On-line Boat Insurance


Thank you for considering our on-line boat insurance service.   Because Greater National Group is an insurance broker, not an insurance company, we will process your application with major insurance companies in order to find the right boat insurance for you.

Please fill in the following form as fully as possible, then click 'submit' at the end of the form.
You can use the TAB key to move to the next field. We will respond with your terms as soon as we have researched the market for the right available deal that fits your requirements.

Boat & Engine Details:
(Only answer questions relevant to your boat - otherwise leave fields blank)
1a. Boat Make:
1b. Boat Type:
1c. Boat Year of Manufacture:
1d. Boat Length:  metres
1e. Boat Construction:
1f. Boat Current Esimated Value: $ 
2a. Engine Make & Model:
2b. Engine Year of Manufacture:
2c. Engine Size:  HP
2d. Maximum Speed:  knots
2e. Type of Engine
Inboard Outboard Sterndrive Jet
3a. Trailer Make & Model:
3b. Trailer Year of Manufacture:
4. What are the sails made of:
5. Do you want cover for racing?
Yes No
6. Do you want cover for water skiers risk?
Yes No
7. Accessory Cover - Item Description & Sum Insured (Please list items worth over $500 that you want covered):
1  $
2  $
3  $
8. Is your boat laid up for a regular period of time each year?
Yes No
If Yes, Please list the months laid up:
9. Do you owe money on this boat?
Yes No
Applicant Details
10a. Date of birth of applicant (DD/MM/YYYY):
10b. Percentage of use:  %
10c. Occupation of applicant:
10d. How long has the applicant held a boat licence?  years
10e. Are you entitled to a No Claim Bonus with your current insurer?
Yes No
If yes, please specify what rating:
10f. If you hold rating 1, how many years has it been since your last claim (enter 99 if you have never claimed):
11. For each other person who will use, tow or carry your boat:
Date of birth of applicant 2 (DD/MM/YYYY):
 Percentage of use: %
How long has the applicant held a boat licence?  years
Date of birth of applicant 3 (DD/MM/YYYY):
 Percentage of use: %
How long has the applicant held a boat licence?  years
Have any of the applicants (Note you must answer these questions):
12. Ever had any insurances refused or cancelled?
Yes No
Details:
13. Suffered any claims in the last five years?
Yes No
Details:
14. Been charged or convicted of any offense in the last ten years?
Yes No
Details:


Duty of Disclosure:
Are you aware of any matters not disclosed above that is relevant to the underwriter's consideration of this insurance?
Yes No
If so, please provide details:
I/We hereby declare that:
My/Our attention has been drawn to the Important Notices accompanying this form and further I/we have read these notices carefully and acknowledge my/our understanding of their content. The above statements are true, and I/we have not suppressed or mis-stated any facts and should any information given by me/us alter between the date of this form and the inception date of the insurance to which this relates I/we shall give immediate notice thereof. I/We authorise GNG and the Insurer to collect or disclose any personal information about another individual (for example, an employee, or client), I/we declare that the individual has been or will be made aware of that fact and the Privacy Policy. I/We also confirm that I/we am/are authorised to act for and on behalf of all persons who may be entitled to indemnity under any policy which may be issued pursuant to this form and I/we complete this form on their behalf.
Any other comments, requests or relevant information you need to add:
Contacting you about your quote:
In order to select the most appropriate cover for you, it may be important to discuss quote details in person. Please leave a contact phone number and best time to call to facilitate this.
Your full name:
Company/Business/Name of Applicant to be Insured:
ABN:
Your phone number (please include area code):
Your mobile phone number:
Best time(s) to call:
Please send my quote by (select at least one):
email phone fax mail
Your email address:
Your website address:
Your fax number:
Your postal address:
Country: