01424 718800 - Narrowboat/Yacht/Motorboat

01702 710041 - Dinghy/Sailboard/Small Powercraft

Proposal Form For Dart 16

Fields with * are mandatory, if any are not applicable please enter N/A or 0

Your Details

Owner's Full Name:*

If under 18 name of parent or guardian must be entered here with minor noted as an additional owner

Date of Birth:* (dd/mm/yyyy)
Exact occupation and nature of business:*
Telephone Number:*
Email Address:
Postcode*
Address:*
Club or place stored if other than home:*

Please see policy wording + IPID for list of excluded locations/sailing clubs but go to & use Yacht section for craft kept on mooring.

Country of Residence:*
Additional Owner Full Name (N/A if none):*

Craft

Make:*
Class:*
Sail/Hull No:*
If none, owner must permanently mark home postcode on Hull
Purchase Date:* (dd/mm/yyyy)
Purchase Price:*
Year Built:*
Hull Material:*
Mast Material:*
Present Condition:*

Have you or any person likely to use the craft:

Made any claim or had any accidents with any craft owned or used by you/them in the past 5 years?
Had any insurance for craft declined, refused, cancelled or charged at a higher rate?
Been charged or convicted of any crime or dishonest act including theft or fraud?
Derive any income from sailing/boating or sponsorship or are likely to in the future?
Do any exclusions on policy apply to your intended use or ownership?

Premium

Note - the Sum(s) requested should be New Cost Price for craft and equipment up to one year old, current market value thereafter.

Please enter '0' into any boxes not being completed.

Current Market Value
Premium

Only if additional cover is required complete the following:

C) New For Old
£17.00 Extra full cover spars, sails, rigging and covers damaged beyond repair
Premium

Road Trailer/Combi
£2 per each £100 value. Warranted trailer itself wheel clamp locked unless stored in locked building & ID marked.
Current Market Value
Premium

Launching Trolley
£1 per each £50 value. Warranted trolley id marked.
Current Market Value
Premium

Outboard Motor
£2 per each £100 value. Max 6 hp. Must be locked inside locked building or vehicle when unattended, serial # retained for I.D.
Current Market Value
Premium

Row boat-canoe
£5 per each £100 value (max £500). Must be I.D. marked with name & post code and kept inside locked secure premises when unattended.
Current Market Value
Premium

Personal Effects
£4 up to £150 max sum. Clothing, waterproofs wetsuits & buoyancy aids. Excluding cash, mobiles or other electrical items or fishing gear.
Premium

Legal Protection
£1.00. Provides Legal & Associated fees up to £25,000 to enable assured to pursue uninsured & injury claims against others following boat accidents as per separate policy wording.
Premium

Total Premium

 

Who were you recommended to us by?
Have you recently or are you presently insured with Newton Crum?*

Important

Please read before completing/submitting form.

CONFIRMATION - Note that in submitting this proposal you agree that we collect your personal data as detailed in our Privacy Policy you have read and that you are the owner/joint owner of the craft and that all information & answers are true, correct & complete with no requested information known to you withheld or misstated & that this form creates the basis for assessment, quotation, insuring by the Underwriters applicable in accordance with the Consumer Insurance (Disclosure and Representations) Act 2012.

I confirm the above and wish to start the cover from (cannot be backdated):*

Please contact us on 01702 710041 to discuss your Insurance Proposal before completing this form.

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