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    Aviation Insurance Proposal Form

    Uploaded by

    bestontheka
    This aviation insurance proposal form requests information about an applicant's aircraft, safety equipment, personnel, maintenance, and operations. It asks for details on the make, model, and value of aircraft, as well as pilot experience and training. Information is also requested on the applicant's financial backing, route network, and estimated passenger and flight numbers. The form notes that non-disclosure of material facts may allow insurers to void any resulting policy.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Aviation Insurance Proposal Form

    Uploaded by

    bestontheka
    55 views4 pages
    This aviation insurance proposal form requests information about an applicant's aircraft, safety equipment, personnel, maintenance, and operations. It asks for details on the make, model, and value of aircraft, as well as pilot experience and training. Information is also requested on the applicant's financial backing, route network, and estimated passenger and flight numbers. The form notes that non-disclosure of material facts may allow insurers to void any resulting policy.

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    AVIATION INSURANCE PROPOSAL FORM

    Original Title

    AVIATION INSURANCE PROPOSAL FORM

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    This aviation insurance proposal form requests information about an applicant's aircraft, safety equipment, personnel, maintenance, and operations. It asks for details on the make, model, and value of aircraft, as well as pilot experience and training. Information is also requested on the applicant's financial backing, route network, and estimated passenger and flight numbers. The form notes that non-disclosure of material facts may allow insurers to void any resulting policy.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    55 views4 pages

    Aviation Insurance Proposal Form

    Uploaded by

    bestontheka
    This aviation insurance proposal form requests information about an applicant's aircraft, safety equipment, personnel, maintenance, and operations. It asks for details on the make, model, and value of aircraft, as well as pilot experience and training. Information is also requested on the applicant's financial backing, route network, and estimated passenger and flight numbers. The form notes that non-disclosure of material facts may allow insurers to void any resulting policy.

    Copyright:

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    AVIATION INSURANCE PROPOSAL FORM

    SCHEDULE OF AIRCRAFT
    Name of Insured: _____________________________________________________________

    Address of Insured: ____________________________________________________________

    Make and Model:______________________________________________________________

    Serial Number & Registration: ____________________________________________________

    Seating Capacity:_______________________________________________________________

    Agreed Values: ________________________________________________________________

    If the aircraft is leased who is the lessor? ____________________________________________

    Planned fleet changes detailing aircraft type and estimate attached dates in the policy period:
    _______________________________________________________________________________

    Date of last C&D check and who performed such work:

    (not applicable for new aircraft) ______________________________________________________

    SAFETY
    What Safety equipment is installed on each aircraft?

    TCAS: __________________________________________________________________________

    Windshear detection system: _______________________________________________________

    (E) GPWS: _______________________________________________________________________

    Other: __________________________________________________________________________
    What percentages of flights are captured?
    _______________________________________________________________________________

    What percentage of flights are analysed? ______________________________________________

    AIRLINE BACKGROUND (including key personnel)


    Details of the airlines financial backing: __________________________________________________

    __________________________________________________________________________________

    Who are the senior personnel within the airline and what airline experience do they have?

    (Specifically the, CFO, Chief pilot, Head of Maintenance and Safety officer)
    __________________________________________________________________________________

    __________________________________________________________________________________

    __________________________________________________________________________________

    ROUTE
    Route Network: ____________________________________________________________________

    Is the operation scheduled or charted or both?____________________________________________

    Scheduled %: _______________________________________________________________________

    Charter %: _________________________________________________________________________

    OPERATIONS
    Estimated number of passengers for the next 12 months: ___________________________________

    Estimated number of aircraft departures for the next 12 months: _____________________________

    Estimated nationality of passengers: ____________________________________________________

    Estimated load factor:

    FLIGHT CREW
    What is the minimum pilot requirements for captains and first officers both total hours and hours on
    aircraft operated? ___________________________________________________________________

    Please give a list of all pilots with hours broken down by type flown:
    __________________________________________________________________________________

    __________________________________________________________________________________

    __________________________________________________________________________________

    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________

    Who provided flight crew training and what does this contain?
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________

    MAINTENANCE
    Who provides maintenance for:

    Line maintenance: __________________________________________________________________

    A to D checks: ______________________________________________________________________

    Engines: ___________________________________________________________________________

    Will third party maintenance be performed? If so to whom and what work will be performed

    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________

    __________________________________________________________________________________

    If the airline perform their own maintenance please give details of engineers:

    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________

    Signing this proposal does not bind the proposer to complete the insurance

    NON - DISCLOSURE CLAUSE

    Please note that under English law it is your duty to disclose all material facts to Insurers/Reinsurers
    prior to inception of the policy, and to keep them advised of any such facts or changes to such facts
    throughout the currency of the policy, and upon renewal of the policy. A material fact is a fact which
    may influence an Insurer’s/Reinsurer’s judgement in their assessment of a risk. If you are in any
    doubt as to whether a fact is material, we recommend that it be disclosed. Failure to disclose
    material facts may entitle Insurers/Reinsurers to avoid the policy from inception.

    Print Name: ________________________________________________________________________

    Position: __________________________________________________________________________

    Signature: _________________________________________________________________________

    Date: _____________________________________________________________________________

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