Racing Yachts Insurance Form

Please enter your personal details

Private Person* Company*

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First Name*

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Last Name*

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Company Name*

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VAT-ID Number*

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Street and House Number*

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Adress Add-On

ZIP Code*

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Town*

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Country*

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Phone*

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E-Mail*

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Please enter a valid email address

Please note that the quote will be sent to this e-mail adress.

Team Name*

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Name of the Skipper*

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Please upload the Skipper‘s CV (PDF or Image, max. 5 MB)*:

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Choose File Remove

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Skipper's claims in the past five years*

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Remove Skipper

Add additional Skipper

* Mandatory Fields

Please enter your boat details

Design Type*

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Boat Name*

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Boat Number (HIN)*

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Builder*

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Prototype/Production Boat*

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Year Built*

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Dimensions

Length Overall (m)*

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Width Overall (m)*

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Max. sail area (m²)*

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Flag of Vessel*

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Main moorage place* (Country and Town):

Moorage place

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Is the vessel equipped with foils?*

No Yes

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Vessel was built to foil

Vessel has been modified to foil

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Year of the last replacement of standing rigging:

Year

If the standing rigging hasn't been replaced yet, please enter the year of construction of the yacht.

Insurance/Claims History of the Boat:

Previous Insurance Company*

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Has the yacht had any claims yet?*

No Yes

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Type of Claim*

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Amount of Claim*

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Year of Claim*

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Remove Claim

Add additional Claim

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* Mandatory Fields

Summary

Personal Details

change

first name

last name

company name

vat-id number

street and number

adress add-on

ZIP Code

town

country

phone

e-mail

team name

name of skipper

Skipper‘s claims in the past five years

Boat Details

change

design type

boat name

boat number

Builder

Prototype/Production Boat

year built

length overall

width overall

max sail area

flag of vessel

main moorage place

foiling vessel

built to foil

modified to foil

Previous Insurance Company

Claims?

Type of Claim

Amount of Claim (€)

Year of Claim

Scope of Insurance

change

cruising areas

use of vessel

name of regatta

year

crewed

duration

type of cover

hull value

mast

rigging set

sails

electronics

rib

foil

container

total insured value

Third Party Liability Insurance

Additional Comments:

Your Message

All material facts must be disclosed to Underwriters whether or not the subject of a specific question above. A material fact is one which a prudent Underwriter would regard as likely to influence the acceptance or assessment of the proposal. Nondisclosure or misrepresentation of material fact may result in the insurance being void. If you are in any doubt about whether facts would be considered material, you should disclose them. I declare that the particulars and answers are correct and complete in every respect to my knowledge and belief. I agree that this proposal and declaration shall form the basis of the contract of insurance between me and the Underwriters if a policy is issued. I further declare and agree that if the statement and particulars above have been completed by any other person other than the undersigned, such person deemed to be the agent of the proposer for the purpose of completion purposes.*

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* Mandatory Fields

Racing Yacht Insurance

Please enter your personal details

Please enter your boat details

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Summary