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a division of Coastal Insurance Agency

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Simply complete the form below, and we'll be in touch soon!

Number of Operators

Number of Vessels

Include Trailer? *

Yes

No

Include Trailer? *

Yes

No

Have you taken a boater safety course? *

Yes

No

Do you have an existing boat insurance policy? *

Yes

No

Have you filed a claim on any owned vessels in the last 5 years? *

Yes

No

Please provide the details of the claim(s) to include month/year, cause of loss, total payout, and anything that was done to mitigate similar losses in the future

Please provide any additional information that might be useful during the quoting process

Thank you!

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