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Insured's Details

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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), Area, LGA and state
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Kindly state in full
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Particulars of Principals

Please attach resumes with the following details name, age and qualifications

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A PDF document or photo containing a list of resumes for employees (Max file size: 2MB)
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Please upload a copy of your company profile (Max file size: 2MB)
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Declaration

I/We declare the foregoing to be true and I/We hereby authorize AXA Mansard Insurance and /or their Legal representatives to deal with all matters arising from this accident at their discretion and if they deem it expedient to admit liability and/or negligence on the part of myself/our servant or Agents.

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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