Hunter MH37 - Page 34

Documents and Forms
2.14
For each question below, please provide answers IF APPLICABLE AND IF KNOWN, otherwise leave blank.
ACCIDENT DETAILS – ACTIVITIES AND OPERATIONS ON YOUR BOAT
OPERATOR/PASSENGER ACTIVITIES
Operator/passenger activities on your boat at time of accident:
Activities were VHOHFWRQH Operator/Passenger activities VHOHFWDOOWKDWDSSO\
Recreational
Fishing
Tubing
Starting engine
Commercial
Hunting
Water Skiing
Making repairs
White water activity HJUDIWLQJ
Relaxing
Other OLVW
BOAT OPERATIONS
Your boat operations at time of accident VHOHFWDOOWKDWDSSO\
Cruising XQGHUZD\XQGHUSRZHU
Drifting
Racing
Towing another vessel
Changing direction
At anchor
Rowing/paddling
Launching
Changing speed
Being towed
Docking/undocking
Tied to dock/mooring
Sailing
Other OLVW
ACCIDENT DETAILS – CONTRIBUTING FACTORS ON YOUR BOAT
CONTRIBUTING FACTORS
Indicate factors on your boat which may have contributed to this accident VHOHFWDOOWKDWDSSO\
Alcohol use
Improper lookout
Dam/lock
Starting in gear
Drug use
Operator inattention
Force of wake/wave
Sharp turn
Excessive speed
Operator inexperience
Hazardous waters
Restricted vision HJIRJ
Improper anchoring
Language barrier
Heavy weather
Mission/inadequate aids to
navigation HJEXR\GD\PDUNHU
Improper loading
Navigation rules violation
Ignition of fuel or
vapor
Inadequate on-board navigation
lights
Overloading
Failure to vent
Hull failure
People on gunwale, bow or transom
Other GHVFULEH:
ACCIDENT DETAILS –YOUR BOAT
MACHINERY/EQUIPMENT FAILURE
Failure of the following machinery/equipment on your boat contributed to this accident VHOHFWDOOWKDWDSSO\
Engine
Onboard lights
Shift
Sound equipment HJKRUQZKLVWOH
Electrical system
Seats
Radio
Auxiliary equipment
Fuel system
Steering
Fire extinguisher
Other (OLVW):
Sail/mast
Throttle
Ventilation
Onboard navigation aids HJ*36
ACCIDENT DETAILS – EVENTS ON YOUR BOAT
ACCIDENT EVENTS
Types of events occurring to/on your boat during accident VHOHFWDOOWKDWDSSO\
Collision with recreational boat
Flooding/swamping
Person fell overboard
Collision with commercial boat HJWXJEDUJH
Fire/explosion – fuel
Person fell on/within boat
Collision with fixed object HJGRFNEULGJH
Fire/explosion – non-fuel
Sudden medical condition
Collision with submerged object HJVWXPS
FDEOH
Carbon monoxide exposure
Person struck by boat
Collision with floating object HJORJEXR\
Mishap of skier, tuber, wake
boarder, etc.
Person struck by propeller or propulsion
unit
Capsizing
Person left boat voluntarily
Person electrocuted
Grounding
Person ejected from boat FDXVHGE\FROOLVLRQRUPDQHXYHU
Sinking
Other GHVFULEH
CG-3865 (1/11) Page 3 of 6