Online Sun Drive Insurance Proposal
The questions on this form and any other questions which we specifically ask, relate to facts considered material to underwriting the insurance. If you answer them fully and honestly you will be considered to have fulfilled your duty to disclose material facts. Failure to do so may invalidate your insurance. A copy of the completed proposal form will be supplied on request, but you should keep a record (including copies of letters) of all information supplied to us for the purposes of entering into this contract. A specimen policy is available on request.
The Proposer
Title
First Name
Last Name

Address at which Car is normally kept:
Correspondence Address (if different from above)

Type of residence
Home Telephone
Work Telephone
Email Address
Occupation
 
Your car(s)
  First Vehicle   Second Vehicle
Reg No.:
Reg No.:
Make:
Make:
Seating:
Seating:
Type of body:
Type of body:
Engine Cc:
Engine Cc:
Year:
Year:
Purchase Date:
Purchase Date:
Cost:
Cost:
Value Now:
Value Now:
Has the car been modified or converted in any way (eg: Car Radio & equipment in excess of standard)? Yes No
  If yes, give details:      
Do you own the car (for the purposes of this question buying the car under a bank loan signifies ownership): Yes No
  If no, give details:    
Do you or your spouse own or have regular use of another car: Yes No
  If yes, give details:    
Does a bank or Finance company have an interest in the car: Yes No
  If yes, give details:    
 
Drivers

Give details of yourself and all other persons who will drive the vehicle(s):NOTE: If you or the main user of the vehicle(s) is aged under 25 years, the policy will automatically be restricted to named persons only.
Title

First Name
Surname
Occupation
Date of Birth
Licence No
How Long Held?
Likely percentage of use of vehicle by this driver?
 
Have you or any of the persons who will drive:
Resided outside this country during the last three years: Yes No
  If yes, give details      
Suffered from Diabetes, Epilepsy, Heart condition or any other physical or mental disability, infirmity or disease: Yes No
  If yes, give details:      
Ever had any motor insurance declined or cancelled or special terms imposed: Yes No
  If yes, give details:      
Been convicted during the past 5 years of an offence in connection with a motor vehicle, or are any prosecutions pending: Yes No
  If yes, give details:  
(include driver's name, date and nature of offence)		    
Had a driving licence suspended at any time: Yes No
  If yes, give details:      
Had during the past 4 years, any accident, loss or claim in connection with any motor vehicle: Yes No
  If yes, give details:  
(Include drivers name, date and circumstances)		    
Are you now, or have you been insured in respect of any motor vehicle: Yes No
  If yes, state current or previous Insurer      
 
If entitled to a No Claim Bonus from previous insurers, please state number of years entitlement:  
 
Your Insurance Requirements
Type of cover required: Comprehensive Third Party, Fire & Theft Third Party Only
Sun Drive Comprehensive includes EC$3000 windscreen breakage, Hurricane, Flood, Earthquake, Volcanic eruption and Riot & Strike
Additional cover Tick purposes for which car will be used
  Personal Accident Temporary Replacement Car
  Commercial travelling Windscreen Limit EC$5000
  Business, by you alone Your, or your employer's business by others
  Social, domestic & pleasure
Racing, competition, trials, rallies or the carriage of passengers for hire or reward are excluded in all cases
If the quotation is acceptable, when is the insurance to commence:
Quotations are available for the following, Please indicate which you require:
  Yourself only driving Three Named persons driving
  Two Named persons driving Any person aged 25yrs or more driving with your permission
Note: No insurance is in force until a temporary cover note or Certificate of Motor Insurance has been delivered to the proposer.
 
 
Declaration
I declare that to the best of my knowledge and belief the statements made by me or on my behalf on this form are true and complete, and I have not withheld any information material to this proposal. I accept full responsibility for statements made on my behalf. I undertake that the car to be insured is in a roadworthy condition and will not be driven by any person who, to my knowledge, has been refused motor vehicle insurance or continuance thereof. I agree that this proposal and declaration shall be incorporated in the contract between me and the insurers and I agree to be bound by the terms of the policy - Tick this box to affirm the declaration
   
"SunDrive" Private Vehicle Insurance:
Cover Provided
i. Comprehensive Cover:
 
  • Loss of or damage to the Insured Vehicle and it's accessories and spare parts whilst thereon caused by accidental means. Accidental means also include catastrophe perils.
  • Legal liability to Third Parties ii. Third Party Fire and Theft: - Loss of or damage to the Insured Vehicle and it's accessories and spare parts whilst thereon caused by fire, theft or attempted theft.
  • The cost of replacing locks and keys for the insured vehicle following the loss by theft of the keys to the insured vehicle.
  • Legal liability to Third Parties
iii Third Party
  Legal liability to Third Parties In accordance with the insurance provided as specified in the effective schedule in respect of occurrences in the geographical area during the period of insurance Exclusions
 
  1. We will not be required to contribute towards any claim arising while the Insured vehicle is in the custody of a member of the motor trade for the purposes of overhaul, upkeep or repair.
  2. Any act of War or Terrorism
  3. Information Technology
  4. Airside