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MEMBERSHIP FORM
Member and car details and accident history
1. Member Details
Individual
Company
Choose files
Driving License Front
Choose files
Driving License Rear
2. How old is your Taxi DC
Select Year
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12 Years
13 Years
14 Years
15 Years
16 Years
17 Years
18 Years
19 Years
20 Years
21 Years
22 Years
23 Years
24 Years
25 Years
26 Years
27 Years
28 Years
29 Years
30 Years
31 Years
32 Years
33 Years
34 Years
35 Years
36 Years
37 Years
38 Years
39 Years
40 Years
41 Years
42 Years
43 Years
44 Years
45 Years
46 Years
47 Years
48 Years
49 Years
50 Years
3. Driver Type
Select
Owner driver only
Owner driver and random second casual driver
Owner driver and permanent second driver
4. Car Details
Add Five Images (Must)
Front
Rear
Driver side
Passenger side
Odometer
5. Previous Insurance
No
Yes
Club name
No of Accidents In Last 3 years
Select Number of Accidents
0
1
2
3
4
5
6
7
8
9
10
6. Membership Starting Details
7. Account Details
CLAIM EXCESS
1.Standard sedan non -luxury vehicle basic excess $1300
Standard basic excess owner (Above 25 years): (camry , ford , hyundai etc )
$1,300.00
Standard basic driver excess (Above 25 years): (camry , ford , hyundai etc )
$1,500.00
2. Luxury vehicles basic excess $1500
Standard basic excess owner/driver (Above 25 years): (Caprice, Kluger, Mercedes, Audi, Lexus)
$1,500.00
3. Wheelchair taxi basic excess $1500
Standard basic excess for owner/Driver (Above 25 years)
$1,500.00
4. Total loss excess $3000
Total loss excess $3000
$3,000.00
5. Additional excess where applicable
fire excess where applicable ( pls read club rules in detail , fire if caused in accident, not electrical/fuel leak cause )
$3,000.00
Age excess for drivers over 21 years but under 25 years
$1,000.00
If Second accident during short period, additional Excess plus basic excess: (Short Period of 3 months)
$500.00
Unlisted Driver additional excess
$1,000.00
3rd party p2p excess is applicable on claims lodged after 72 hours of the accident .claim to be lodged in person at our address
$10,000.00
Claims above $15000 . Total claim cost including your car and 3rd party damage
$1,000.00
theft is not cover in policy . if vehicle is recovered after theft - theft excess is applicable for repairs
$3,000.00
I agree and I have read
rules and regulations and terms and conditions
of the club
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