Form for taking out a bicycle insurance online

Your needs

What would you like to insure?

Select the type of bicycle(s) to be insured*

Important:

  1. By completing this form, you will insure your bicycle(s) for up to € 5000 for €10 per month.
  2. If the total purchase price of your bicycle(s) exceeds €5,000, please go to the Soft Mobility Pack quote request form.

Are you already a LALUX customer?

Are you already a LALUX customer? *
For instance: 700001234
Concerning your home, are you ... ? *
Are you living in a ... ? *
Fields marked with an asterisk (*) are mandatory