PWC Insurance Indicative Quote Request

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Personal Details

* denotes compulsory fields
Name:

*
Email:

*
State:
Postcode:
Phone:

Type Of Cover  
comprehensive
third party only

other:
Insurance Details  
Has the insured  
1. Ever had any insurance refused or cancelled? Yes | No
2. Had any boat or any theft claims in the last five years? Yes | No
3. Been convicted of any offence in the last five years? Yes | No
Runabout Details  

Hull Details

  
Make:
Year of construction:
Length (ft / mtr):
Max. speed (knots or km/hr):

Motor/s

  
Make:
Year:
Power / HP:
Type of motor: inboard
  outboard
  stern drive
  jet
  other

Fuel:

 petrol
  diesel
  gas
  other
Legal Liability  

Select liability required:

 $5,000,000
  $10,000,000

Do you require water skiing legal liability cover?

 Yes | No
Boat Value  

Total sum insured:
Lay Up (optional)  
Number of months lay up required:
Postcode of lay up address if different from the above:
Product disclosure
To ensure this product meets your needs, you must first read the Product Disclosure Statement (click here to read).

I have read the Product Disclosure Statement  *

 
 

 

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