New Client
 
Coverage starting on:
This is the day the policy becomes effective, policy will start on this date and end on the returning date you select
Policy starts at: :01 This will determine the time you enter and leave Mexico. You must enter Mexico after this time and return to Mexico before this time
Ending on / Duration:
 
If you do not know the exact dates you will be traveling to Mexico you can enter an approximate number of days, select a 6 month policy or 1 year policy.
Type of use: Policy usage (type of use for this policy, are you a Tourist traveling in Mexico, will you use this policy for business or are you a Resident)
For additional discounts choose appropiate territory?  What part of Mexico are you traveling to? (select the territory you will be traveling to. Daily policies cover all of Mexico.)
(Daily policies cover all of Mexico)   

Baja California Norte/Sur, Sinaloa, Sonora, Chihuahua

 
Vehicle type:
Will you be towing a trailer or towed unit?
Existing Vehicles: * Required
Year: * Required
Make: * Required
Model: * Required
Actual Cash Value: * Required

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Trailer Cash Value:
Number of towed units: Number of towed units (This are the motor units i.e. Car, watercraft, boat, Atv, dirt bike etc., that you will be towing)
Total towed units Cash Value: Total value of towed units. (enter the total dollar amount of all motor towed units)
Yes No
Is this a salvage vehicle? Vehicle info: Is vehicle salvage ( Enter the regular market value for you vehicle we will deduct 50% of the market value to insure)
Is the vehicle convertible?
Do you carry Theft & Collision coverage on your US or Canada Policy?
Do you want fixed deductibles? (Required by GMAC)
Are you a resident of California?
Are you under 21 years of age?
Are you retired in Mexico, or is your vehicle in Mexico more than 180 days per year?

Broker fee:  

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