Personal Water Craft - Trident Marine Insurance

Online Quote

Looking for a quick quote? Please fill in the compulsory fields * and we will provide you with an indication. Please note the remainder of the form may be required to provide formal terms or cover.
Brokerage
Brokerage
Contact Person*
Email*
Phone*
Please provide
Cover is subject to Underwriter acceptance however may commence from the date requested and submitted.
The Insured
Insured Name*
Owner Title Owner Name D.O.B.
Are there more owners to be noted?
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
Mobile
Interested Party
(Finance, Bank, Credit Union etc. if applicable)
%/$ Financed
Previous / Current Insurer
Expiry Date
The Personal Water Craft
Year*
Length
Construction*
Make & Model*
Type*
Reg No.
H.I.N (Hull Id Number)
No. Of Seats*
The Motor
Year*
HP*
Make & Model
Type*
Fuel*
Serial Number
Maximum Capable Speed*
Comment
Has the motor(s) been modified in any way?
Comment
Does the motor(s) meet the ski manufacturer's recommendations?
Comment
The Trailer
Year
Reg.
Make & Model
Equipment & Accessories
Item Value
Storage
Method of Storage*
Post Code*
Location: (Marina / Address)*
Do you intend to take the craft more than 5nm from land?
If yes:
Vessel Use
What will the vessel be used for?
Private Use
Timeshare Arrangement
Hire
Demonstration
Rescue
Commercial Work
Other
Other. Please provide details:
Additional Comments
Owner's & Driver's experience
Date this ski was purchased
Please provide details of previously owned craft. Leave blank if none.
Skipper Name Make & Model Hull Length Type (Power or Sail) Length of Ownership Area of Navigation
Please provide details of relevant licences and qualifications.
Skipper Name Marine Licences / Qualifications Date Obtained
Claims & Convictions
Have you, the Proposer(s), or Drivers(s) in the past 5 years:
Had any insurances cancelled, refused or had special conditions imposed?
If yes, please provide details
Made any pleasurecraft insurance claims?
Date of Loss Description of Loss Settlement Amount
Been charged or convicted with any offence?
If yes, please provide details
Is there any other information you wish to tell us or think we should know?
If yes, please provide details
Sum Insured
Purchase price
Purchase Date
If the total amount paid for everything is different from the agreed value nominated, please explain why.
TOTAL SUM INSURED*
including hull, motor, trailer, equipment & accessories
Additional Comments / Information:
Email
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