Get a Quote: Motorcycle Insurance

Broker Details
Broker ID*
Broker Email*
Your Details
Title*
First Name*
Middle Name(s)
Last Name*
Date of Birth*

Occupation*

Employer's Business*

Phone Number*

Email*

Postcode Lookup
Home Address*
Postcode*
Island*

Your License
Have you passed your CBT?*
- Yes
- No
Please advise the date of your CBT*
(cover will commence from this date)
Month and Year you obtained driving license*
License Type*
License Issuing Country*
Type of Policy*
- Rider - covers just you to ride motorcycles up to a selected engine size, including motorcycles not owned by you but subject to having the owner's permission.
- Specified Motorcycle - with more than one driver.
Please select the maximum engine size you require
Drivers
How many drivers do you want to cover?*
Drivers
Please provide details of any other drivers to be covered, click the button below to add further drivers.
Title First Name Middle Name(s) Last Name Date of Birth Occupation Employer's Business Month and Year they obtained driving license License Type
Edit
Delete
There are no Drivers.
Maximum number of drivers reached.
Who will be the main driver?*
Has any driver had any previous motor accidents or motor claims within the last 5 years in any motor vehicle?*
- Yes
- No
Claims
Please provide details of each claim, click the button below to add further claims.
Name Date of incident Type of incident Was this driver held to be at fault by their insurers? Was anyone injured or taken to hospital?
Edit
Delete
There are no Claims.
Maximum number of claims reached.

Full make and model of the vehicle*
e.g. Yamaha MT-09 TRACER or Honda PCX 125
Vehicle value*

Vehicle year of manufacture*

Engine Size (cc)*

How many vehicles are there in your household?*

Is this vehicle replacing an existing vehicle currently insured with us?
- Yes
- No
What is the registration number of the vehicle you are replacing?*
Current Insurer
Current Premium

Date of renewal or date cover required from*
Date Format: DD slash MM slash YYYY
Cover*
(tick each option you would like us to quote)
- Comprehensive
- Third Party Fire & Theft
- Third Party Only
Policy Excess*
Please select the excess required for comprehensive cover.
Please advise which use you require by ticking all the boxes which apply:*
- Social, Domestic & Pleasure (including commuting and voluntary use) by any named or authorised driver
- Business use by any named or authorised driver but not including commercial travelling
- Other
Other use*
(Please call the office so we can confirm what options are available)
General Questions
How many years No Claims Discount have you earnt?*
What prompted you to request a quote from Islands on this occasion?*
Do you currently hold any existing insurance through Islands Insurance?*
- Yes
- No
Please provide your existing policy number (if possible)

Your quote will be based on the following assumptions about you and any other persons who you have asked to be covered, please tick the box to confirm that you have read and all persons who will drive do satisfy these assumptions.
- You and any other persons who will drive have been resident in the Channel Islands or the UK for 2 years or more.
- You and any other persons who will drive have no motoring convictions/sanctions (except parking fines) or criminal convictions. We have assumed that all drivers are conviction free – this means that within the last 5 years they have not received any motoring or criminal convictions or parish hall sanctions.
- You and any other persons who will drive have not been charged with or warned of pending prosecutions for motoring or criminal offences or have any parish hall enquiries pending.
- You and any other persons who will drive are free from medical conditions or infirmities which could affect their ability to drive. Any medical conditions have been disclosed to the relevant local driver licencing authorities.
- The vehicle has not been modified from the manufacturer's standard specification for that model.
- You are the registered owner of the vehicle.
- The policy automatically covers trips to the UK of up to 30 days and the continent for 14 days. You will advise Islands Insurance if you need cover for trips longer than this and an additional charge may be payable.
- You and any other persons who will drive have never been declared bankrupt, had any court judgements made against them or made arrangements with creditors.
- You and any other persons who will drive have never been refused insurance, had a policy cancelled or renewal refused or had special terms or exclusions applied.
I have read and all persons who will drive do satisfy these assumptions*
- Yes
Please note that non-disclosure can render your policy invalid.
If you and any other persons who will drive do not meet all of the assumptions, it may still be possible to quote for you but you should provide more information in the box below or contact us either by telephone or in person instead.
Please provide any extra information in the box below
As a policy holder, we offer a range of other insurance services. Would you like to hear about these through our marketing emails?*
You can read our data protection policy, or change your preferences at any time here, or just give us a call.
- Yes
- No

Title	First Name	Middle Name(s)	Last Name	Date of Birth	Occupation	Employer's Business	Month and Year they obtained driving license	License Type
									Edit Delete
There are no Drivers.

Name	Date of incident	Type of incident	Was this driver held to be at fault by their insurers?	Was anyone injured or taken to hospital?
					Edit Delete
There are no Claims.

Get a Quote: Motorcycle Insurance

Broker Details

Your Details

Your License

Drivers

General Questions