Nautilus Marine Insurance Agency

Trailer Sailer Insurance Indicative Quote Request

All fields are required unless marked (optional)

Personal Details

Name:

Email:

State:

Postcode:

Phone:

Type of Cover

Type Of Cover

Comprehensive Third Party Only Other? Please specify:

Insured Details

Has the insured(s):

Ever had any insurance refused or cancelled?

Yes No

Had any boat or any theft claims in the last five years?

Yes No

Been convicted of any offence in the last five years?

Yes No

Trailer Sailer Details

Hull

Make:

Year of Const:

Length (ft/mtr):

Const. Material:

Max Speed (Knots or km/h):

Motor/s

Make:

Year:

Power/HP:

Fuel?

Petrol Diesel Gas Other

Mast, Spars & Rigging

Running backstays?

Yes No

3 or more Sweptback Spreaders?

Yes No

Rod Rigged?

Yes No

2 or more Inline Spreaders?

Yes No

Carbon Mast?

Yes No

Age Of Rig:

Legal Liability

Select liability required:

$5,000,000 $10,000,000

Boat Value

Total Sum Insured:

Optional Benefits

Sailboat Racing

* 50nm full racing cover included as standard

Is the sailboat used for official and/or organised races exceeding a distance of 50 nautical miles?

Yes No

If Yes, Details:

Lay Up (optional)

Number of months lay up required:

Postcode of lay-up address if different from the above:

Experience details

Insured Age

Boating Experience

Boating Courses?

Yes No

We will provide you with an indicative quote for the insurance of your boat.

Nautilus Marine Insurance Agency - Quote Request Form

Trailer Sailer Insurance Indicative Quote Request