“An Insurance Agent who assists an applicant to complete application or proposal form for insurance shall be deemed to have done so as the agent of the applicant – Section 54 (2) Insurance Act, 2003”.

    DETAILS OF PROPOSER



















    PLAN TYPE

    DETAILS OF VEHICLE








    Click here to fill vehicle fleet sheet
    DOCUMENTS/ INFORMATION TO BE SUBMITTED:










    INSURANCE/LOSS HISTORY













    DECLARATION:


    I/We, hereby declare that the above particulars and answers are true and complete in every respect and that no information has been
    suppressed or withheld.

    I concur that the details provided are true and permit that my details be added to the mailing list of Heirs Insurance.​

    Disclaimer:

    All premium payments are to be paid directly to Heirs Insurance Ltd UBA Account Number 1019317954. Please do not pay cash to any of our representatives as they are not authorised to receive cash.