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Quote Request – Bundle – Auto & Auto
Bundle Insurance Germany
Car & Car
Save 10% on your second car policy!
1
Personal Information
2
Vehicle Information
3
Coverage & Submit
1/3
Personal Information
I understand that this insurance is not intended for rental cars, nor for covering my (US) car for holidays / vacation in Germany.*
Your Active Policy Number
*
First Name
*
Last Name
*
Personal Email
*
Phone Number
*
Are you affiliated with NATO Forces?
*
Yes
No
Where will the vehicle be registered?
*
USAREUR
BFG
German registry
Are you married?
*
Yes
No
Date of Birth
*
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Vehicle Make
*
Vehicle Model
*
Year of Vehicle
*
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2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
VIN - Vehicle Identification Number
Horse Power
*
Actual Cash Value in USD
*
(max. value 95,000 USD)
Is there a lien on your vehicle?
*
Yes
No
Please specify the registered name on the lien:
Have you had any at-fault accidents in the last five years?
*
Yes
No
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Third Party Liability Insurance incl. Motor Assistance Coverage (mandatory)
*
Yes
Comprehensive Coverage (e.g. theft, broken windshield, natural hazard) Deductible 300 EUR
*
Yes
No
Collision Coverage (own damage) Deductible
500
300
EUR (Note: If you select to have Collision Coverage, you will also carry Comprehensive Coverage with a 300 EUR deductible)
*
Yes
No
Loyalty Repair Program?
*
Yes
No
Effective Date of Coverage
*
PCS Date / DEROS
I hereby consent to my data submitted in the contact form being collected and processed in order to answer my request.
Please note: You can withdraw your consent anytime via email to privacy@mirascon.com. Please see our privacy statement for detailed information about user data handling.
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