Motomaxx Quote - Sussex Insurance

Thank you for inquiring about our Motomaxx Replacement Policy. In order for us to provide you the best possible quote and determine eligibility please answer the questions below.

1) Do you drive more than 50,000Km a year?

YES
NO

2) Is your vehicle rebuilt or salvaged?

YES
NO

3) Are you using this vehicle for delivery, compensation, or hire?

YES
NO

4) Is the vehicle older than 10 years?

YES
NO

If you answered YES to any of the questions above, unfortunately you are not eligible for Motomaxx coverage at this time.

Good News! If you answered NO to all of the questions above you may quality for Motomaxx Replacement Policy. In order to provide an accurate quote the agent will need additional information when they contact you. Please fill out your contact info below and we'll be in touch soon.

First Name*

Last Name*

Date of Birth*

Phone*

Email*

What is your Vehicle Model & Year?*

Would you like a quote on an additional vehicle?*

YES
NO

Are you a Sussex Insurance Agent?

Yes
No

Agent Name

First Last

Agent, Select your Sussex Insurance office below:*

Select your closest Sussex Insurance location:*

How did you hear about us?

Google Search
TV Commercial
Social Media
Radio
Existing Customer
Word of Mouth
Newspaper Ad
Other

Other

How did you hear about us?

Consent*

YES, I accept

By ticking this box I consent to sending/receiving my personal information, insurance information and, if applicable, banking information by email and phone.

Consent*

YES, I accept

I agree my coverage will NOT take effect until a licensed insurance agent contacted me and has confirmed coverage is bound.

Submit your request and we'll get back to you as soon as possible. Please note: In order to provide an accurate quote the agent will need additional information when they contact you.

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