Request for Rally Comprehensive Insurance

Request a Quote for Rally Comprehensive Insurance

Are you interested in rally comprehensive insurance or do you need a customized insurance solution for your rally vehicle—for example, for the WRC, DRM, DRC, or national rally series?

We would be happy to provide you with a customized quote tailored to your vehicle, area of operation, and rally season.
Please send us the completed application form. (* Required fields)

Please enable JavaScript in your browser to complete this form.

Name / Company *

First name *

Street *

Postal code *

City *

E-Mail *

Phone *

Team name *

Driver Information

Number of drivers1234

Please select the number of drivers.

Driver 1

Driver details – Full name of driver 1 *

Date of Birth, driver 1 *

How long have you held a competition license? *

(driver 1)

License number *

(Driver 1, for the current year)

Number of years of competition experience *

(Information about Driver 1, in years)

Number of events you have participated in over the last 3 years *

(Information about Driver 1: Please enter the number here.)

Have you (the driver) ever had a physical disability or infirmity, diabetes, heart, circulatory, epilepsy, mental health or alcohol problems, or visual or hearing impairments? *

Information about Driver 1: Please indicate any physical disabilities or health conditions, such as diabetes, heart or circulatory problems, epilepsy, mental health issues, alcohol-related problems, or vision or hearing impairments.

Driver 2

Driver details – Full name of driver 2 *

Date of Birth, driver 2 *

How long have you held a competition license? *

(Driver 2)

License number *

(Driver 2, for the current year)

Number of years of competition experience *

(Information about Driver 2, in years)

Number of events you have participated in over the last 3 years *

(Information about Driver 2: Please enter the number here.)

Have you (the driver) ever had a physical disability or infirmity, diabetes, heart, circulatory, epilepsy, mental health or alcohol problems, or visual or hearing impairments? *

Information about Driver 2: Please indicate any physical disabilities or health conditions, such as diabetes, heart or circulatory problems, epilepsy, mental health issues, alcohol-related problems, or vision or hearing impairments.

Driver 3

Driver details – Full name of driver 3 *

Date of Birth, driver 3 *

How long have you held a competition license? *

(Driver 3)

License number *

(Driver 3, for the current year)

Number of years of competition experience *

(Information about Driver 3, in years)

Number of events you have participated in over the last 3 years *

(Information about Driver 3: Please enter the number here.)

Have you (the driver) ever had a physical disability or infirmity, diabetes, heart, circulatory, epilepsy, mental health or alcohol problems, or visual or hearing impairments? *

Information about Driver 3: Please indicate any physical disabilities or health conditions, such as diabetes, heart or circulatory problems, epilepsy, mental health issues, alcohol-related problems, or vision or hearing impairments.

Driver 4

Driver details – Full name of driver 4 *

Date of Birth, driver 4 *

How long have you held a competition license? *

(Driver 4)

License number *

(Driver 4, for the current year)

Number of years of competition experience *

(Information about Driver 4, in years)

Number of events you have participated in over the last 3 years *

(Information about Driver 4: Please enter the number here.)

Have you (the driver) ever had a physical disability or infirmity, diabetes, heart, circulatory, epilepsy, mental health or alcohol problems, or visual or hearing impairments? *

Information about Driver 4: Please indicate any physical disabilities or health conditions, such as diabetes, heart or circulatory problems, epilepsy, mental health issues, alcohol-related problems, or vision or hearing impairments.

Vehicle specifications

Vehicle details – brand and model *

Year of manufacture *

Date (MM/YY) of purchase *

Are you, the applicant, the owner and registered keeper of the vehicle? *—please select—YesNo

Is the vehicle fully paid for? *—please select—YesNo

License plate number if registered

VIN number *

Please enter the VIN number here.

Original price *

Original price of the vehicle in €.

Current value *

Current value of the vehicle in €.

Has the vehicle been modified? *—please select—YesNo

Please indicate whether the vehicle has been modified to alter the manufacturer's standard equipment or to change its performance or handling. This includes any upgrades and modifications to the software, firmware, and hardware installed in the vehicle.

Event details

Event details – Event name *

Enter the name of the event here.

Start date *

day/month/year

End date *

day/month/year

Anzahl der Etappenmeilen / km bei der Veranstaltung: *

in km.

Events (race series) *-select-VLNRCNADAC GT MastersCreventic 24h Endurance SeriesADAC Formel MastersPorsche Sports CupPorsche Super Sports CupPorsche Carerra CupPorsche AlpenpokalPorsche Drivers Cup/TrophyPorsche Sports Cup EndurancePorsche Mobil 1 SupercupPorsche GT 3 CupsSTT H&R CupADAC WestfalentrophyHisto CupBördesprintGTWCDRMGT OpenBlancpain GT Endurance SeriesBlancpain GT Sprint SeriesBlancpain GT AsiaGT 3 Le Mans CupVolkswagen Racing CupPrototype Cup LMP3ELMSFormula EF4 German ChampionshipGT4 European SeriesLamborghini Supertrofeo EuropeLamborghini Supertrofeo AsiaLamborghini Supertrofeo Middle EastRadical Challenge ChampionshipRadical European Masters RXCRadical SR1 CupAndere (tragen Sie Ihre Eigene ein)

Would you like to insure the engine and transmission? *-select-YesNo

Required property damage coverage € *

Please enter the amount in €.

Fire damage insurance required € *

Please enter the amount in €.

Have you previously been insured for rally competitions? *— please select —YesNo

Have you, the insured driver (if different from the applicant), or a member of your racing team ever been convicted of a criminal offense related to fraud or theft? *— please select —JaNein

Privacy Policy *

• Yes, I agree that my personal data may be collected and processed by Raceinc. – Die Versicherung im Motorsport / Trackdayversicherung.de, owned by Mr. Tobias Groenen, and used for the purpose of preparing a one-time quote. The data will only be forwarded to the respective insurance companies for the purpose of preparing the requested quote. I may revoke this consent at any time with future effect by calling 002151-3523051 or by emailing groenen@raceinc.de or info@trackdayversicherung.de.

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