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BVBA E. Laureys
Home
Menu
Our Team
Our vision
Insurance
Insurance
Private individuals
Self-employed & SMEs
Associations
Offer
Private individuals
Self-employed & SMEs
Calculate your price
Extra
Useful links
Digital
Available Apps
Stappenplannen
Damage
Information
Documents
Report damage
Contact
News
Language
Nederlands
English
Français
Quotation Car
Step
1
of
10
10%
Policyholder
Name
*
First
Last
Address
*
Street Address
City
ZIP / Postal Code
Email
*
Telephone
*
Your contract type
*
First contract (in own name)
Replacement vehicle (in existing contract of KBC)
Acquisition contract (other company)
Additional vehicle
Which policies have you already with KBC?
Fire (> 180 € / year)
Family insurance
Accident insurance
Vehicle specifications
Type of vehicle
*
Passenger car
Light truck
Brand
Type
Capacity of engine (CC)
Power (KW)
Fuel
*
Gasoline
Diesel
LPG
CNG
Electrical
Hydrogen
Date 1st commissioning
DD slash MM slash YYYY
License plate
Chassis number
Use of vehicle
< 10.000 km/year
Pulls trailer (> 750 kg)
Daily traffic
Professional use
Leasing/Renting-contract
Drivers
Frequent drivers
(each name + date of birth + date of license)
Ensuring safeguards
Civil liability
Judicial assistance
Full omnium
Partial omnium
Assistance (VAB, replacement vehicle,...)
Accident insurance (driver)
In case to ensure Full Omnium
Invoice price
(incl. VAT) without reducing of a possible takeover price!
Invoice date
DD slash MM slash YYYY
Exemption
€250
€500
€750
€1000
€1250
Exemption theft
€0
€250
€500
€750
€1000
€1250
VAT recovery
0%
50%
100%
(for self-employed)
In case you currently have no car insurance at our office
Frequent driver?
Yes
No
With which company?
How many years have you been insured as a frequent driver?
Number of accidents in error?
(last five years)
Number of accidents in right?
(last five years)
Current Bonus Malus?
Extra
Other remarks
Comments
This field is for validation purposes and should be left unchanged.
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