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Home
About Us
Partners
Products
Health Insurance
General Need
Visa Need
Property and Liability Insurance
Travel Insurance
Motor Insurance
Contact US
Get a Quote
Home
About Us
Partners
Products
Health Insurance
General Need
Visa Need
Property and Liability Insurance
Travel Insurance
Motor Insurance
Contact US
Get a Quote
Online Quotation Form
BSI Insurance Broker Limited
>
Online Quotation Form
Obtaining the best insurance for expats in Thailand starts right here
We’ve tried to make this inquiry form as user-friendly as possible, however,
if you prefer you can simply give us a call or drop us an email with your insurance requirements.
If you are a human and are seeing this field, please leave it blank.
Fields marked with an
*
are required
Name
*
Email address
*
Contact Number (Optional)
Insurance Type
Health Insurance
Motor Insurance
Home and Contents Insurance
Travel Insurance
Business Insurance
Personal Accident
Desired Commencement Date for Cover
Type of Cover Required
In-Patient (Hospital)
Outpatient
Dental
Optical
Maternity
Unsure - please provide options
Level of Cover Desired
Basic
Premium
International
Unsure - please provide options
Current insurer if applicable
Deductible/excess desired
Nil
Less than US$500 or equivalent in local currency
Up to US$1500 or equivalent in local currency
US$3000 or more or equivalent in local currency
Unsure - please provide options
How many people require cover?
Just me
2 people in family
3 people in family
4 people in family
5 people in family
6 or more people in family
Group of employees
1st Person Name
1st Person Nationality
1st Person Date of Birth
2nd Person Name
2nd Person Nationality
2nd Person Date of Birth
3rd Person name
3rd Person Nationality
3rd Person Date of Birth
4th Person Name
4th Person nationality
4th Person Date of Birth
5th Person Name
5th Person Nationality
5th Person Date of Birth
Additional people or Employee groups
Type of Vehicle
Private car/SUV
Business vehicle
Motorcycle
Level of Cover:
1st Class
2nd Class
3rd Class
Make:
Model:
Year:
Engine Size:
Value (Baht):
Current insurer (if any):
Current Policy Expiry Date:
Owner/Primary Driver Date of Birth
Cover required
Building structure
Home contents
Personal items outside home property
Address of insured property:
Number of floors:
Wall Construction:
Concrete
brick
brick/wood
wood
Roof:
Tile
Concrete
Roof Beams:
Concrete
Steel
Wood
Value – Buildings:
Value – Contents:
Value - Personal Items Outside Property
Current insurer (if any):
Current Policy Expiry Date:
Type of Policy:
Individual
Family
Group
Duration
Annual multi trip
Specified duration - single trip
Number of People:
Medical Insurance Required:
500,000 min
1,000,000 min
2,000,000 min
3,000,000 min
Duration:
Annual
Short Term
Date of departue
Date of return
Number of Days - count day of departure and day of return
Destinations
Is cover required for active or dangerous sports/activities?
Pre-existing health conditions
Type of Cover Required
Building/structure
Plant and machinery, equipment etc
Trading stock
Loss of Profits
Goods in transit
Vehicle(s)
Liability and indemnity cover
Employee health, travel, life
Other
Type of business:
Address:
Desired risk commencement date:
Additional information
Amount:
Date of Birth:
Occupation:
Current insurer (if any):
Current Policy Expiry Date:
+662-634-5200
bsi@bsibroker.co.th