Boat Insurance Claim Form

Postal Details

Authorised Contact

What is your entitlement to an input Tax Credit in respect of:

What Happened Photos

2MB file size limit (per file)

What were the weather conditions at the time of the incident:

Postal Details

Provide Details

If yes, please provide details.

Other party 1

Other party 2

If this incident involved another boat or vehicle please provide:

Boat/Vehicle 1

Boat/Vehicle 2

Witness 1

Witness 2

If yes, provide details

Have you ever...

Please provide full details of your loss. If there is insufficent space below please show additional details at the end of this claim form.

Item 1:

What you need to do:

• Take every reasonable precaution to prevent further loss, damage, cost or liability;
• Notify the police as soon as possible if the incident involves injury, theft, attempted theft, malicious acts, or impact by a boat or vehicle;
• Notify us as soon as possible about the claim;
• Assist us to manage the claim. This may include us inspecting your boat, interviewing you, or you providing written statements to us under oath;
• Provide us with all reasonable proof that we require in respect of lost or damaged items claimable under this policy;
• Keep items that have been damaged and make them available for inspection or assessment of repair costs;
• Allow us to take possession of damaged property that is the subject of a claim.

You must not:

• Admit guilt, fault, or liability (except to the Police);
• Approve any repairs or arrange replacements (other than emergency repairs reasonably necessary to protect your boat against further loss or damage);
• Dispose of any damaged property.

• I/We will notify Nautilus Marine immediately where this claim is for lost or stolen property and any of it is found.
• I/We certify that the information given in this form is truthful accurate and complete. No information likely to affect this claim has been withheld.
• I/We understand that this claim may be refused if information is untrue, inaccurate or concealed.
• I/We authorise Nautilus Marine to give to, or obtain from, other insurers or any insurance reference bureau, any information relating to this claim or any other claim made by me/us or any insurance held by me/us.

Please use this area to provide any additional details in relation to this incident.

Please upload a Diagram of Incident