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STEP 1 Of 4
Next step is Personal Information
  • User Type
  • Personal Information
  • Corporate Information
  • Account Information
  • Finish

User Type

Individual

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Broker

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Salesman

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Personal Information

First Name En Middle Name En Third Name En Last Name En
First Name Ar Middle Name Ar Third Name Ar Last Name Ar
Gender Date of Birth (hijri)* Nationality* Occupation
Client Id Expiry Date Social Status

Corporate Information

Firm Name CR Number Issue Date Expiry Date Status

Account Information

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ACKNOWLEDGMENT:

1. I acknowledge that I am the claimant, or a legal agent on his behalf, under a valid agency, and a direct and legitimate authorization from him, "whether the main claimant is an individual or a company, and I commit, in the event of any change in the legitimacy, to update the data and refrain from filing any claims related to the vehicle/vehicles that is/are non-owned or under legitimate delegation.

2. I acknowledge that all submitted data, information and documents are correct, and I am committed to updating them in case they change, and I accept communication accordingly.
3. I acknowledge the correctness of the contact information and the means of identification information such as the ID number, date of birth, mobile number, and e-mail address. Additionally, I acknowledge the validity of the entered bank information.

4. I accept text messages and emails sent by the United Cooperative Insurance Company, especially for purposes of identity verification, and to inform me of the status of my requests.

5. I agree to upload all copies of the original documents in a clear, and high-quality copies as required by the company as related to the accident or proof of identity and relationship, or to the vehicle (s), additionally, I will submit any original documents as required by the company.

6. I pledge that if any of the previous clauses are violated, I bear all the legal procedures taken against me, and I also bear full responsibility for any damages resulting from that.
I agree with above ACKNOWLEDGMENT.
By checking this box and clicking "Register" below, I acknowledge that I have read and agree to the Privacy Notice
By checking this box, I agree I want to receive news, offers, and other promotional materials from UCA.



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