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Policy Holder

Skipper Information

Third Party Insurance

If the claim is for Personal Injury to a Third Party, the following details are required:

Motor Vehicle Accident

If the claim is for damage to property arising out of a motor vehicle accident, the following details of the vehicle towing the vessel is required

Documents Required

Please tick the appropriate boxes of documents attached to this claim form:

Quotation for repair work

Preferred Repairer address / contact details

Certificate of Competence (if applicable to claim)

Colour Photograph of damages (this will speed up the claim)

Damage Report from repairer

Trailer Claims supply proof of latest service & registration certificate

Certificate of Fitness (if applicable to claim)

Any Third Party documents (if applicable)

How did you hear about us? Please specify which .. Magazine / Dealer / Friend / Show .....(provide source to get 5% discount):

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PLEASE NOTE: By clicking "Submit Claim Request" you hereby solemnly declare that the information above and on the face hereof is a true and faithful account of the event/damages sustained and that to your knowledge nothing has been concealed which may be relevant to consideration of this claim.