Welcome to Wehbe Insurance Services

Wehbe Insurance - Contact

Please fill out the form below to request a quotation.
(All fields marked with * must be completed)
Click here to Download this Proposal in PDF format.

General Info:

Insured Full Name:

Email Address:

P.O.Box:

City:

Office Number:

Fax Number:

Contact Number:

Best Time to Call:

Date of Birth (DD/MM/YYYY):

Nationality:

Profession:

U.A.E. Driving License No.:

U.A.E. Driving License Issuance Date:

1- Type of Cover:

2- Vehicle Details:

Make & Model:

Year of Manufacture:

Number of Passengers: (including driver)

Registration Number:

Colour:

Type of Body:

Number of Cylinders:

Number of Doors:

Chassis Number:

Engine Number:

Sum Insured in AED:

Finance:

3- Repair Condition:

Agency / Dealer Repairs will be provided for the first 2 years as of the New vehicle's first registration. (Additional Premium will be charged for agency / dealer repairs after 2nd year)

4- Additional Cover:

Personal Accident Cover required for:

Driver:

Yes No

Passengers:

Yes No

5- Claim History / No Claim Bonus:

Any Accident(s) during the last 5 years.
if yes, please provide full details of the claim(s) including approximate cost in the field below:

if NO, how many year(s) of NO Claim Bonus / Discount can you provide from current
insurer: year(s).

6- General Questions:

Is the main driver’s age under 25 years?	Yes No
Does any one else Drive Your Vehicle on a regular basis?	Yes No
Has any Insurer Declined, Cancelled or Imposed special conditions/ terms?	Yes No
Any Traffic Convictions in the past 3 years?	Yes No
Any Physical Disabilities?	Yes No
Will the vehicle be used for: Racing/ Rallies/ Speed Test/ Driving Tuition/ Rental/ Lease Hire/ Towing Purpose ?	Yes No

if Yes, please give details in the fields below:

If you wish to take a higher Voluntary Excess, to reduce your premium, then please indicate
the amount: AED (Minimum Excess is AED 250 depending on the vehicle)

Important Notice : DECLARATION BY THE INSURED (PLEASE READ CAREFULLY)

- In addition to any other details supplied to the Insurers I, the undersigned, also declare that all the details outlined in this proposal are an integral part of the proposed motor vehicle insurance policy and are true to the best of my knowledge and belief
- 10% additional deductible will apply for drivers below age 25.