• 1

      Personal Details

    • 2

      Vessel Details

    • 3

      Incident Details

    • 4

      Stolen/Damaged items

    • 5

      Finalise Claim

    1/5

    Personal Details

    Personal Details

    Policy Number

    Name of insurer

    Claim Number

    Insured/Owner

    Full Name

    Address

    Mobile no

    Email Address

    Do you consider yourself vulnerable? Please provide details

    Navigator/Helmsman

    If the person in charge of the vessel at the time of the incident was someone other than the above-mentioned, please provide the person’s name, age, address, and occupation together with qualifications and experience in handling craft

    Vessel Details

    Name of vessel

    Type of vessel

    Age of vessel

    Full Value (£)

    If your outboard motor is involved, please provide the age, make and serial number

    If your dinghy/tender is involved, please provide the age, length, construction, and confirm she was marked with the parent vessel’s name

    Details of the crew on board, and clarification for what purpose the vessel was being used for at the time of the incident

    Details Of Incident

    Date and time of the incident

    Location of the incident

    When was the vessel last inspected prior to the incident?

    Weather conditions at the time of the incident – please include wind direction, Beaufort Scale Force, and any other known information

    What was the cause of the incident?

    Was the vessel racing at the time?
    YesNo

    Crime reference (required for all theft claims) and the name of the reporting police station

    Explain fully how events giving rise to your claim occurred. If necessary, continue on the back page and provide a sketch. For theft claims – please advise what security measures were in place, what anti-theft devices were installed, and how entry was gained

    Description of Damage

    Please describe the nature and extent of loss or damage to your vessel

    What is the approximate cost of repairs or reinstatement? (an estimate from a firm of repairers should be submitted as soon as possible)

    What was done to minimise the loss or damage?

    Where can the vessel be inspected?

    Salvage

    If any salvage services have been rendered, please give full details including names and addresses of those who claim to have given such service and under what circumstances

    Witnesses

    Please provide full details of all witnesses

    Third Parties

    Please give full details of any injury to third parties or damage to third party vessels or property including names and addresses of all persons concerned

    Damaged/Stolen Items

    Total (£)

    Finalise Claim

    If there are any other policies in force providing cover for the property claimed for please give details

    Are you registered for VAT?
    YesNo

    Registration Number

    I/we declare that the above answers and particulars are true and complete in every respect

    Signature of Insured


    Date

    Signature of person in charge of vessel


    Date

    Add me to your mailing list

    Once submitted, please refer and respond to our introductory email outlining all requested documentation to progress your claim.