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Personal Water Craft
Online Quote
Looking for a quick quote? Please fill in the compulsory fields
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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
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Email
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Please provide
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Quote by:
Cover from:
Cover is subject to Underwriter acceptance however may commence from the date requested and submitted.
The Insured
Insured Name
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Owner Title
Owner Name
D.O.B.
Are there more owners to be noted?
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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
*
***select***
Catamaran POWER
Catamaran SAILING
Flybridge / Sports Cruiser
Half Cabin Cruiser
Houseboat
Jet Boat
P.W.C. (Jet Ski)
Mono Hull MOTOR Yacht
Mono Hull SAILING Yacht
Pontoon / BBQ Boat
Rigid Inflatable
Runabout
Sailing Dinghy / Skiff
Ski Boat
Trimaran
Other
Reg No.
H.I.N (Hull Id Number)
No. Of Seats
*
The Motor
Year
*
HP
*
Make & Model
Type
*
***select***
Inboard
Outboard
Sterndrive
Jet
Sail drive
Other
Fuel
*
***select***
Petrol
Diesel
Electric
Other
Serial Number
Maximum Capable Speed
*
***select***
Up to 40knots / 75km/hour
40-60knots / 75-110km/hour
Over 60knots / 110km/hour
Comment
Has the motor(s) been modified in any way?
***select***
Yes
No
Comment
Does the motor(s) meet the ski manufacturer's recommendations?
***select***
Yes
No
Comment
The Trailer
Year
Reg.
Make & Model
Equipment & Accessories
Item
Value
Storage
Method of Storage
*
***select***
TRAILER - Garage / Shed
TRAILER - Roadside / Carport / Other
HARDSTAND / RACK
MARINA BERTH
PRIVATE JETTY
FORE & AFT MOORING
SWING MOORING
OTHER
Post Code
*
Location: (Marina / Address)
*
Do you intend to take the craft more than 5nm from land?
***select***
Yes
No
If yes:
Vessel Use
What will the vessel be used for?
Private Use
***select***
Yes
No
Maybe
Timeshare Arrangement
***select***
Yes
No
Maybe
Hire
***select***
Yes
No
Maybe
Demonstration
***select***
Yes
No
Maybe
Rescue
***select***
Yes
No
Maybe
Commercial Work
***select***
Yes
No
Maybe
Other
***select***
Yes
No
Maybe
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?
***select***
Yes
No
I don't know
If yes, please provide details
Made any pleasurecraft insurance claims?
***select***
Yes
No
I don't know
Date of Loss
Description of Loss
Settlement Amount
Been charged or convicted with any offence?
***select***
Yes
No
I don't know
If yes, please provide details
Is there any other information you wish to tell us or think we should know?
***select***
Yes
No
I don't 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:
Comments
This field is for validation purposes and should be left unchanged.