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  • About
  • POSP
  • Support
  • Login
  • 1

    Basic Detail

  • 2

    Quotation

  • 3

    CKYC Detail

  • 4

    Proposer Detail

  • 5

    Preview & Payment

Previous Policy Zero Dep


For Selected Add-on Does the previous policy have nil dep?


PA cover is mandatory. you can opt out If the following one you do not have


1. The owner does not have driving license or
2. Owner already has PA cover of atleast 15 lacs.


Confirmation(Previous Policy Addons)


Does the previous policy have nil dep?


Confirmation(Previous Policy Addons)


Does the previous policy have ?


1 Basic Detail

Policy required
Proposer required
Policy Cover required

Vehicle Details

Select Vehicle Type Please Select Vehicle Type.
Select Manufacturer Please Select Manufacture.
Select Model Please Select Model.
Select Fuel Type Please Select Fuel.
Select Variant Please Select Variant.
Vehicle Invoice Date required
Registration Number required Please enter valid Registration Number
Please Select Permit Type.
Please Select Manufacturing Built Type.
Gross Vehicle Weight required

Add-ons

Additional Covers

No. Of Driver is required Min No. Of Driver is 1
No. Of Cleaners is required Min No. Of Cleaners is 1
No. Of Employees is required Min No. Of Employees is 1
No. Of Unnamed Passenger is required Min No. Of Unnamed Passenger is 1
Un. Paid Driver PA Cover is required Min No. Of Un. Paid Driver PA is 1
Un. Passenger PA Cover is required
No. Of Unnamed PA Passenger is required
Un. Cleaner PA Cover is required
Un. Conductor PA Cover is required
Select as least one country
CNG Value is required
Electrical Accessories is required
Non Electrical Accessories is required
TPPD required

Default alt text Previous Policy Detail

Policy Expired required
Select Expired Type
Claim in previous year required
Select Previous NCB
Previous Policy Expiry Date is required

2 Your Insurance Quotation Change Basic Detail

Best Plans For Your 5 Plans Found For Your
Quotation number :

No Result Found.

Third Party Cover
IDV
NCB
List of Garages
Zero Dep 210
more
No Add-Ons selected
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Premium Breakup

View Details

  • Downloads
  • Brochure
  • Claim Form
  • Policy Wording

No Plans Found.

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3 CKYC Detail Back to Quotation

CKYC Type One required
image
Document No. required Please enter valid Document No.
image
CKYC Type One required
Document No. required Please enter valid Document No.
Document Type required
Document No. required Please enter valid Document No.
image
First Name required Please enter valid First Name
Last Name required Please enter valid Last Name
Date of Birth is required Please enter valid Date of Birth
Date of Corporation is required Please enter valid Date of Corporation
image
POA Type required
POA Document No. required Please enter valid POA Document No.
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image
image
POI Type required
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POA Type required
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4 Proposer Details Back to CKYC

Own Damage Period :
To
Liability Period :
Policy Tenure : 1 Year 5 Year
Model Variant :
Reg. No. :
NCB : %
year of purchase :
Premium :
Value (IDV) :
CPA cover unselected required
Previous Policy type required
Valid license is required
PA Cover Policy required
Previous Insurance Company required
Please enter CPA Previous policy No. Please enter valid CPA Policy No.
Please enter Sum Insured & Value should be minimum 15 Lakhs.
Please enter CPA Expiry Date
Salutation required
First Name required Please enter valid First Name
Last Name required Please enter valid Last Name
Gender is required
Date of Birth is required Please enter valid Date of Birth
Company Name required Please enter valid Company Name
Mobile No. is required Please enter valid Mobile No.
Email required Please enter valid Email

Proposer Communication Details

Address is required Please enter valid Address
Address Two is required Please enter valid Address
Select Marital Status
Note: State code of GSTIN should match with the communication state GSTIN required Please enter valid GSTIN
PAN No. required Please enter valid PAN No.
Please enter valid AADHAR No.

Nominee Details

Nominee Name required Please enter valid Full Nominee Name
Nominee Relation required
Marital Status is Single hence Nominee cannot be the selected option.
Nominee Age required Please enter valid Nominee Age
Nominee Gender required
Appointee Name required Please enter valid Appointee Name
Appointee Relation required
Marital Status is Single hence Nominee cannot be the selected option.
Appointee Date of Birth is required Please enter valid Date of Birth

Vehicle Details

Please keep registration certificate (RC) and expiring insurance policy document ready to fill this form.

RTO City Code required
Previous Insurance Company required
Previous Policy No. required Please enter valid Previous Policy No.
Previous Policy type required
Previous TP Insurance Company required
Previous TP Policy No. required Please enter valid Previous Policy No.

Previous Insurance has CNG/LPG Cover required
Chassis No. required Please enter valid Chassis No. with minimum 6 characters.
Engine No. required Please enter valid Engine No. with minimum 6 characters.
Vehicle usage type is required
Bank Name required
Account Number required
IFSC Code required IFSC Code Length should be 11
PUC required
Agreement Type required
Note: Please type slowly to view financiers and select from list. Financier required Please enter valid Financier Name.

5 Preview & Payment Change Proposal Detail

Proposer Details

Company Name
Proposer Name
Date of Birth
Mobile No.
Email Id
State
City
Contact Address
Pincode
Nominee Name
Nominee Relationship
Nominee Age
Nominee Gender
GSTN
PANNo
Appointee Name
Appointee Relationship

Vehicle Details

Registration No.
Chassis No.
Engine No.
Model & Variant
Date of Registration
Previous Insurance Company
Previous Policy No.
Previous TP Insurance Company
Previous TP Policy No.
Agreement Type
Finanancer
Finanancer City
Please select Terms & Conditions
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Email Quote PDF
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Connect With Us

Email: contactus@upsurebrokers.com Call: +91 90452 83235

Address: B-11, 2nd Floor, Sector 4, Noida UP - 201301

Upsure Insurance Brokers Pvt. Ltd., IRDAI Broker code - IRDAI / DB 958 / 2022, Valid Till date - 25 / 06 / 2026, Licence Number-899, CIN No.: U67200UP2022PTC164788, Principal officer name: Ankush Jain,
Contact No.: 91+ 90452 83235, Email ID: ankush.jain@upsurebrokers.com

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