Bundle Insurance Germany
Auto & Motorcycle

Save 10% on your second vehicle policy!

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      Personal Information

    • 2

      Vehicle Information

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      Coverage & Submit

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    Personal Information

    Your Active Policy Number*

    First Name*

    Last Name*

    Personal Email*

    Phone Number*

    Are you affiliated with NATO Forces?*YesNo

    Where will the vehicle be registered?*USAREURBFGGerman registry

    Are you married?*YesNo

    Date of Birth*

    Vehicle Make*

    Vehicle Model*

    Year of Vehicle*

    VIN - Vehicle Identification Number

    Horse Power*

    Actual Cash Value in USD* (max. value 25,000 USD for Motorcycle, 95,000 USD for Car)

    Is there a lien on your vehicle?*YesNo

    Have you had any at-fault accidents in the last five years?*YesNo

    Third Party Liability Insurance (mandatory)*
    Yes

    Comprehensive Coverage (e.g. theft, broken windshield, natural hazard) Deductible 300 EUR*
    YesNo

    Collision Coverage (own damage) Deductible 300 EUR (Note: If you select to have Collision Coverage, you will also carry Comprehensive Coverage with a 300 EUR deductible)*
    YesNo

    Effective Date of Coverage*

    PCS Date / DEROS

    How did you find out about MIRASCON?

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    Third Party LiabilityThird Party Liability & Comprehensive CoverageThird Party Liability & Collision Coverage (incl. Comprehensive Coverage)

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