Spirit Financial Services Dublin | Insurance for your Car, House or Business

car insurance

Personal Details

Title*

Firstname*

Surname*

Address

Occupation

Phone :

Email Address*

Date of Birth*

Marital Status*

Living how long in Ireland/UK**

Have you a medical condition which needs to be notified to the Licencing Authority?*

Car details

Make and Model of car:

Engine Size:

Registration Number:

Value:

Comprehensive or TPF&T

Do you have an Alarm / Immobilser / Tracker

Where is the car kept :

Majority of driving area :

How many years of No Claims Bonus :

Have you been named on a policy before:

How long for:

Whose policy was it:

Is car imported?

Is car a left hand drive?

Licence Details

Licence type*

Country license was obtained?

Years licence Held*

Penalty Points*

Convictions*

Driving Record

Accident & Claims Free for 5years

Were you previously insured?*

Current Insurer

Country of Issue

No Claims Discount
This is the number of years claims free driving you have in your own name which is certifiable (in the form of a No Claims Bonus document) from your previous insurance company. This document is provided with your renewal pack from your current insurer. An original proof of No Claims Bonus must be supplied if you proceed with cover. The No Claim Bonus must have been earned within the last two years and earned in the Republic of Ireland, Northern Ireland or the UK. Please note that failure to provide evidence of the number of years quoted on, may result in a higher quotation or the underwriters being unable to offer cover at all.

Named Driver Experience
Named driving experience is gained when you are a named driver on someone else's insurance policy. Example: A daughter named on a mothers policy for 2 years, has 2 years named driving experience. A letter from the insurance company proving these years must be supplied if you proceed with cover. Named driving experience must be consecutive (i.e. no gaps in cover), and must be current (i.e. still active at least up until 30 days prior to inception of your new policy). In addition, named driving experience must be claim free, you may only count the number of full years driven without making a claim. Please note that failure to provide evidence of the number of years quoted on, may result in a higher quotation or the underwriters being unable to offer cover at all.

* I accept the Assumptions and Terms Of Business on which the quote and cover are based.

** ** Spirit Financial source all general policies to IRM (Insurance Risk Managers) who are regulated by the The Central Bank of Ireland.