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 Boat/Watercraft Insurance Quote 
In order to provide you with a quote and to determine your eligibility for our programs that we offer through various carriers, our agency and/or companies we represent may use information contained in credit, MVR reports, insurance loss history, and other various consumer reports.  In order to provide you with a quote, our carriers may also develop a credit-based insurance score using these reports and sometimes this is accomplished by using a third party.  For additional information on collection and disclosure of personal information, and your right to see and have the opportunity to correct any personal information in your files, please contact our office.   The reports provide us and/or our carriers with information that assists with determining your eligibility for insurance and the final price you are charged.  By completing these forms, you agree to this process in making a request for a quote.
Owner Information
Full Name
 *
Street Address
 *
City
 *
State
 *
Zip
 *
Daytime Telephone
Evening Telephone
Email Address
Current Insurance Information
Insurance Company Name (Not Insurance Agency/Broker)
Policy Expiration Date
Term
Premium Amount
How Long with Current
Boat/Watercraft Information
Year
 *
Make
 *
Model
 *
Length
 *
Value
 *
Horsepower
 *
Maximum Speed
 *
Type of Hull
 *
Body Style
 *
Power Description
Engine One - Year/Make/Model
 *
Engine Two - Year/Make/Model
Trailer Description
Year
Make
Model
Operator(s) Information
Operator One Name
 *
Date of Birth
 *
Drivers License Number
Any Motor Vehicle Citations in Last 3 Years?
Completed Approved Safety Course?
Operator Two Name
Date of Birth
Drivers License Number
Any Motor Vehicle Citations in the Last 3 Years?
Completed Approved Safety Course?
Additional Information
Requested Limits of Liability
Original Owner
Any additional comments or information that might be helpful:
By completing this form you are acknowledging your understanding of and agreement with the following terms:
1. No coverage of any kind is bound or implied by submitting information via this online form
2. Information from you and other sources such as your driving claims and insurance histories may be used to calculate an accurate price for your insurance.
3. We will not distribute information to other parties other than for insurance underwriting purposes.
4. We value your privacy. Every precaution has been taken to insure your privacy and security.
5. By submitting this form you agree to release us from any liability should this information be accidentally viewed by others.
Security code:
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Call 1-800-352-3416

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We currently provide insurance services in: 
  • North Carolina
  • South Carolina
  • Virginia

    Please note: Changes to policies via this website are not effective or binding until you, or any party involved, receive official notification from your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

    First Casualty Insurance Group, Inc.
    190-A Turner Street
    Southern Pines, NC 28387
    1-800-352-3416
    fciginfo@fcignc.com
     
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