www.24hourdinghyinsurance.com

Sailboard Windsurf Insurance - Proposal Form

Personal Details

Owner's FULL Name:
Home Address:
Post Code:
Day Phone:
e-mail address:
Date of Birth (DD/MM/YYYY):
Occupation & Business:
Additional owner full Name:
Home Club
Have you or any other person likely to use the craft, both in respect of the proposed craft or any others:
*Yes / No      
(a) made any claims or suffered any accidents or losses?*
(b) had insurance Declined/Cancelled or special terms?*
(c) been charged or convicted of any crime/theft/fraud?*
(d) derive any income from boating or sponsorship in any way?*
If answer is yes to any of the above - provide full details here.

1st board to insure - complete each section for cover to be operative:
Make, Model & Length:
Makers Board Number*:
Year Made:
Date Purchased:
Purchase Price:             £

2nd board (warranted not afloat at same time as 1st) complete all sections:
Make, Model & Length:
Makers Board Number*:
Year Made:
Date Purchased:
Purchase Price:             £

*If not manufacturer numbered, warranted permanently marked with your post code

I warrant all details given are true & complete in every aspect with no information withheld. My craft & equipment are in sound, seaworthy condition and will be so maintained whilst insured. I understand and accept the full policy terms, conditions & exclusions detailed on the specimen policy which I have read.


Date cover to start:

Continue

 

Cover Requested

Restricted cover of: £3,000,000 Third Party Only

one board Premium £18
two boards Premium £35

£ Total premium enclosed. Note extensions below are not available with this restricted cover.

Policy excess applicable to all cover £45 each claim to be borne by the insured, this may be doubled were board over five years old.

or

Fully Comprehensive including £3 million third-party

Current Market ValuePremium
1st Board (excluding spars/sails): ££
2nd Board (excluding spars/sails): ££
All Spars (mast & boom): ££
All Sails: ££
Total sum insured££

Additional Cover Extensions:

Current Market ValuePremium
Road Trailer/Combi at £2 per each £100 sum.££
Launching Trolley at £2 per each £100 sum.££
Personal Effects at £5 up to £100 or £10 up to £200 max.££
Legal Protection providing legal & associated fees up tp £25,000 to pursue uninsured loss or injury action against third parties from boating accidentsas stated£
TOTAL PREMIUM ENCLOSED£

PREMIUMS
FOR COMPREHENSIVE COVER

on total sums all craft gear & equipment but excluding 'additional' items separately rated.
Sums up to:Premium
£100£19
£200£21
£300£23
£400£25
£500£28
£600£31
£700£34
£800£37
£900£41
£1000£46
£1100£52
£1200£59
£1300£65
£1400£70
£1500£75
£1600£80
£1700£85
£1800£90
£1900*£95
*above this sum please refer by phone

TO INSURE

  1. Check the specimen policy first here
    then 'about us and key facts' here
    to make certain that what is offered meets your exact requirements.

    If so,

  2. Fill in every section of the proposal form above

  3. Check that all the answers in "yes-no" section 5 a-e are no, otherwise phone 01702 710041 with details for special acceptance or terms.

  4. Submit the proposal by:

    POST - send completed form with your cheque or the Debit/Credit card form found ( here - Click here to print form),

    FAX - as per post, but only use Credit/Debit card form.

If you have any questions please phone 01702 710041 9 - 5 Monday-Friday or 9 - 1 Saturdays during the Summer season.

To check out what clients have to say about us, click here


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24 Hour Dinghy Insurance from Newton Crum Insurance,

839 London Road,Westcliff on Sea, Essex. SS0 9TE
Telephone: 01702 710041 Fax: 01702 471375
Email: better@24hourdinghyinsurance.com

Authorised and regulated by the Financial Services Authority

Updated 11 September 2007 S