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  Insurance Quote  
 
AIRCRAFT RISK QUESTIONNAIRE


You want aircraft insurance with better guarantees at the best price. We offer tailor-made insurance cover :

  • Liability (for damages incurred by passengers and third parties)
  • Hull insurance (for damages incurred by your aircraft)
  • Personal accident insurance for bodily injury suffered by the pilot (cover afforded to a named pilot or the pilot seat, depending on your choice).

Please fill in the following form and we will send you our best quote as soon as possible.

About you About the aircraft About the coverages About the pilot(s)  
 
Club / Commercial operator  
* NAME  
* First name  
Address / City / Post code  
* Country  
Day phone  
* Cell phone  
Fax  
* Email  
Occupation/business  
Date of birth  
  About the owner and the operator of the aircraft
Who is the operator of the aircraft ?  
* Is a trustee or a financial organisation involved in the aircraft finance or ownership?  
If yes, please write down their name and address in full  
* Does a financial institution have a financial interest in the aircraft ?  
If yes, please specify name and address  
If the aircraft is financed or mortgaged, please indicate the mortgage value or loan amount (including currency)  
Does the financial institution have any insurance requirements (additional insureds’ clause, Breach of warranty, AVN67B…), and if so, which ones ?  
tell us whom we should contact and how we should contact them for further information concerning the financial institution’s insurance requirements :  
 
 
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© Air Courtage Assurances 2008