engine size.

cc

Has the bike been modified in any way?

Select 'Yes' if you have made any changes that affect the bike's performance or handling

YES

NO

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First Name

Last Name

Email

Phone

Desired Policy Start Date

Thank you!

We will email you our detailed quotation within the next few business days.

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Quote for Bike Insurance

Personal Details

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Quote for Bike Insurance

Riding Experience

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Quote for Bike Insurance

Bike Details

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Please, fill in the additional information to finish your policy application

Additional Information

Selected Cover

1. Personal Information

2. Riding Experience

3. Bike Details

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