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Home Protection Plan
Status
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Customer
Agent
Agent code
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Payment Mode
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Online
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Variant (Cover type)
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Bronze
Silver
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Amount Insured
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Amount Payable
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THE PROPOSER/APPLICANT
Surname
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Other Names
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Gender
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Male
Female
Phone Number
*
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Occupation
*
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Email Address
*
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DETAILS OF PROPERTY TO BE INSURED
Address of the property
*
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Type of Residence
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One Room
Self-Contained
2-3 Bedroom Flat
Duplex
How long have you lived in this premises
*
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Type of materials used in construction of the Wall
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Brick
Concrete Block
Steel Sheet
Aluminium Sheet
Type of materials used in construction of the Roof
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Zinc
Abestos
Slate/Tile
Concrete
Steel
Aluminium
What is the estimated value of the content in the apartment
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Enter your Policy Number
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