Insurance Boat Policy

INSURANCE BOAT POLICY

Policy Identification

Policy Number:     Issuing Agent/Broker:

Policy Period From:    To:    Renewal Type:

Named Insured / Contact

Date of Birth:    Phone:    Email:

Vessel Description

Vessel Name:    Make / Model:

Year:    Hull Identification Number (HIN):

Length:    Engine Make/Model:    Horsepower:

Propulsion Type:    Home Port / Mooring:

Policy Coverages (Select applicable coverages and state limits)

Hull Coverage (Agreed Value): $

Liability Coverage (Bodily Injury & Property Damage) — Limit per occurrence: $

Medical Payments — Per person limit: $

Personal Effects — Limit: $

Towing & Assistance — Aggregate limit: $

Pollution Liability — Limit: $

Uninsured/Underinsured Watercraft Coverage — Limit: $

Deductible, Premium & Payment

Beneficiary / Loss Payable

Relationship:    Percentage:

Exclusions, Warranties & Acknowledgements

The insurer will not be liable for loss or damage caused by wear and tear, gradual deterioration, mechanical breakdown, freezing unless due to insured peril, intentional acts by the insured, war, or use of the vessel for commercial hire unless specifically endorsed. Operation while intoxicated or in violation of law voids coverage for resulting loss.

The named insured warrants that the vessel will be maintained in a seaworthy condition and that all required navigation and safety equipment (including life jackets, fire extinguishers, and required signaling devices) will be carried when the vessel is underway. Failure to maintain required equipment or to comply with warranties may result in denial of a claim.

Acknowledgement of Exclusions and Warranties: I acknowledge I have read and understand the exclusions and warranties contained herein.

Navigation Limits / Endorsements (if any):

Conditions — Claims, Cancellation & Subrogation

Notice of loss: In the event of loss, the insured must give immediate notice to the insurer or agent, protect property from further damage, and furnish a detailed proof of loss upon request. The insurer may inspect the vessel and salvage any insured property. Failure to provide prompt notice or to cooperate with the insurer may prejudice coverage.

Cancellation: This policy may be cancelled by the insured or insurer in accordance with the cancellation provisions contained in the policy. Premium adjustment upon cancellation shall be computed pro rata unless otherwise provided by endorsement.

Subrogation and Recovery: The insurer shall be subrogated to all the insured's rights of recovery against any party for loss covered by this policy. The insured shall cooperate with the insurer in preserving such rights.

Arbitration: Disputes regarding coverage or claim valuation not resolved by agreement shall be submitted to binding arbitration in accordance with the arbitration provisions of this policy.

Claims Reporting (For reference under this policy)

Date of Loss:    Location of Loss:

Estimated Damage / Loss Amount: $

Documentation submitted: Photos    Police Report    Receipts / Invoices

Declaration and Certification

I, the undersigned named insured, declare that the foregoing statements and answers are true and complete to the best of my knowledge and belief. I understand that this policy (including endorsements) constitutes the entire agreement between the parties. I further acknowledge that coverage is subject to the terms, conditions, limitations and exclusions contained in the policy and any endorsements.

I authorize the insurer to obtain and share relevant loss, claims, and underwriting information as necessary to administer this policy and any subsequent claim. I certify that no material fact has been omitted or misstated in obtaining this coverage, and I agree to notify the insurer immediately of any material change in the risk.

Warning: Any person who knowingly files a false statement or conceals a material fact may be subject to civil and criminal penalties under applicable law.

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