E- Business Portal

Verify your identity

Enter your National Identification Number to get started

National Identification Number *

Please enter a valid 11-digit NIN.

Your Information

Confirm your personal details below

First Name *

First name is required.

Middle Name

Surname *

Surname is required.

Gender *

Please select your gender.

Mobile Number *

Mobile number is required.

Email *

A valid email is required.

Occupation *

Occupation is required.

Residential Address *

Residential address is required.

Nationality *

Please select your nationality.

State *

Please select your state.

City / Town *

Town is required.

LGA *

Please select your LGA.

Date of Birth *

Date of birth is required.

ID No *

ID number is required.

📄 Upload your ID * Accepted formats: JPG, PNG, PDF • Max size: 10MB

Please upload a copy of your ID.

Resident Permit (applicable to foreigners resident in Nigeria)

Type of Employment *

Please select employment type.

Vehicle Details

Tell us about the vehicle you want to insure

Vehicle Class *

Please select a vehicle class.

Cover Type *

Please select a cover type.

Chassis Number *

Chassis number must be at least 11 characters.

Vehicle Reg No *

Vehicle registration number is required.

Vehicle Type *

Please select a vehicle type.

Vehicle Make *

Please select a vehicle make.

Vehicle Model *

Please select a vehicle model.

Vehicle Year *

Please select the vehicle year.

Vehicle Colour *

Please select a vehicle colour.

Engine No *

Engine number is required.

Engine Capacity *

Seat Capacity *

Seat capacity is required.

Mileage *

Mileage is required.

Estimated Present Value (Including Accessories) *

Estimated value is required.

Vehicle Purpose *

Please select vehicle purpose.

Location (Address) Where the Vehicle Can Be Inspected

Do You Have a Driver's License or Learner's Permit?

How Long Have You Been Driving Continuously? *

This field is required.

Any Accidents or Losses in the Last 3 Years? *

Please select an option.

If Yes, Give Reason (optional)

Front View (Vehicle) *

Front view photo is required.

Back View (Vehicle) *

Back view photo is required.

Left Side View (Vehicle) *

Left side photo is required.

Right Side View (Vehicle) *

Right side photo is required.

Dashboard View (Vehicle) *

Dashboard photo is required.

Interior View (Vehicle) *

Interior photo is required.

Boot/Trunk View (Vehicle) *

Boot/trunk photo is required.

Declaration: I/We do hereby declare that the above statements and particulars are true, and this proposal and declaration shall be the basis of a contract of insurance between me/us. I am/We are willing to accept a policy subject to the terms, exceptions and conditions prescribed by the company. I/We confirm that I am authorized to fill this data collection form and authorize REX Insurance Limited to collect and use the information disclosed in accordance with the relevant Laws & Regulations of the Federal Republic of Nigeria. I hereby certify to the best of my information and belief that the above information is true and correct in all material respects.

I agree to the Terms and Conditions and Declaration

You must agree to the declaration to continue.

Payment Summary

Review your details and complete payment

Product
Premium
Transaction Charge
Total Payable

Click "Pay Now" below to complete your payment securely via Paystack.

Payment Successful

Your policy has been created

Policy Number

Download Certificate