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Megalines Insurance And Risk Advisers

Over 3,000 Australian Businesses entrust us to look after their Insurances. That is all we do. In 13 + years, that trust continues to grow.

Motor Vehicle Quote

Step 1 of 5 - Personal information

20%

Hi, let's get some details for your vehicle quote.
Contact Name*
First Last
Email*
Phone No*

Tell us about Driver details.
Name of Registered Owner*

Tell us about Vehicle details.
Vehicle Year/Make/Model*
Accessories
Modifications
Transmission*
Type of Cover Requested*
- Comprehensive (Unlimited kms)
- Comprehensive ‘Limited Kilometres’ (Limited to 5,001-8,000 kms per year)
- Comprehensive ‘Low Kilometres’ (Limited to 0 – 5,000 kms per year)
Agreed Value*
If Purchased in Last 12 months
Purchase Price
Purchase Date
DD slash MM slash YYYY
No Claim Bonus or Rating No*

Tell us more details about your vehicle.
Use of Vehicle*
Occupation*
Finance*
- Yes
- No
Financier*
Address where vehicle is left overnight*
Street Address
Parked overnight in*
If Other*
Security Device Fitted?*
- Yes
- No
If yes, details of immobiliser or tracking system*
Drivers Details*
First Name Last Name % of Use Date of Birth (dd/mm/yyy)

Please ensure % of Use totals to 100% across all drivers.

1. Drivers less than 25 years of age not acceptable (30 in some cases).
2. Approved drivers must be licensed in Australia or New Zealand (provisional licenses excluded).
In the LAST THREE (3) YEARS have any of the drivers had any accidents, vehicles stolen or burnt, or any other losses involving a vehicle where an insurance claim has been made?*
- Yes
- No
Please provide details*
Driver Name Description of Loss Date of Loss Cost of Loss
In the LAST THREE (3) YEARS have any of the drivers committed any traffic offences which have resulted in a conviction or for which a penalty has been imposed or points lost?*
- Yes
- No
Please provide details:*
Driver Name Description of Offence Date Penalty Imposed If Speeding, kms over limit
Thanks for your details, please confirm you are not a robot and we'll get onto your quote request straight away. We'll make contacts directly to you via email.
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