Online Aviation Quotation Request Form

Purpose of use (please tick the appropriate usage)

PRIVATE PLEASURE means use for private and pleasure purposes but NOT use for hire and reward.

BUSINESS means the uses stated in the Private Pleasure and for the purpose of the insured's business but NOT for hire and reward.

COMMERCIAL means the uses stated in the Private Pleasure and Business and use for carriage by the insured of passengers, baggage accompanying passengers and cargo for hire and reward.

INSTRUCTION and RENTAL means instruction of student pilots from ab-initio status upwards:
including advanced instruction/type ratings, rental, lease, or hire by the insured to any purpose, company or organisation for Private Pleasure and Business uses only, where the operation of the aircraft is not under the control of the insured. Rental for any purpose is NOT included under your policy.

CLUB USE

Any other use please state

Area Of Aircraft Operations

UK and Europe

Worlwide

Specific Country (please specify)

Pilot 1

Pilot 2

Pilot 3

Pilot 4

Pilot's Name:

Date of Birth:

Licences/Ratings Held:

Total Hours:

Hours on Type:

In addition to the pilots stated do you require other people to fly the aircraft?
If so what would be their age/minimum experience? (e.g. minimum 500 hours)

Have you or any pilot who will fly this aircraft ever had an accident or suffered any losses? (give details)

Is the aircraft Hangered?

Where is the aircraft based?

How long have you owned this aircraft?

How many hours do you expect to fly in the next 12 months?

Is the aircraft insured at present?

If so, what is the expiry date?

Who is your current broker?

Is there a finance company involved?

Who maintains your aircraft?

Additional Information

Renewal date for home/car insurance?

Renewal date for other aircraft related insurance

Renewal date for business/other insurance policies

Have you or any of the pilots ever been reported to the CAA for an accident/incident or been prosecuted for a flying related offence?

Have any of the pilots named been involved in an incident involving theft or accidental damage of any aircraft?

Have any of the named pilots/proposer been convicted of fraud, theft, arson or any other offence involving dishonesty?

Would you like information on Travel Insurance for Pilots?

Declaration

By submitting this form I hereby declare that to the best of my knowledge and belief the answers to the foregoing questions are true and complete and that I have not withheld any information which might influence the decision of the Insurers with regard to this proposal. I agree that this proposal and declaration shall be the basis of the Contract between me and the Insurers if a policy is issued.

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