Boat Claims

Claim Form - Boat

DD slash MM slash YYYY
Type of Claim
Where did the incident occur?
Name of person operating the boat
DD slash MM slash YYYY
Is it alleged that any person involved in this incident was under the influence of alcohol or a drug?
Details of Items Damaged, Lost or Stolen(Required)
Purchase Date
Replacement Value
Have you reported the incident to police?
Was another party injured or their property damaged in this incident?
Witness Details- Name
DD slash MM slash YYYY
Drop files here or
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