Allcare Insurance Agency Ltd University Roundabout
Msida MSD 1751 Malta

Tel: (356) 21 330011
Fax: (356) 21 347947/8

 
 

RENEWALS FORM

Name of Insured *
Address  
Postcode  
E-Mail Address *
Tel. No. / Mobile No. *

Type of Policy to be Renewed

Motor
Home
Others

 
Policy Number to be Renewed *
Renewal Date  

If you have ticked ‘yes’ to the questions requesting changes to your policy cover we will contact you shortly with the revised premium based on the requested changes.

Changes in policy cover will not be carried out prior to having paid the respective additional premium due and a written confirmation from Allcare has been submitted.

Would you like to effect any changes to the present cover?

Yes
No
(If yes, please provide details)

Would you like to effect any changes to the present sum/s to be insured?
Yes
No
(If yes, please provide details)

Would you like to receive your renewal documentation? By Mail
By collecting them from our offices
Please let us have any comments you wish to make in the following space

APPLICABLE ONLY TO MOTOR RENEWALS

Would you like us to renew the road licence on your behalf?
Yes
No


Is your vehicle subject to VRT ?
Yes
No
(This information is stated on your road licence disc)

DATA PROTECTION

Insofar as the information that you provide us with in this form constitutes personal data for the purposes of the Data Protection Act 2001, Allcare Insurance Agency Limited will only process this information in the manner and for the purposes laid down in its Privacy Policy. By completing this form and clicking on the ‘Submit’ button below, you consent to Allcare Insurance Agency Limited processing this information in accordance with this Policy. Please view our Privacy Policy before submitting this form.

Please note that underwriters will not be on risk until a confirmation of renewal acceptance in writing is received from Allcare Insurance Agency Ltd.


Renewal Premium Due