Pleasurecraft | Private Vessel form

  • 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
  • Cover is subject to Underwriter acceptance however may commence from the date requested and submitted.
  • Is the Customer/You within the Target Market for this Product?
  • It is important that our insurance policies are only sold to customers that are inside our target market.

    If you answer ‘yes’ to any of the following the proposed customer is outside our target market.

    Is the vessel(s) to be insured by this policy;

  • Please consider our Target Market Determination (TMD) in full on the Forms and Documents page of our website.
  • The Insured
  • Owner TitleOwner NameD.O.B. 
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  • (Finance, Bank, Credit Union etc. if applicable)
  • The Vessel
  • (Hull Id Number)
  • The Motor
  • The Trailer
  • Sailing Vessel Only (Yachts / Catamarans)
  • MastRiggingSails 
  • MastRiggingSails 
  • MastRiggingSails 
  • MastRiggingSails 
  • Equipment & Accessories
  • ItemValue 
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  • Vessel Storage
  • Vessel Use
  • What will the vessel be used for?
  • Owner's & Skipper's experience
  • Please provide details of previously owned vessels. Leave blank if none.
  • Skipper NameMake & ModelHull LengthType (Power or Sail)Length of OwnershipArea of Navigation 
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  • Please provide details of relevant licences and qualifications.
  • Skipper NameMarine Licences / QualificationsDate Obtained 
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  • Claims & Convictions
  • Have you, the Proposer(s), or Drivers(s) in the past 5 years:
  • Date of LossDescription of LossSettlement Amount 
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  • General
  • If yes, please provide a copy
  • If yes, please provide details
  • Options
  • NOTE: Race MUST be organised by a Club or Association. The Standard limit for Yacht Racing cover is 50nm. If you require longer nautical miles distance, please advise.
  • Sum Insured
  • Please note a split up of the sum insured is not compulsory. You may nominate values when an Agreed Value policy is offered.
  • Split up of Sum Insured
  • $0.00
  • including hull, motor(s), trailer, masts, spars, rigging, sails, equipment & accessories
  • This field is for validation purposes and should be left unchanged.