Protect yourself and your dream car on the road with AAS – Insurance Agency and get $100 off and up to 10% discount on your motor insurance premium! What's more, insure now and receive a 1-year free AA Ordinary Membership (worth S$112.35)!

+ FREE S$10,000 Group Term Life (GTL) Insurance Offer
Personal Particulars
Title * :
Title others * :
Surname * :
Name * :
Gender * :
ID Type * :
ID others* :
NRIC / Passport No * :
Nationality * :
Nationality others * :
Date of Birth * :
Occupation * :
Work Enviroment * :
Marital Status * :
Mobile * :
Email Address * :
Address
House No. / Blk * :
Building Name :
Street Name * :
Floor Level :
Unit No :
Postal Code * :
Country * :
Driver Details
Driving License Date * :
NCD Entitlement Upon Renewal * :
Claim Experience (Past 3 years) * :
Total Claim Amount (Past 3 Years) * :
Please enter the accident details * :
Are you the main driver? * :
Is there an additional driver? * :
Is there an additional driver 2? * :
Main Driver Details

Title *
Title others* :
Name * :
NRIC / Passport No * :
Date of Birth * :
Driving License Date * :
Occupation * :
Work Enviroment * :
Marital Status * :
Driving Experience:
Relationship to Applicant * :
Claim Experience (Past 3 years) * :
Total Claim Amount (Past 3 Years) * :
Please enter the accident details * :
Additional Driver Details

Title *
Title others* :
Name * :
NRIC / Passport No * :
Date of Birth * :
Driving License Date * :
Occupation * :
Work Enviroment * :
Marital Status * :
Driving Experience:
Relationship to Applicant * :
Claim Experience (Past 3 years) * :
Total Claim Amount (Past 3 Years) * :
Please enter the accident details * :
Additional Driver 2 Details

Title *
Title others* :
Name * :
NRIC / Passport No * :
Date of Birth * :
Driving License Date * :
Occupation * :
Work Enviroment * :
Marital Status * :
Driving Experience:
Relationship to Applicant * :
Claim Experience (Past 3 years) * :
Total Claim Amount (Past 3 Years) * :
Please enter the accident details * :
Car Details
About Your Car * :
Vehicle Type :
Car Model * :
Modifications * :
Modifications Details*:
Car Registration Number * :
Year of Registration*:
Year of Manufacture*:
Type of Coverage * :
Current Insurance Company * :
Insurance Company others * :
Current Insurance Expiry Date * :
Desired New Insurance Start Date * :
Promotion Code
If you are responding to one of our promotions, please enter the promotion code.


Important notice

Statement pursuant to section 25(5) of the Insurance Act (Cap. 142) -You are to disclose fully and faithfully all the facts which you know or ought to know, otherwise the policy issued hereunder may be void.

FREE Group S$10,000 Term Life (GTL) Insurance Offer
Enjoy FREE Group Term Life (GTL) Insurance coverage with every Motor Insurance Policy purchased for limited time only!
Please click here to find out more. Terms & Conditions Apply.

I wish to sign up for FREE Group Term Life (GTL) Insurance with my Motor Insurance policy.

I consent to and authorize AAS-IA to release my Personal Particulars and Address to the underwriters, Tokio Marine Life Insurance Singapore Ltd (TMLS) for purposes of administering and contacting me with regards to this FREE Group Term Life (GTL) Insurance offer.

I DO NOT wish to sign up for FREE Group Term Life (GTL) Insurance with my Motor Insurance policy. Please DO NOT contact me on the FREE Group Term Life (GTL) Insurance.