NEWTON CRUM
INSURANCE
64 years of excellence
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FIND THE RIGHT POLICY FOR YOUR BOAT WITH OUR FRIENDLY SPECIALISTS IN MARINE INSURANCE

Proposal Form For RS Quba

Fields with * are mandatory, if any are not applicable please enter N/A or 0. If you have any queries, please call us on 01702 710041.

Your Details

Title:*

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

Owner's Full Name:*
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 for list of excluded locations/sailing clubs but go to & use Yacht section for craft kept on mooring.

Country of Residence:*
Are there any additional owners of the craft?*
If so, please give full names, date of birth, address & occupation*

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

£8.00. Extra provides full cover spars, sails, rigging, foils, 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/ Kayak

£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 IPID.

Premium

Total Premium

Excess

£35

Have you recently or are you presently insured with Newton Crum?*

Important

Please read the following before submitting this 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.  That you have checked the specimen policy and comply fully with all terms, conditions and exclusions and that all information & answers are true, correct & complete with no requested information known to you withheld or misstated especially that the craft will only be for non-commercial private unpaid use & that this form creates the basis for assessment, quotation, insuring by the Underwriters applicable in accordance with the Consumer Insurance (Disclosure & Representations) Act 2012. It is understood, however, that submitting this form does not commit you to acceptance of any quotation.

Even though the premium may have been paid, the contract is not activated until the proposal is accepted & policy issued by Newton Crum Insurance Agents Ltd.

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

“I would thank Linda, very prompt service & replies to mails – thank you.”

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