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Boat Insurance

  

 

Name & Surname*

ID card number*

Date of birth*

Address


Phone number*

Mobile number*

Email Address*

Details of any incidents or claims you have had in the past 10 years*

Please provide us with the following details of your vessel

Model*

Builder

Max speed*

Material of hull*

Length*

Beam

Draft

When built*

When purchased (in euro)

Price paid*

Details of any tenders or dinghies to be covered (including serial numbers for any outboard motors)*

Vessel location and type of mooring when in commission*

Vessel location and type of mooring/storage when laid-up*

Period vessel laid up (if any)*

Cruising area to be covered

Engine model and make

Engine year of make

Fuel type

Is the engine inboard or outboard?

What kind of insurance do you require?

Type of cover

Total Sum to be insured (inclusive of Hull, Machinery, Equipment and Tender)

Details of your current insurance

Current Insurer

Insurance period

From

To

I have read and accept the Terms and Conditions