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Business
Aviation
Personal
About
Contact
Proposer Details
NAME
EMAIL
OCCUPATION
STREET/AREA
POSTAL TOWN
POST CODE
Proposer Contact Details
LANDLINE
MOBILE
Owner Details (if different to proposer)
Owner Name
Email
Contact
Street/Area
Postal Town
Post Code
Aircraft Details
Aircraft Make(Type)
Aircraft Model(Variant)
Number of Engines
Engine Type
MTOM (Kg)
Number of Passenger Seats
U/C Type Fixed/Retractable
Registration
Serial Number
Year of Manufacture
Aircraft Value
Aircraft Value (include fixed instruments)
Ancillary Item Values
Headsets Value
Other Items Value (please specify)
Details Of Pilots To Fly This Aircraft
Number of pilots
select Numbers of pilot
1 - 4 named
5 - 10 named
unnamed
club
Pilot Names & Ages (10 pilots or less)
select your num of pilots
1 - 4 named
5 - 10 named
unnamed
club
Qualifications/Hours of least Experienced Pilot to fly this Aircraft
Rotary Wing Hours
Select Rotary Wiing Hours
Zero
less than 200 hours
more than 200 hours
more than 500 hours
more than 1000 hours
Hours on Type
Select Hours on Type
Zero
less than 200 hours
more than 200 hours
more than 500 hours
more than 1000 hours
Turbine Hours
Select Turbine Hours
Zero
less than 200 hours
more than 200 hours
more than 500 hours
more than 1000 hours
Hours on Similar Types
Licence Type
Annual Hours Use
Cover Required
Cover Start & End Dates (all dates in format dd/mm/yy)
Full Flight Risk Start and End Dates
Ground Risk Start & End Dates
Your Demands and Needs
Private & Pleasure
No
yes
Taxy Flights
No
yes
Air Freight
No
yes
Industrial Aid (Business Related Flights)
No
yes
PPL Schooling
No
yes
Training for Higher Certificates
No
yes
Scenic Flights
No
yes
Photography Below 1000ft AGL
No
yes
Competition Flight
No
yes
Dealer/Demonstration Flights
No
yes
Line Inspections Below 1000ft AGL
No
yes
Air Displays
No
yes
Others (describe in comments field)
No
yes
Aircraft Passenger & Third Party Liability
Legal Limit of Liability Will Be Quoted i if higher limit please state below
Important Additional Information About The Aircraft
Aircraft Base/Hangared
Area of Operation (if outside Europe state specific countries)
Any outstanding finance on Aircraft
No
yes
Current Premium/Current
No Claims Discount Amount
No Claims Discount Amount
No Claims Discount Percentage
0%
5%
7.5%
10%
12.5%
15%
20%
25%
30%
35%
Losses/Claims in last 5 years, if yes provide details in further notes
No
yes
Do you have any other insurances you would like a quote on? If so provide details
Has insured ever been declined insurance
No
yes
Further Notes
Has insured ever been declined insurance
By submitting this proposal I hereby declare that to the best of my knowledge and belief that 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 myself and the insurers if a policy is issued.
Submit
Other code
ROTARY WING PROPOSAL
PROPOSER
Name
Email
Occupation
Address Street/Area
Address Town
Post Code
Landline
Mobile
OWNER (if different to proposer)
Owner Name
Owner Email
Owner Contact
Address Street
Address town
Address Post Code
AIRCRAFT DETAILS
Aircraft Make(Type)
Aircraft Model(Variant)
Number of Engines
Engine Type (if fitted):
MTOM (Kg)
Number of Passenger Seats
U/C Type Fixed/Retractable
Registration
Serial Number
Year of Manufacture
SUM INSURED
Aircraft Value
Headsets Value
Other Items Value
PILOTS TO FLY
Number of Pilots
Pilot Names
QUALIFICATIONS AND HOURS OF LEAST EXPERIENCED PILOT
Rotary Wing Hours
Hours on Type
Turbine Hours
Hours on Similar Type
Licence Type
Annual Hours Use
QUALIFICATIONS AND HOURS OF LEAST EXPERIENCED PILOT
Insurance Cover Period
Full Flight Risk
Ground Risk
QUALIFICATIONS AND HOURS OF LEAST EXPERIENCED PILOT
Private & Pleasure
Taxy Flights
Air Freight
Air Freight
Industrial Aid (Business Related flights)
PPL Schooling
Training for Higher Certificates
Scenic Flights
Photography
Limited Competition Flights
Dealer/Demonstration Flights
Line Inspections below 1000 ft AGL
Air Displays
Others(see comments field)
LIABILITY
Aircraft Passenger & Third Party Liability
OPERATIONAL INFORMATION
Operating Base
Geographical Operation
Outstanding FinanceOperation
Current Premium
Current Broker
No Claims Discount Amount
No Claims Discount Percentage
Claims Losses In Last 5 Years
Insurance Ever Declined
OTHER DATA
Other Insurance Quotes Required
Further Notes
By submitting this proposal I hereby declare that to the best of my knowledge and belief that 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 myself and the insurers if a policy is issued.
SUBMIT