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AD&D - Pilot Disability Questionnaire
The underwriters have found that in order to determine the amount of risk involved in your piloting activities, certain questions must be answered. Depending on your answers, your application may be "rated" do to the extra risk involved in your activities.
Below is a list of the questions which are asked on application when the insured is a pilot. It is important to answer the questions honestly so that there would be no claims issues should you be involved in an accident.
This information is provided here for educational and informational purposes. Should you submit an application and the underwriters would deem it necessary to gather further flight details, you will then be asked to complete a questionnaire with questions similar or the same as those below.
In addition to name, date of birth and piloting experience in hours, the following questions will be asked. Should you answer yes, you will need to provide full details.
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As Pilot or Copilot |
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Estimate
Next 12 Months |
In Past Year |
1 to 2
Years Ago |
| As student in training |
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| For business reasons |
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| For pleasure |
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| As flight instructor |
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| Non-scheduled in company owned planes |
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| Non-scheduled on chartered flights |
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| Military (specify brand of service) |
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| Testing or experimental flights |
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| Agricultural flying |
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| Civil air patrol, mapping, surveying, etc. |
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| Overseas flying |
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| Other |
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| If Agricultural pilot, indicate agricultural flying experience in hours |
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- Pilot Certificate Currently Held: Student Private Flight Instructor Commercial Instrument Flight Rating Airline Transport Rating (ATR) Rotocraft Multi-Engine
- Date of Issue
- Date of Last License Renewal
- Date of Last FAA Biannual Exam
- Date of Last FAA Biannual Class
- Date of Last Flight as Pilot
- Have you ever been in an aircraft accident?
- Have you ever had your pilot's license suspended?
- Do you contemplate a change in your present flying activity?
- Give details to any yes answer:
- Remarks--include description and models of aircraft being flown:
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Last updated on: 07/18/2008
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