Wniosek o ubezpieczenie pontonu

Składka ubezpieczenia zależy od kraju stałego pobytu właściciela. Proszę o wpisanie danych i wybór kraju. Dopiero wtedy pojawi się kwota w okienku składka.

Niniejsze ubezpieczenie obejmuje wyłącznie ryzyko dotyczące użytkowania pontonu do celów prywatnych.

Application form dinghi insurance new

First and last name (must be the owner of the dinghi)*
Please fill-out the fields and choose the insurance you want. You build your own insurance cover. Note that every insurance product is insuring different risks. The terms and conditions can be found in downloads.
Imię Nazwisko
Address*
Ulica Dodatkowy wiersz adresu Miasto Województwo / Stan / Prowincja / Region Kod pocztowy Kraj
Birthday of the insured*
DD ukośnik MM ukośnik RRRR
Phone*
Email address*
Wpisz adres e-mail Potwierdź adres e-mail
Unique ID
Who is the producer of the dinghi?*
What is the dinghi type?*
Please fill-out the boat type. For instance: Lagoon 52
Build year of the dinghi?*
Cruising area*
How much horse power does your dinghi have?*
Producer and type of the outboarder?*
Serial number of the outboarder*
Dinghi third party liability insurance*
The premium of the jetski third party liability insurance is depending on the horsepower of the jetski. Note: if you are using your jetski in Italy, then you need € 10.000.000,- insured sum.
Third party liability premium
Here you can see the premium according to your data, you have written in the application form.
Cena:
Worth of the dinghi according invoice (new worth):*
Please write the worth of the jesski, if you want to insure also the hull insurance. Otherwise please delete the worth.
Dinghi hull insurance*
Please choose if you want to have a hull insurance or not.
Dinghi hull insurance premium
The premium of the hull insurance is depending on the worth of the jetski, written in the invoice.
Cena:
Sum
Total sum of jetski hull insurance and jetski third party liability insurance.
0,00 €
Terms of Service*
I agree, that I read the terms and conditions of the insurances YACHT-POOL dinghi insurance terms and conditions and the Conditions of business and that I accept them. The insurance can´t be canceled if the insurance period already started.
With confirmation you will be forwarded to the payment screen.
- I agree to the Terms of Service
Please proceed for payment and automatical insurance confirmation after payment.
Phone
To pole jest używane do walidacji i powinno pozostać niezmienione.

Wniosek o ubezpieczenie pontonu

Wniosek o ubezpieczenie pontonu

Application form dinghi insurance new

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