Leisure Yacht Insurance 1 Personal Details 2 Yacht Details Name* First Last Email* Telephone (Landline)*Mobile*Address* Emirates / City*Select a CityAbu DhabiAjmanDubaiFujairahRas al-KhaimahSharjahUmm al-QaiwainPO Box Period of Insurance requiredFromDay12345678910111213141516171819202122232425262728293031Month123456789101112Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920ToMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Boat make and manufactureBoat TypeBoat TypeMotor BoatSail BoatOtherBoat Built YearEngine MakerType of EngineInboundOutboundBoat Length (in Meters)Depth (in Meters)Breadth (in Meters)Maximum Speed (in Knots)Sum InsuredValue of HullValue of MachineryUse Operator’s Experience Cover OptionDo you have a Current PolicyYesNoIf yes, With Whom?Have you suffered any losses in the past years (Claims experience)YesNoif Yes, then claim history for last 5 yearsAdditional Cover RequiredPersonal AccidentPersonal EffectHas any insurer ever declined to insure youYesNo