Yacht and Motor Boats Enquiry Form...
You have a duty to provide complete and accurate information. Failure to disclose material information may invalidate cover and could mean part, or all, of a claim may not be paid. If in doubt disclose it anyway.
NOTE: * identifies a mandatory question, which must be answered to allow your enquiry to proceed
Personal details:
Are you a permanent UK resident?
 
Is the craft registered outside of the UK?
      Full name of Owner
* 
Address
* 



Post Code
* 
Day Time Phone Number
* 
e-mail

Occupation

*
Age
* 
 Vessel details:
Level of Cover
 *  
Total Value to be Insured (FULL Cover only)
 * (NOTE:  This must not exceed the total actual price paid, as professionally valued)

Name of Builder

 *

Class or Type

 * 
Year Built
* 
Length Overall
* 
Hull Material
* 
Maximum design Speed
* 
H.P. of engine
* 

Fuel Used

*
Date of Latest Survey
(NOTE: a copy is required)

Cruising range

*   

if 'Other' please specify

  
Mooring/Storage details:
 
Is your craft moored when unmanned
 * 
If YES please confirm mooring location
If Laid Up please confirm Laid Up Dates
from to
If Laid Up please confirm Lay Up location
 

 
If Laid Up please confirm which applies
  
     
If NO please confirm where craft is stored
  

What is the Post Code

 
 Past/present insurance details:

Current Insurer
Current Renewal Date
Number of years no claims discount
Number of Years Experience with this type of craft
* 
Details of any Marine Qualifications
Details of any Marine claims, or any convictions.
State if NONE
*
Additional details:
If selected, please provide full details below 
Transit
Single Handed Sailing
Boat In Build
Racing
Live Aboard
Other - Please Specify below
Or  Any Other Details
   

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Curtis Marine Insurance is the trading name of Curtis Marine Insurance Brokers Limited, which is Authorised and regulated by the Financial Services Authority. Registered in England & Wales.
Registered Number: 6465804. Registered Office: Plymouth Marine Centre, Pomphlett Quay, Billacombe Road, Plymouth, PL9 7HP.