Your car quote

Where did you hear about AXA Agence International?
What is the name of the relocation agency, estate agent, person who recommended us, or which exhibition
Car registration (i) If you don’t know the registration number, please put 31XXX31
Is the vehicle currently registered outside of France ?
For us to insure a foreign registered vehicle we require you to have at least one additional policy with us
Vehicle make (i) Your vehicle's make can be found in the D.1 section of your carte grise
Vehicle model (i) Your vehicle's model can be found in the D.3 section of your carte grise.
Please write the vehicle model type if it is not in the list above
Fuel type (i) The type of fuel can be found in the P.3 section of your car registration document
What is the specific version of your vehicle? i.e. comfort, sport
What is the CV of your vehicle? (horse power) (i) section P.6 on your car registration document
If you don’t know the CV of your vehicle please let us know the CC (cylinder capacity)
Date of manufacture (i) top right hand corner on a carte grise (Format DD/MM/YYYY)
If available, please complete the vehicle type mine/variant number if available (i) section D.2 on the registration document
Means of purchase
If you already own the vehicle, what is the date when your vehicle was registered in your name? (i) written next to the registration number on the bottom third of the carte grise, section 5 on a V5. Location will vary depending on the country of issue (Format DD/MM/YYYY)


First line of your address
Additional address details
Additional address details
Post code
Type of garage
Is it a
Are you the
Is the main driver named as the owner on the registration document (or lessee in the case of leasing) ?
Who is the vehicle registered to?
First name
Date of birth (Format DD/MM/YYYY)
Same as address where car is parked overnight?


First line of your address
Additional address details
Additional address details
Post Code
Mobile telephone number
Country Code
Email address
Marital Status
Job Title
Date you obtained your driving licence (Format DD/MM/YYYY)
Use of the vehicle
Post Code of place of work
Town/City of place of work
How many vehicles are there in the household? (i) Motor homes and classic vehicles should not be included in the number of household vehicles
How many people in the household have a driving licence? (i) These are people usually living under the same roof as the main driver, and their financially or fiscally dependent children.
Has anyone included in this figure held their full driving licence for less than 36 months?
Yes No
Would you like to add your partner as a named driver?
Surname partner
Firstname partner
Date of birth (Format DD/MM/YYYY)
Date they obtained their driving licence (Format DD/MM/YYYY)
Are they insured on a vehicle in their own name?
Yes No
How many months of the last 24 has the main driver been insured
Is the vehicle
How long have you owned your current or previous vehicle?
Has your current policy ended?
What date did the policy end? (Format DD/MM/YYYY)
Will the current policy continue?
Please indicate the end-date of your policy, meaning the date on which you are not (or will no longer be) insured with your current insurer (Format DD/MM/YYYY)
Will you drive more or less than 8 000 km per year?
Number of declared claim(s) in the last 36 months (i) include all claims, at fault or not, including windscreen repair/replacement
Date of claim 1
Type of claim 1
Date of claim 2
Type of claim 2
Date of claim 3
Type of claim 3
Name of your current or previous insurer
If applicable, what is your current French bonus (please only answer if you have a current or recent French insurance policy)
How many years no claims bonus can you prove? - If you have proof of driving experience and history of insurance from outside France, please include this as we can take this into consideration

In the last 3 years

Have you had your licence cancelled or suspended for more than 45 days?
Yes No
Had insurance refused or cancelled?
Yes No
Have you been convicted or fined for fleeing the scene of an accident?
Yes No
Within the last 5 years have you been convicted or fined for driving while intoxicated or under the influence of drugs?
Yes No
When would you like your insurance policy to begin? (Format DD/MM/YYYY)
Level of cover required
Breakdown assistance 24/7 in under 1 hour
Yes No
Replacement hire car
Yes No
Excess/deductible for windscreen, window and headlight repair and replacement reduced to 0€
Yes No
Driver safety extended to €450,000.
Yes No
How would you like to pay?
Driver Licence
Proof of no claims
Carte Grise

* Required fields