Marine Cargo Questionnaire

Transcription

1 Helvetia Swiss Insurance Company Ltd, St.Gallen Marine Cargo Questionnaire 1. Actual situation 1.1 Policy Holder Name: Street / no.: Postcode / Town: Responsible person for insurance matters: Insured firms with name and adress (in addition to the policy holder): 1.2 Broker (if existing) Name: Street / no.: Postcode / Town: Contact Person: 1.3 Designated local insurer (if applicable) Name: Street / no.: Postcode / Town: Contact Person: 1.4 Nature of goods / species Details on the business activity: If available, please enclose to this questionnaire copy of your product brochure / s. 1 / 8

2 1.5 s turnover (please indicate currency) Previous year: Estimated for the following year: 1.6 Value of the goods / species shipped (please indicate currency) Domestic Intercompany Third Parties Intercompany Third Parties EU/EFTA Other Europe Total Europe USA /Canada Central- / South America Far East Middle East Other Asia Total Asia Australien Ozeanien North- / South Africa Other Africa Total Africa TOTAL 1.7 Delivery conditions Intercompany Third Parties Intercompany Third Parties CIF or similar FOB / ex Work other conditions 1.8 Packing Carton Bags Cases Bales goods are suitable packed and protected for transportation goods are unpacked Stowage Container Pallets 1.9 Method of transit Intercompany Third Parties Intercompany Third Parties Railway Truck Seafreight: container conventional Airfreight 2 / 8

3 1.10 Transits covered in a property insurance Inland transit Deductible in the property programme: Deductible in the property programme: Deductible in the property programme: 1.11 Scope of your current insurance Please provide with a copy of your existing Marine Cargo Policy or answer the following questions. Insured shipments: Intercompany shipments Existing coverage: Restricted cover All Risks War/Strike/Civil commotion Maximum limit for: anyone conveyance: seafreight: airfreight: railway / truck: postal sendings:: fairs / exhibitions: Internal movements (handling) in warehouses: carriage by own vehicles: warehouse: accumulation (in any port /place) average value per transit: Deductible: Premium rate: 3 / 8

4 1.12 Contract status Termination of the contract: Contract has been already terminated as per: 1.13 Statistics (please indicate currency) Your current insurance company or your broker will supply the premium/loss statistics on request, if you do not have these figures at hand. Year Premium paid Claims paid Claims pending Total of incurred claims Total Further claim information (if available): loss amount per claim number amount number amount number amount up to to over Main origin / causes of major losses (if available): specified accidents (general average, jettison, fire, explosion, lightning, hurricane (windspeed in excess of 100 km per hour), falling of goods during loading, transhipment or discharge, etc.) political risks (war, strike, civil commotion) damages (rough handling, inadequate or insufficient packing / shipping) wetness (seawater, sweet water, etc.) weather influence (humidity of the air, influence of temperature) lost (burglary,theft, disappearance) 1.14 Other Insurances Luggage Insurance Collection of samples If you have already an Marine Cargo policy, please provide a copy of the existing policy (s) as well as the premium / loss statistics for the last 3 years. If you don t have these numbers yourself, please ask your Insurer or Broker for assistance Insurance certificates yes Number per month: Issued by: Broker Insurer Ourself no 4 / 8

5 2. Deductible 2.1 Please indicate currency: USD EUR or 2.2 Interests to be insured Intercompany shipments Transportations to / from packaging / processing firms Repair- / return-shipments (free delivery i.e. in guarantee or compensation / refusals) Trade fairs / exhibitions up to 30 1) days: countries domestic number per year 1) Longer stays / periods can be arranged: Transportation related stays over : 60 days 90 days Internal movement (handling) in own and / or third warehouses In-house transportation / manipulations / movements Montage Investment goods Demonstration and maintenance / service material Travel baggage during business travels If yes: numbers of insured persons: geographical extend: domestic worldwide Collection of samples If yes, how many collections are available: geographical extend: domestic Other: 5 / 8

6 Coverage for Warehouses No, the storage risk is covered under the property insurance Yes, full insurance cover requested: please fill in the following schedule Type of warehouse 1 = own 2 = freight forwarder 3 = other Place Average storage value Max. storage value Average storage period, number of days Max. storage period, number of days If possible, please indicate details of location / s, construction, security, fire protections, etc. If the warehouses have been surveyed recently we kindly ask you to enclose to this questionnaire copies of the survey reports. 2.3 Coverage required Restricted cover All Risks War/Strike/Civil commotion Costs for clearing, cleaning and salvage Additional costs occuring in a claim Subsidiary insurance Other: 2.4 What deductible per loss do you want to take over? no deductible / 8

7 2.5 Required limits Maximum limit for : anyone conveyance: seafreight: airfreight: railway / truck: postal sendings (please specify the typ of transport i.e. receiving against signature or without signature) fairs / exhibitions: internal movements (handling) in warehouse: carriage by own vehicles: warehouse: accumulation (in any port /place) collection of samples: luggage insurance during business trips: average value per transit: 2.6 Which insurance value should apply? Buy / sell price (billing value plus costs for freight) 2.7 Which registration procedure do you want? Annual sales turnover reported every year, latest: Individual registration of every single shipment 2.8 Do you need further insurance? Collection of samples Luggage insurance 2.9 Policy period Inception: Expiry: Cancellation period: 7 / 8

8 2.10 Are there any additional points which could be important in respect of Marine Cargo Insurances (special needs, etc.)? 2.11 This Enquiry Form was filled in: by: Date: / 8