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Proposer

e.g Driver's License, National ID Card, International Passport (Max file size: 2MB)
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Contact address must contain House No. and street name (i.e 7, Kufo street)
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Area Name (i.e Victoria Island)
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Please state in full
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Risk Details

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If owned, state details of the vehicles below

1. Make of vehicle, Type of body, year of make, cubic capacity

Download sample template
A PDF document containing a list of beneficiaries to be covered (Max file size: 2MB)
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Declaration

It is declared that to the best of the knowledge and belief of the insured the statements and replies set out herein are true and that no material facts have been misstated or suppressed after enquiry. The insured undertake to inform insurers of alterations to any facts which are or thereby become material before inception of the contract of insurance. A material fact is one which would influence the acceptance or assessment of the risk.

 

I/We agree to accept a policy in the Company's usual form for this class of insurance

AXA Mansard is joining the rest of the world in being environmentally responsible. We invite you to join us in this cause by using only the electronic copy of your policy document which will be sent to your registered email address. You can also access it from your online account at www.axamansard.com or on MyAXA Plus App (available on Play Store or IOS Store).

Should you still want to receive a hard copy of your document in addition to the electronic copy, please place a request with your account officer or send an email to insure@axamansard.com. Your choice to decline making such request will serve to indicate that you do not agree to partner with us to preserve the environment.

By clicking Submit you agree have agreed to the terms and condition stated above.

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