Get Your Boat Insurance Quote

We Cover all 50 States!

As an independent marine broker, I can shop around to get you the best options for your needs.

Fill out the form below, and I’ll send you a competitive, custom quote to fit your needs. I'll be in touch within 24 hours.

How to Apply

Use our online form, or downloadable application below. Have all of your boat docs and information handy - it'll go even faster!

Have Questions?

I’m here to help! Email: billy@boatcoverage.org Phone: (252) 570-8535

Download Application Form

Click below to download and fill out the application.
When completed, resave and rename the file: "Your Name"-Billy Cox Boat Insurance Application.PDF.
Next click to Upload and choose attach your application file.
Then click Submit Upload and you are done.

You can also email your completed application to billy@boatcoverage.org.

DOWNLOAD APPLICATION

UPLOAD APPLICATION

(Your full name) application.pdf

SUBMIT UPLOAD

Online Application Form

Please answer ALL questions, (Those marked with a * are mandatory). Write N/A for anything that does not apply to you.

Particulars of Prosper

Owner of the Vessel:

First name

Last name

Phone

If non-US citizen, do you have a U.S. mailing address?

Yes

No

Are you a homeowner?

Yes

No

Date of Birth

Month

Day

Year

Email

Multi-line address

Country/Region

Address

City

Zip / Postal code

Occupation

Boating Experience (Years)

Boating Qualifications

Have you owned any previous vessels?

No

Yes

Other Boat Operators

Name, Date of Birth, Address, Boating Experience (Years), Boating Qualifications

Particulars of Vessel

Name of vessel

Date of last survey, Name of surveryor

Serial / Hull Number

Year Built

Price Paid

Length

Manufacturer

Model

Particulars of Vessels Main Engine(s)

Manufacturer

Model

Year Built

Horsepower

Number of Engines

Type of Fuel

Diesel

Gasoline

Serial Number

Maximum Designed Speed (Knots)

Particulars of Tender/Dinghy/Life Raft

Do you want an individual policy for your tender, dinghy, or life raft?

Yes

No

Serial/Hull Number, Manufacturer, Model, Length, Year Built, Purchase Date, Purchase Price

Does it display parent vessel's name?

Yes

No

Particulars of Tenders Outboard Motor

Manufacturer, Model, Year Built, HP, Fuel, Serial Number,

Outboards locked to transom or stored in locked premises when not in use?

Yes

No

Particulars of Trailer

Make/Model, Age, Value (Include Currency), Serial Number

Is the trailer fitted with a wheel clamp?

Yes

No

Is the trailer stored in a locked building?

Yes

No

Safety Equipment

Number of Handheld Fire Extinguishers

Location of Automatic Fire Exinguishers

Engine

Tank Space

Galley

Other

Gas System

Cruising Itinerary

Please give full details of your Cruising Itinerary

Mooring Location

If absentee owner; who watches over the vessel, Name of Location, Type of Mooring Used, Laid up location, Laid-up Dates: (From: date To: date)

Is the vessel stored ashore every day after use?

No

Yes

Sums to be Insured

Please List The Type of Currency and Amount of Value for each of the following: Hull/Machinery/Gear/Equipment: (Items that come as standard) Tender and Outboard, Trailer (Include Serial Number with Currency and Value)

Please list the type of currency and amount of value, for all items you wish to cover in the two following categories: 1- Personal Effects, 2- Portable Navigation Equipment

Please add up all of the values from the previous two questions and list the total here

Liability

Please list type of currency & value amount for the following: Third Party Liability (amount required for your area), Uninsured Boater, Medical Payments, Captain & Crew Liability (Employed) Passenger Liability (paying passengers for commercial operations)

Coverage Required

Please put a checkmark by all types of coverage you want for your boat and answer any questions that apply

Types of Insurance

Fully Comprehesive (If checked, the sums to be insured box above must be completed)

Third-Party Liability only

Private and Pleasure only

Commercial Cover (If Yes, choose type below, if not shown, please advise usage)

Bareboat Charter

Captain Charter

Fishing Charter

Other

In-Water Activities (Commercial operations only. Covers passengers only while swimming/snorkeling with a buoyancy aid)

Yes

No

Commercial Passenger Liability

No

Yes

Employed Captain and Crew Liability

No

Yes

Endorsements

Please put a checkmark next to all endorsements that you need.

Breach of Warranty

No

Yes

Commercial Fishing

No

Yes

Racing Risks

No

Yes

Storm Cover Beaufort Scale Force 12+ (All Storm Cover - Includes Named and Numbered storms).

No

Yes

Declaration

Have you or any person who may use this vessel with your permission ever had any of the following?

Insurance on any vessel declined or special terms imposed

No

Yes

Any accident or losses in respect of any vessel

No

Yes

Have you ever been charged with or convicted of any offense involving dishonesty?

No

Yes

Is the vessel the subject of any mortgage or financial agreement?

No

Yes

Are you the sole owner of the vessel?

Yes

No

Do you have any disabilities of illnesses that may affect your ability to operate your vessel?

No

Yes

Preferred cover start date, Previous/current insurance company, No claims years bonus

Welcome Aboard! We're thrilled to have you as part of our marine insurance family!

Anchors Aweigh

Ready for safe fun on the water? We'll map out your coverage so that you are ready to set off on your next adventure with confidence and peace of mind.

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