Bangladesh National Insurance Co. Ltd

Basic Information

Insurance Type

Application Type

Plan Type

Insurance Sub Type

Insurance Category

Vehicle Information

Vehicle Type *

Capacity *

Policy Start *

Policy End *

Personal & Vehicle Information View Calculation

Insured Full Name: *

Insured Address: *

Mailing Address: *

Mobile Number: *

Vehicle Brand/Make: *

Registration Number: *

NID: *

Vehicle Document(s)

To upload multiple file select together

Email ID: *

City: *

Mailing City *

Year of Manufacture *

Registration Date: *

Engine Number: *

Chassis No: *

I accept the Terms & Conditions.

Personal Information View Calculation

Visa Type *

Policy Date *

Name *

Address *

Email Address *

Mobile Number *

Passport No. *

Passport's Personal Data with Photo *

To upload multiple file select together

Visited Countries *

Auto Renew

I accept the Terms & Conditions.

Fire Insurance

Full Name of Proposer

Proposer Phone

Proposer Email Address

Proposer Address

Name of Partners Bank(If Any)

Partners Bank Address (If Any)

Trade of Profession

Terms on Insurance Form

Marine Information

Full Name of Proposer

Proposer Phone

Proposer Email Address

Proposer Address

Name of Insured M/S

Insured M/S Address

Nature of Commodities

Mode of Packing

Insurance Date

Via

To Be Shipped Per

Risk Covered

Amount Tk

Insurance Information

Plan Type *

Class of Occupation *

Risk Cover *

Sum Insured *

0.00

Date of Birth *

Benefits Show

Full Name of Insured *

Insured Email*

Insured Address *

Insured Occupation *

Mobile Number:

Passport / NID with Photo *

Period of Insurance *

Name of Beneficiary *

Relationship with Beneficiary *

Auto Renew

I accept the Terms & Conditions.

Insurance Information

Plan Type *

Sum Insured *

100,000.00

Date of Birth *

Full Name of Insured *

Father's Name *

Mother's Name *

Spouse's Name *

Insured Email*

Insured Address *

Insured Occupation *

Mobile Number *

Passport / NID with Photo *

Period of Insurance *

Name of Beneficiary *

Relationship with Beneficiary *

Auto Renew

I accept the Terms & Conditions.

Motor Insurance
Session Reset in 15:00

Basic Information

Vehicle Information

Personal & Vehicle Information View Calculation

Travel Information

Personal Information View Calculation

Fire Insurance

Marine Information

Insurance Information

Personal Information View Calculation

Insurance Information

Personal Information View Calculation

Motor Insurance Session Reset in 15:00

Basic Information

Vehicle Information

Personal & Vehicle Information View Calculation

Travel Information

Personal Information View Calculation

Fire Insurance

Marine Information

Insurance Information

Personal Information View Calculation

Insurance Information

Personal Information View Calculation

Motor Insurance
Session Reset in 15:00