Partner Quote - Cyclesure

Express Quote

Complete the information below and click on the calculate quote button to get an instant quote.

Dealership Name *

Make and Model *

Year Model *

Purchased Price *

ZAR

Invoice of the purchased cycle *

Please provide us with the purchase invoice.

Policy Holder

Please enter the policy holder information below so that we can contact the owner for further processing.

Prefix

First Name *

Middle Name

Last Name *

Email Address *

Phone Number *

Date of Purchase *

Previous Cancellation of Insurance *Has an insurer ever cancelled the insurance of the policy holder?

Reason for cancellation *Please note that this cover will first need to be referred to us before activation.

How many bicycle related claims have you had in the last 3 yearsHow many bicycle related claims have you had in the last 3 years? If more than 3, this quote first needs to be referred to us before cover can be enabled.

Contact Consent *I declare that the information in this application is, to the best of my knowledge and belief, true and accurate in every respect and that no fact, circumstance or hazard that could affect the acceptance of my application has been withheld. I confirm that this application and declaration shall be the basis of the contract between Cyclesure Insurance Consultants and myself.To proceed with this quotation request you have to accept our contact and data processing consent.

Contact and Data Disclaimer

In order to provide you with insurance, we have to process your personal information. We will share your personal information with other insurers, industry bodies, credit agencies and service providers. This includes information about your insurance, claims and premium payments. We do this to provide insurance services, prevent fraud, assess claims and conduct surveys. We will treat your personal information with caution and have put reasonable security measures in place to protect it.

Calculate Premium

Some preconditions for instant cover has not been met thus cover cannot be activated immediately. Instant cover can only be issued where:

No more than 3 claims in the last 3 years
Previous insurance has not been cancelled by Insurer
Bicycle model is not older than 5 years

Should the client wish to still get cover, please click the Submit button below and a Cyclesure team member will be in contact shortly with a revised premium.