Gender
Select Gender
Male
Female
Business Sector
Select Business Sector (OPTIONAL)
Agriculture
Art & Culture
Aviation
Banking
Computer & Information Technology
Construction
Education
Electricity
Engineering
Food and Beverages
Healthcare
Hotel, Travel and Tourism
Insurance
Manufacturing
Media
Mining and Quarrying
NGO/Humanitarian Services
Oil and Gas
Other Financial Institution
Professional Services
Public Sector
Real Estate
Religious Organisation
Shipping and Marine
Sport and Entertainment
Telecommunication
Trade
Transportation, Logistic and Distribution
Marital Status
Select Marital Status
Single
Married
RISK INFORMATION (DETAILS OF COVER OR PRODUCT REQUIRED)
TRANSIT DETAILS/INFORMATION
Goods Location
Select Goods Location
Abia
Adamawa
Akwa Ibom
Anambra
Bauchi
Bayelsa
Benue
Borno
Cross River
Delta
Ebonyi
Edo
Ekiti
Enugu
Gombe
Imo
Jigawa
Kaduna
Kano
Katsina
Kebbi
Kogi
Kwara
Lagos
Nasarawa
Niger
Ogun
Ondo
Osun
Oyo
Plateau
Rivers
Sokoto
Taraba
Yobe
Zamfara
Abuja Federal Capital Territory
Goods Destination
Select Goods Destination
Abia
Adamawa
Akwa Ibom
Anambra
Bauchi
Bayelsa
Benue
Borno
Cross River
Delta
Ebonyi
Edo
Ekiti
Enugu
Gombe
Imo
Jigawa
Kaduna
Kano
Katsina
Kebbi
Kogi
Kwara
Lagos
Nasarawa
Niger
Ogun
Ondo
Osun
Oyo
Plateau
Rivers
Sokoto
Taraba
Yobe
Zamfara
Abuja Federal Capital Territory
TRANSPORT/VEHICLE INFORMATION
Mode of Shipment
Select Mode of Shipment
Airline
Courier
Commerical driver
Own Vehicle
I hereby consent to the collection, processing, use and the transfer of personal data to third parties (within or outside Nigeria), for the performance of this contract and any other data processing activities which may arise therefrom between myself and Royal Exchange General Insurance Company Ltd (Royal Exchange). I affirm that I am aware and take cognizance of my rights under the relevant Data Protection Laws in Nigeria and other terms detailed in the Data Protection and Privacy Policy of Royal Exchange available on our policy
I authorize and consent that any person who may be in possession of, or hereafter acquire, any information pertaining to my records may disclose such information to Royal Exchange.