Car Insurance

Please fill in the form below for a competitive quotation from Hastings Insurance Brokers. We will revert to you with your quotation promptly.

About You

* Title

* First Name

* Surame

* Address:

* Date of Birth

* Occupation

* Email Address

* Phone

About Your Licence

* Licence Type

* Have you received Penaly Points in the last 5 years?

* Have you ever had any convictions or endorsements on your licence?

* Have you a medical condition which needs to be notified to the licencing authority?

* How many years No Claims Bonus do you have?

* Have you had any accidents or claims in the last 5 years?

About Your Named Drivers

About Your Car

* Make of Car

* Model of Car

* Engine cc

* Year of Manufacure

* Value of Car   €

Reg Number of Car (if known)

* Is the car Petrol or Diesel?

* Is the car used for business use?

Complete Submission

* I have read the Terms & Conditions
and Privacy Statement