To contact us with a question or comment,about house or property insurance Fill in all the fields in the form below and press the Submit button.

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Name	：
ZIP code	：
Property address	：
Telephone number	：
E-Mail	：	(Please fill it in)
Request type		Brochure Policy quote
The policy start date	：	Insurance period： YEAR
Additional earthquake coverage	：	No Yes
Requested policy cost	：
Do you live in a wooden building consisting of 5 individual units or more? (for example;Apartment blocks) Yes No
Structure of building ： The area of the building （monopoly part） ： �u Please fill it in concretely. (ferroconcrete, iron frame make, and wooden, etc.)

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Please send mail to 　insurance@human-corporation.com

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