woodwork factory module 5 - santam

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Woodwork Factory Module 5

Copyright © Santam Ltd. 2007 Course code: ASSESS123 / Module 5

Copyright © Santam Ltd. 2007 2 Course code: ASSESS123 /Module5

Module introduction LWC Woodworks was taken over by Mr X, the new owner. Currently, Mr X only has a personal policy with a claims ratio of below 30% for the past five years. Since he is highly satisfied with the service of SA Insurers, he approaches you to give him a quotation for his new business. The prospective insured has never had a commercial policy and will therefore ask you a couple of general questions. You inform him that you will have to do a review of the business before you may provide him with a quotation. The following sections are relevant to this case study: • Section: General • Section: Fire • Section: Business Interruption • Section: Theft • Section: Motor • Section: Public Liability • Section: Electronic Equipment and reinsurance After the application form has been completed, Mr X will once again ask you a couple of questions. If you use the following guidelines in relation to this risk, you will be able to complete this module effortlessly. 1. Firstly, read the module thoroughly. 2. Then, complete the questions of Task 1. 3. Study the content of Task 2.

• Complete the inspection reports. • Complete the quotation and recommendation/requirement form. • Complete the application form, as well as the underwriting/clause

form. 4. Now, complete the questions of Task 3.


Module objective The goal of this module is to evaluate your knowledge of the following aspects of a woodwork factory as a risk:

• General questions continually asked when applying for insurance;

• Risk evaluation with the necessary recommendations;

• Completion of an application form and the application of underwriting principles; and

• The answering of questions on possible changes in the risk.

Motivate your answers with the relevant facts throughout to qualify for the maximum allocation of marks as indicated per question. Case study Task 1 1. Mr X wants to know on which day of the month his debit order will be collected. Does

he have a choice or is it on a fixed date? ______________________________________________________________________________

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2. Will he still enjoy cover if his debit order is not collected due to insufficient funds?

Some of his clients may fail to pay their accounts on time, which could lead to a shortage of money in his bank account. Remember that Mr X has recently taken over the business and his cashflow is subject to the payments he receives from clients.

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3. According to an agreement with his bank, he had to insure the machinery on hire-purchase with them. What will happen in the event of a claim?

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4. He is planning to buy another delivery vehicle (LDV) soon. Will he have to inform Santam immediately or will it be covered even though a premium has not yet been agreed to?

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5. Mr X wants to know what the term “first loss basis” means and when does it apply. ______________________________________________________________________________

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6. Mr X wants to know how many days’ notice is required for the cancellation of his

policy.

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7. Mr X wants to know how we go about in determining the gross profit (sum

insured) for Business interruption. Illustrate the two methods in short. ______________________________________________________________________________

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8. The insured wants to know over which period in time we will compensate him for his

loss in profit. Most of his machinery is imported and the period from placing the order to delivery could take up to 18 months. And he also foresees that it could take him a minimum of 6 months to return to normal production after a loss. (Explain in full the indemnification limits / options available to him and give him a direct answer to his unique needs).

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9. Mr X informs you that his rent amounts to R30 000 per month for the two premises. He is worried that the owner of the building may hold him responsible for the rent of the whole premises if for instance a fire hampers production. Under which section should he insure the rent?

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10. Lastly, the insured would like know if he is in terms of Section Fire covered for the wages of his labourers should he not make use of their services for a specific time. He would prefer not to dismiss them, but rather retain their expertise.

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TOTAL

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Task 2 LWC Woodworks approaches you to give them a quotation on their business. They do not have a policy, but have the following amounts available: Value of woodwork machinery R10 000 000 Value of hand tools R 200 000 Value of timber (average on premises) R 550 000 (purchase cost) Value of ready-made products (average on premises) R 200 000 (cost price)

R 250 000 (selling price) Value of spraying rooms (insured’s own property) R 20 000 Value of paint, glue and other mediums R 10 000 Value of office furniture and equipment R 30 000 Average amount of money on premises R 5 000 He wants theft cover for all his hand tools R 200 000 Isuzu 250 diesel bakkie (LDV) R 80 000 Trailer R 15 000 He wants liability cover R 2 000 000 including Products liability R 500 000

Electronic equipment

Description Date of purchase

New value Market value

1x Acer Veriton 3200 computer (serial number 1234)

01/2003 R 5 000 R 3 000


01/2003 R 5 000 R 3 000


03/2004 R 6 000 R 5 000

1x HP colour Laserjet 4500 printer (serial number 000888)

10/2003 R 15 000 R11 000

1x Minolta fax machine (model MF 2800) (serial number 335577)

12/1999 R 8 500 R 3 000

1x Minolta photocopier (model PS 3600) (serial number 336688)

01/1995 R20 000 R 5 000


Turnover for 2004 by previous owner R 10 000 000 Projected turnover for 2005 R 10 833 000 (escalation of 8,33%) Trade account and profit and loss account of previous owner for 2004 are as follows:

Profit and loss account DT CT

Rent for 2 premises R 360 000 Interest on investments R 12 000 Salaries

R1060 000

Profit on investments converted into money

R 2 000

Commission (representative)

R 240 000 Rent received (Store in Pretoria)

R 60 000

Electricity R 36 000 GROSS PROFIT R5 602 000 Vehicle costs R 120 000 Telephone costs R 12 000 Delivery costs R 360 000 Discount granted R 100 000 Advertising costs R 24 000 Auditor’s fees R 70 000 Insurance R 50 000 Interest (overdraft bank account)

R 14 000

Pension fund contributions

R 70 000

Legal costs R 30 000 Depreciation R 100 000 Bad debt R 30 000 NETT PROFIT R3000 000 TOTAL R5676 000 TOTAL R5676 000

Trade account Opening stock Purchases Discount Gross profit

R 3 000 000 R 3 298 000 R 100 000 R 5 602 000

Turnover Closing stock

R10 000 000 R 2 000 000

Total R12 000 000 Total R12 000 000 You inform him that you have to do an overview before you could give him a quotation. Use the site layout and visual material to evaluate the risk.


SITE LAYOUT

DRAIN FIRE EXTINGUISHER FIRE HOSE

C O N S T R U C T I O N : WALLS: BRICK ROOF : CORRIGATED IRON

YARD YARD

SPRAY BOOTH

SPRAYBOOTH

WORKSHOP 2 (BUILDING 2)

WORKSHOP 1 (BUILDING 1)

OPENING

CLOAKROOMS & OFFICES (LOW & UPPER LEVEL)

STREET

YARD


Inspection reports Complete the following inspection reports to determine the risk. The sections on which no information was made available in the visual material, site layout or other information pieces have already been filled-in or marked as “N.A.”. Take note: Where “N.A.” is marked on the inspection report, it does not necessarily imply that it is “not applicable” to all similar risks. It is only “not applicable” to this specific risk/case study.

FIRE SURVEY REPORT

TO: ………………………………………….…… FROM: …………………………………………… BRANCH: ………………………………….…… SURVEYOR: ….…………………………...…… DEPARTMENT: ………..……………………… SURVEY NUMBER: ………..…………………. REFERENCE: ………….……………………… DATE: ……..………………….…………………. DATE: ……..……………………………………. Name Address Postal code Occupation Area class: ( ) Retention class: Construction class: GENERAL DESCRIPTION Locality Industrial Commercial Closed Shopping Centre Residential Other Details (if other)

Construction Roof Reinforced Concrete Corrugated Iron Tiles

Thatch Saw tooth Details other

Box guttering Condition of gutters Good Poor Skylights Plastic Fibre glass Walls Reinforced concrete Brick I.B.R. Details other Is building older than 10 years? YES NO r No. of floors No. of basements Construction of floors Concrete Timber Condition of premises Good Average Poor Adjacent exposure Low r Average Poor Rivers/Canals Debris Block-up Detail (Type of exposure) Adjacent Risk Communcates YES NO r Seperation by Security Chain link fence 2m Wall Access Control

Street lights r Floor Lights 24hr Security Electric Perimeter fence

S.A.I.D.S.A. Corporate Alarm Other Alarm - Name


Electrical Municipal supply Eskom Supply

Contact Breakers Condition appears to be- Good Otherwise

Flexible extenstion leads noted YES NO r

Are plug points overloaded? YES NO

Process (if major process involved, attach on separate sheet)

None Storage/Retail/Distribution only

Heat Process/Welding/Grinding Flammable liquids Quantity

Flammable liquid store – brick under concrete slab YES NO

LP Gas installation ons site Number of cylinders Size …………………KG

Is wall block manifold in good condition YES r NO

All goods stored on racking or pallets Ja Nee If ‘Yes’, height of floor ……………..mm

Construction of racking Timber Steel

Storage Neat, tidy and well organised Ja Nee

Risk congested Disorganised Untidy

Spray painting (detail) Deep fat cooking

Grease extraction filters clean YES NO

Fire Protection

Local Fire Brigade ( ) would attend any ourbreak of fire Fire Station is = …………15…………kms from risk

Appliances on Site – hand held YES NO

Size Number of extinguishes

Service dates marked YES r NO Last date

30m Hose Reels YES r Number of None

Have staff been trained in the use of Fire Extinguishers YES NO

Easy Access to appliances YES NO Hydrant ring main YES r NO

Automatic Sprinklers YES NO

A.S.I.B. Certificate Valid YES r NO

Sprinkler Detail – contact number

Edition ……………….…………………………Supply …….…………………………………………Units ………….…………………….. Hazard…………………………………………Stack Height ………………………………………… Requirements (A.S.I.B.) YES NO Smoke Detectors YES NO

Water Supply Municipal r Bore Hole Dam


LOSS HISTORY

Date

Amount – R

Cause Remedial action MANAGEMENT & HOUSEKEEPING

General Standard Good Average Poor

Waste Disposal Good Average Poor

Smoking Permitted YES NO r

If no, were used smoking materials noted YES NO

Are no smoking signs on display? YES NO

Specified rules for smoking (i.e. smoke areas, etc.) None

Are flammable materials located against or between buildings YES NO

MAXIMUM PROBABLE LOSS (M.P.L.)

All under one roof with free internal communication MPL 100% YES NO

Risk separated by fire break wall or detached buildings YES NO

If in your opinion less han 100% supply site plan Attached

Are buildings less than 5 metres apart? YES NO

Seperation of buildings

OPINION OF RISK

Good Average Poor

Risk acceptable YES NO

Moral Hazard Good Poor

Inception Hazard High Medium Low

Spread Hazard High Medium Low

Fire Load High Medium Low

FURTHER COMMENT

If yes, see attached Complete attached comments and recommendations

Risk improvement requirements attached? YES NO

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Surveyor

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Date


THEFT SURVEY REPORT

TO: ………………………………………….…… FROM: …………………………………………… BRANCH: ……………………………..………… SURVEYOR: …………………..…………...…… DEPARTMENT: ………………………………… SURVEY NUMBER: …………………………….

REFERENCE: …..……………………………… DATE: …………………….……………..………. DATE: ……….…….……………………………. Name

Address P.O. code

Business

Established 1999 This address: r Previous address:

LOSS OF HISTORY

Date of loss Amount of loss

Entry made via Insured by

Additional protections fitted following loss

Theft record area Good r Average Poor

CONSTRUCTION OF PREMISES

Walls Roof Ceilings

No. of floors Portion occupied

Occupied as

INSURED’S NORMAL WORKING HOURS

Monday to Friday Saturday Sunday

Who is on the premises after hours?

Totals E.M.L. Attractive Goods

Stock in trade R R Clothing R

Goods in trust R R Electronic equipment R

Machinery & Plant R R Cigarettes & Tobacco R

Office fixtures & fittings R R Non-ferrousmetals R

Computer equipement R R Radio’s, TV & VCR’s R

Motor hand tools R

Total R R Camera’s /Jewellery R

ALARM SYSTEM INSTALLED Yes No

Name of installer

S.A.I.D.S.A. approved? Yes r No

Type of system Radio r Siren Communicator

System satisfactory? Yes No

See attached risk improvement requirement? Yes No

Inspector……………………………………………..……………………………………. Date ……………17/12/2004…………………


Name Surveyor

Situation Survey no.

Date

Scale

x1999 None

N.A. N.A.

N.A. N.A.

N.A.

x

Yes No NoNone

xx

PLAN


Comment and requirements following on inspection reports ______________________________________________________________________________

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Quotation

Section Sum insured Tariff Premium Excess

Fire • Equipment • Stock and material in trade

0,650%

Business Interruption • Gross profit (difference basis) • Indemnity limit – refer to

Question 8 of Task 1

0,487%

Theft • First loss

Propose R30 000

8% 10% of claim min R500

Motor Isuzu 250KB (LDV) • Reg. number: ABC123 GP • Use: Business • Model: 2002 • NCB 4 • Area 1 • Engine number 11223344 • VI number 99001122 • Loss of keys • Cover: Comprehensive Trailer • Reg. number: ABC111 GP • Use: Business • Model: 2002 • Cover: Comprehensive

R80 000 R 1 000 R15 000

R10 023 R50 R450 (less 40% discount) = R270

10% of claim min R1 500 Hijacking: 10% of claim min R3 500 10% of claim min R500

Public Liability (Claims basis) • Products liability

R2 000 000 R 500 000

R1 100 R 500 Included

5% of claim min R1 500 per event

Electronic equipment

3% 10% of claim min R500

Total


Recommendations/requirements ______________________________________________________________________________

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Application form Complete the application form with reference to the last-mentioned information. It is not necessary to use existing clause numbers. Create your own clause numbers for the purpose of this exercise and list it at the bottom of the application form (if necessary). Example “Clause 1” – Burglar alarm condition with armed response unit “Clause 2” – Security gates at all outer doors It is expected of you to complete the following aspects with regard to reinsurance under the only for office use section of the application form: • Highest single risk (HSR) • Maximum probable loss (MPL) • Same risk number (identify the same risk) Take note: Where “N.A.” is marked on the inspection report, it does not necessarily imply that it is “not applicable” to all similar risks. It is only “not applicable” to this specific risk/case. The remaining details necessary to complete the application form are as follows: Insured: Loubser Woodworks T/A LWC Woodworks Company reg. no.: 200040101283 VAT no.: 112233 Tel.: (011) 900 0000 Fax: (011) 900 0000 E-mail address: [email protected] Postal address: PO Box 123 Street address: 100 Middle Street Krugersdorp Krugersdorp 1739 1740 Contact person: Mr X


Banking details: Loubser Woodworks T/A LWC National Bank Krugersdorp Account number: 12345678 (current account) Branch identification number: 11223344 Monthly payment – before the 1st day of each month

Inception date: 1 January 2005 Remember to complete the reinsurance aspects under the only for office use section of the application form. Remember: Business Interruption should also be considered. The insured doesn’t want cover for riot and strike.


APPLICATION FOR INSURANCE Multimark III

[Mark applicable choice with a . Areas marked with grey MUST ALWAYS be completed] For office use

CLIENT DETAILS

Current/previous Santam Insurance? No Yes Current/previous policy number: ……………………………………

Short name :……………………………………………………………………………………………………………………………. [Name that will appear on the alphabetical index on computer]

Full Trading name :……………………………………………………………………………………………………………………………..

[Namae that will print on policy schedule] Company Reg. No :……………………………………………… VAT No.: ………………………………………………………… Language : Afrikaans English Telephone number : ……………………………………………… Area code: ………………… Int. Code: ……………………… Fax Number : ……………………………………………… Area code: ………………… Int. Code: ……………………… Cellular telephone : ……………………………………………… E-mail address : ……………………………………………… Postal Address : ……………………………………………… Street address: ………………………………………………………. (Premisesl 1 should ………………………………………………. (Premises 1) ……………………………………………………….. this be a street address) if diff. from ……………………………………………… postal address)……………………………………………………….. ……………………………………………… ……………………………………………………….. Postal code : ……………………………………………… Postal code ……………………………………………………… Contact person : ……………………………………………… Responsible area: ………………………………….

GENERAL AREA

1. Has Santam Ltd. Or any other insurer ever turned down your application for insurance, cancelled any policy (or part thereof),

imposed any special conditions, refused to renew any policy or part thereof, or refused to continue any part of your insurance? If YES, please supply the details on the attached memorandum [include/excluded]

2. History of previous losses/claims. Please supply the details regarding any losses you might have sustained during the past five years, including all claims whether paid out or not.

Type of loss/claim Year Amount Insurer

DECLARATION

I/We hereby declare that the particulars and declarations in this application are correct and complete and include all information known to me/us and which concern the risks to be insured, and that this and any other written declaration made by or on behalf of me/us and Santam Limited and that it will be binding. I/We also declare that should such particulars and answers be in the handwriting of any other person except myself/ourselves, such a person will be considered to have been my/our agent for the purpose of filling out the application. I/We hereby further declare that only policy sections where I/we have indicated by answering the questions that cover was required will apply. Signed at …………………………………………… on …………/…………../………….. by ……………………………………..[applicant]

New Policy Number

NEE JA


POLICY CONTENTS Policy type: Client no.: Inception date: Renewal date: ……../……./…….. ……../……./……..

Annual Premium Mark with Policy Sections Policy SARIA: Yes / No

1 Fire 2 Buildings combined 3 Office contents 4 Business interruption 5 Accounts receivable 6 Theft 7 Money 8 Glass 9 Fidelity 10 Goods in Transit 11 Business all risks 12 Accidental damage 13 Pucblic Liability 14 Employers’ Liability 15 Stated benefits 16 Group personal accident 17 Motor 18 External risks 19 Internal risks 20 Homeowners 21 Machinery breakdown 22 Electronic equipment 23 Machinery – Business interruption 24 Householders 25 Deterioration of stock

Total annual premium ÷ 12 = monthly premium

TOTAL AMOUNT PAYABLE Broker’s Fee

METHOD OF PREMIUM PAYMENT Cash Annualy of Monthly per debit order against account being a cheque account a transmission account a credit card account

Debit order detail and authorisation Bank name / address Institution code Branch code

(bank/branch identification number)

Account number (client idenditifaction number)

Account holder (name of account with institution)

D/O frequency: Monthly Annual Monthly debit order collection date: On, or last working day voor* 29th 30th 31st 1st On, or first working day na 25th 26th 27th 28th Two working days after 15th

* Plase note that for this option, collection will take place on the last day before this date in the event of this date dalling on a weekend or public holiday. I authorise Santam Limited (SANTAM) to deduct the amount of the premium for this policy frommy account at the above-mentioned institution in any way that Santam and the institution have agreed upon. I also authorise Santam to pay any amounts, which may accrue to me, to the credit of my account with the above-mentioned institution. All such withdrawals from my bank account by Santam shall be treated as though they have been signed by me personally

…………………………………………………………. SIGNATURE OF ACCOUNT HOLDER


GENERAL POLICY INFORMATION

Agency number: or Agency

name:

Industry: Or Code:

Rewal Code: 0 Does not renew 1 Presented anually 6 Branch renews [by hand]

Co-insurance: 0 No co-insurance 1 Co-insurance lead 2 Co-ins, participating

If collective Placing number:

Participating companies

Insurer Polisnommer %

Brokers fee R:

Survey number Survey date:

Surveyor

Clauses applicable:

Number % Amount Number % Amount

Same risk policy number:

DETAILS OF PREMISES

Should several premises be covered, complete the additional physical address – different from the address listed as Premises 1 under

“Street address” on page 1:

Premises 2 Premises 3 Premises 4 Premises 5

Code: Code: Code: Code:

Business: Business: Business: Business:

ADDITIONAL COMMENTS


SECTION 1 FIRE

Policy number and name (for amendment purpose) [Mark applicable choice with a . Areas marked with grey MUST ALWAYS be completed]

GENERAL SECTION DETAILS

Additional CPC limit: (exceeding R1 000 included) R……………………………… Premium: R…………………………………… Highest risk item number: ……………………………….

ITEM DETAILS

Item Item Item Item

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For exisiting policy/item,

please indicate:

From: / / / / / / / /

Premises no./address:

Column ref 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5

Occupation description: (what is insured and what is it

used for?)

Sum insured: R R R R

Construction: S N G S N G S N G S N G

For “N” please complete Roof

For “N” please complete

Walls

Rental – number of months

Type of rent 1 2 3 1 2 3 1 2 3 1 2 3

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Cession/HP

Cession holder:

Cession/HP no.:

Expiry date: / / / / / / / /

Survey number.:

Survey date: / / / / / / / /

Surveyor:

Column reference is as follows: Type of rent

1. Rent receivable

2. Rent payable

3. Rent value

Construction

S – Standard

N – Non-standard

1. Buildings, including owner’s loose and fixed fittings therein or thereon, walls (except) dam walls,

gates, gate posts and enclosures

2. The number of months’ rent as mentioned in the schedule

3. Equipment, machinery, the owner’s loose and fixed fittings for which the insured is responsible, as

well as all other contents – with the exclusion of property that has been specifically insured.

4. Stock and materials in trade

5. Miscellaneous as described

G – Thatch roof


Basic and extensions Item Item Item Item

Fire/Light/Expl:

Premium

R R R R

Earthquake: Yes No Yes No Yes No Yes No

Malicious damage” Yes No Yes No Yes No Yes No

Special perils: Yes No Yes No Yes No Yes No

R R R R Riot and strike

Premium

Premises

Subsidence/Landslip

Premium

R R R R

R R R R Leakage:

Limit

Premium

R R R R

Disposal of salvage Yes No Yes No Yes No Yes No

Yes No Yes No Yes No Yes No Stock declaration

Basis Month (M) Quart (K)

Percentage (75% - 100%) % % % %

% % % % Inflation/escalation %

Premium R R R R

OFFICE USE ONLY

Item Item Item Item

Occupation code:

HSR: R R R R

EML: % % % %

Same risk no:

Slip number:

Bordereau number

Total facultative %

Reinsurer

Reinsurer policy number

Reinsurer’s facultative %

Contact person

Clauses applicable: (Complete according to inspection report)


Notes:


BUSINESS INTERRUPTION



Additional CPC limit: (exceeding R1 000 ingesluit) R……………………………… Premium: R…………………………………… Highest risk item number: ……………………………….

ITEM DETAILS

Item Item Item Item

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For an existing policy/item please

indicate:

From: / / / / / / / /

Specification number:

Indemnity period: Months Months Months Months


Spesification 1 only Gross Profit basis

Additions Difference Additions Difference Additions Difference Additions Difference

Spesification 5 only Wages – number of weeks

4 8 12 4 8 12 4 8 12 4 8 12

Premium R R R R

Specification 1, 2, 3 only Premium Deposit

Yes No Yes No Yes No Yes No

Additions basis:

Provide list of fixed costs

OR

Difference basis:

Provide list of uninsured costs

Specification number Indemnity period 1 Gross profit 1 Month 9 Months 2 Gross rentals 2 Months 12 Months 3 Revenue 3 Months 18 Months 4 Additional increase in cost of working 4 Months 21 Months 5 Wages (number of weeks) 5 Months 24 Months 6 Fines and penalties 6 Months 36 Months 7 Standing charges 8 Extensions


Extensions Item Item Item Item

Specified suppliers Local Overseas Local Overseas Local Overseas Local Overseas

Limit % % % % Premium R R R R

Unspecified suppliers Local Overseas Local Overseas Local Overseas Local Overseas


Prevention of access Yes No Yes No Yes No Yes No Extended coverage: Premium R R R R Specified customers Local Overseas Local Overseas Local Overseas Local Overseas


Unspecified customers Local Overseas Local Overseas Local Overseas Local Overseas


Public utilities Insured perils Premium R R R R Extended cover Premium R R R R Public telecommunication Insured perils Premium R R R R Extended cover Premium R R R R

Specified suppliers

Specified customers

OFFICE USE ONLY Item Item Item Item Schedule item link: HSR: R R R R EML: % % % % Same risk no.: Slip number:

Bordereau number Total facultative %

Reinsurer Reinsurer policy number Reinsurer’s facultative %

Contact person Clauses applicable (Complete according to in section report)

Number % Amount Number % Amount Notes:


THEFT


GENERAL SECTION DETAILS Additional CPC limit: (exceeding R1 000 included) R……………………………… Premium: R……………………………………

ITEM DETAILS Item Item Item Item

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For an existing policy/item please indicate:

from: / / / / / / / /

Premises no / address:

Occupation description: (what is insured and what is it used

for?)

First loss limit: R R R R

Spesific description:

Unprotected goods: YES NO YES NO YES NO YES NO

Value of total goods R R R R

Construction description

Roof Walls

Protection:

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Cession/HP

Cession holder:

Cession/HP no.:

Expiry date: / / / / / / / /

Survey number.:

Survey date: / / / / / /

Surveyor:

Basic and Extensions Item Item Item Item Basic cover: Premium

R R R R

Alarm condition YES NO YES NO YES NO YES NO

Locks and keys exceeding R2500 free limit

YES NO YES NO YES NO YES NO

Limit R2 500 R R R

Premium R included R R R

Damage to buildings exceeding R5 000 free limit

YES NO YES NO YES NO YES NO

Limit R R R R

Premium R R R R


OFFICE USE ONLY Item Item Item Item

Occupation code:

Slip number:

Bordereau number

Total facultative %

Reinsurer



Contact person

Clauses applicable: (Complete according to inspection report)


Notes:


MOTOR SPECIFIED

Policy number and Name [for amendment purposes]: [Mark applicable choice with a . Areas marked grey MUST ALWAYS be completed]

GENERAL SECTION DETAILS Extenstions/Limitations

Description Applicable Amount/Limit Premium

Liability: Contingency exceeding R2 500 000 R R

- Rating Group ▲ 1 2 3

- Number of persons

Parking facilities and moving of 3rd party vehicles R R

- Number of parking bays

▲ Rating group: 1 – person of Municipality, Public services 2 – Students/Scholars 3 – Any other persons other than group 1 and 2


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For an existing

item/policy, please

indicate:

Vanaf: / / / / / / / /

Motor category A B C F G A B C F G A B C F G A B C F G

Class of use Type of cover 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7 1 2 3 4 5 6 7

Registration no.

Year manufact.

Make

Model

Postal code

Limit of indemnity R R R R

No claim bonus 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5

Discount % % % % %

Vol. Excess disc. % % % %

Premium loading R R R R

Auto loading R R R R

Security 1/VSS

No. of installer 1 321

Name of installer XYZ

Receipt date 113/2002

VESA certificate no. 333 666

Premium R R R R

Gross mass/cc Engin number VIN number

HIRE PURCHASE (FOR CREDIT SHORTFALL PURPOSES) Item Item Item Item Institution number: 100101

H P owne:r ABSA

Hire Purchase no.: 112233999

Expiry date: 31/12/2005

Motor catergory: A = Private Motors & LDV’s B = Commercial vehicle C = Motor cycle F = Buses G =Caravan/Trailer

Cover 1 – Comprehensive cover 2 – Third Party, Fire and Theft 3 – Third Party Only 4 – Comprehensive cover. Excl. Theft & Hijack 3 – Third Party, Fire, Excluding Theft & Hijack 5 – Comprehensive cover with limited Theft/Hijack 4 – Third Party, Fire with Limited Theft/Hijack


Accessories

Accessory no. Description Limit R R R R Premium R R R R

R R R R % Of claim % Of claim % Of claim % Of claim Excess payment % Sum insured % Sum insured % Sum insured % Sum insured

Accessory no. Description Limit R R R R Premium R R R R

R R R R % Of claim % Of claim % Of claim % Of claim Excess payment % Sum insured % Sum insured % Sum insured % Sum insured

Liabilities

Sub-section B Liability Limit R2 500 000 R R R

Premium R included R included R R Passenger Liability

Limit R2 500 000 R R R Premium R included R R R

Paid Paid Paid Paid Number of seats Non-paid Non-paid Non-paid Non-paid

Unauthorised Passenger Liability Limit R R R R

Premie R R R R Standard Extensions

Windscreen / window Yes No Yes No Yes No Yes No Premie R R R R

Riot & Strike Limit R R R R Premium R R R R Credit shortfall Limit R R R R

Premium R R R R Loss of use Limit R R R R

Premium R R R R Loss of keys Limit R R R R

Premium R R R R Wreckage Limit R1 000 R1 000 R R Removal Premium R R R R

Non-standard Extensions

Extenstion No. Description

Limit R R R R Premium R R R R

R R R R % Of claim % Of claim % Of claim % Of claim Excess Payment % Sum insured % Sum insured % Sum insured % Sum insured

Extenstion No. Description

Limit R R R R Premium R R R R

R R R R Excess Payment % Of claim % Of claim % Of claim % Of claim

% Sum insured % Sum insured % Sum insured % Sum insured Limitations

Radio R1 500 R R R Vehicle telephone R R R R CD Player R1 500 R R R Mag wheels R R R R


Excess and excess insurance

Excess:

Basic R R R R

% Claim % Claim % Claim % Claim OR

% Value % Value % Value % Value

Insurance for basic excess: Yes No Yes No Yes No Yes No

Premium R R R R

Excess:

Theft R R R R

% Claim % Claim % Claim % Claim OR


Insurance for theft excess: Yes No Yes No Yes No Yes No

Premium R R R R

Windscreen R R R R

%

Claim Min

R350 % Claim % Claim % Claim OF


Voluntary amount R R R R

Persons under 25 R250 R R R

R R R R

% Claim % Claim % Claim % Claim

Sub-division B

Liability

OR % Value % Value % Value % Value

OFFICE USE ONLY Item Item Item Item

Excess of loss:

Bordereau number

Priority R R R R

Participating Co.

Participating policy no.

Participation R R R R

Clauses applicable Number % Amount Number % Amount

Notes:


SECTION 13

PUBLIC LIABILITY

Policy number and name [for amendment purposes] [Mark applicable choice with a . Areas marked grey MUST ALWAYS be completed]



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For an existing policy/item please indicate:

From: / / / / / / / /

Basis of cover Claims made Occurance

Claims made Occurance



Occupation description: (what is insured and what is it used for?)

Retroactive date Claims made basis only / / / / / / / /

Premises no./Address

Total number of premises

Limit of indemnity R R R R

Other premises with their occupation description

Basic first amount payable % of claim % of claim % of claim % of claim

With a minimum of R R R R OR a basic amount

of R R R R

Workaway first amount payable

% of claim % of claim % of claim % of claim

With a minimum of R R R R OR a basic amount

of R R R R

Basic & Extensions Item Item Item Item Basic Cover:

Premium R R R R

Product Liability: Product

Limit R R R R Turnover R R R R Premium R R R R

Basic first amount payable % of claim % of claim % of claim % of claim With a minimum of R R R R

OR a basic amount of

R R R R

Defective workmanship Limit R R R R

Turnover R R R R Premium R R R R


OR a basic amount of

R R R R


EU Liability:

Limit R R R R

Turnover R R R R

Premium R R R R


OR a basic amount of R R R R

USA/Canada Liability: Limit R R R R

Turnover R R R R

Premium R R R R


OR a basic amount of R R R R

Legal Defence costs Option

Premium R R R R

Wrongful arrest Option

Premium R R R R

Pharmacies Option

Premium R R R R

No. of pharmacists/assistants

Errors/Omissions Option

Premium R R R R

Hair salon Option

Premium R R R R

Medical treatment Option

Premium R R R R

Number of medical officials

OFFICE USE ONLY

Item Item Item Item Occupation code:

Product code: Defective workmanship code:

EU Product code: USA/Canada Product code:

Excess of loss Bordereau number

Priority R R R R Participating company

Participating policy number Participation R R R R

Clauses applicable (Complete according to inspection report)

Number % Amount Number % Amount Notes:


AFDELING 22

ELECTRONIC EQUIPMENT

Policy number and name [for amendment purposes] [Mark applicable choice with a . Areas marked grey MUST ALWAYS be completed]


Highest CPC limit: (exceeding R1 000 included) R……………………………… Premium: R…………………………………… Highest risk item number: ………………………………. Burglary: Premises …………………………………………………….. Limit R………………………………. Premium R……………………………. Premises …………………………………………………….. Limit R………………………………. Premium R ..…………………………. Premises …………………………………………………….. Limit R………………………………. Premium R ..………………………….

ITEM DETAILS SUB SECTION A: MATERIAL DAMAGE

Item Item Item Item

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For an existing policy/item

please indicate:

from: / / / / / / / /

Premises no./address:

Burglary cover B V G B V G B V G B V G

Item description:

Type

Make /Model

Serial number


Incompatibility cover Yes No Yes No Yes No Yes No

First amount payable

% of claim 10 % 10 % 10 % 10 %

R250 R250 R250 R250 General - minimum

Burglary - minimum R500 R500 R500 R500

Com

plet

e fro

cess

ion

note

d

on it

em

Cession/HP

Cession holder:

Cession/HPno:

Expiry date: / / / / / / / /

Survey number:

Survey date: / / / / / / / /

Surveyor:

Burglary Cover B – Limited burglary cover V – Full burglary cover G – No burglary cover

Yes No


SUB SECTION B : INCREASED COST OF WORKING

(if applicable)

Item Item Item Item

Material damage item number

Times excess {hrs} {hrs} {hrs} {hrs}

Indemnity period {mths} {mths} {mths} {mths}

Sum insured R R R R

Premium R R R R

Extensions

Telkom access lines Premium

R R R R

Failure of electricity

Premium

R R R R

SUB SECTION B : REINSTATEMENT OF DATA

(if applicable)

Item Item Item Item

Mateial damage item number


Premium R R R R

First amount payable

% of loss % % % %

minimum amount R R R R

OFFICE USE ONLY

Item Item Item Item

Equipment type code:

Sum insured group: A B C A B C A B C A B C

HSR: R R R R

EML:

Same risk no:

Slip number

Bordereau number

Total facultative % R R R R



Contact person R R R R

SUM INSURED GROUP: A ≤ R100 000 B ≤ R250 000 C ≥ R250 000 Clause applicable (Complete according to inspection report)


Notes:


Motivate your answers with the relevant facts throughout to qualify for the maximum allocation of marks as indicated per question. Task 3 More questions 1. The insured once again confirms that he is contractually bound to provide his clients

with products. Suppose a fire erupts in the workshops which lead to them not being able to continue normal production. Will he enjoy cover for the increased operational costs should he scale his business down and temporarily continue with it from another premises? This will be for the sole purpose of retaining his client-base.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

2. The insured informs you that he receives 90 % of his timber (raw material) from a

specific supplier. Suppose this supplier’s business burns down or is destroyed by a storm. The insured is worried that he could experience problems with finding another timber supplier in time to continue with normal production. Will he be able to acquire insurance against possible losses in such an event?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

3. The insured is also worried because 70% of all his ready-made products are

purchased/distributed by one specific client. Suppose this client’s premises burns down or is damaged by a storm to the extent that his turnover suffers. Is it possible to acquire insurance for it?

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

____________________________________________________________________________

2

2

2


4. From time to time power failures occur in the area where his workshop is located. If it continues for some time, it could have a great impact on his turnover. Do we provide cover for such an event? (Discuss the various options comprehensively.)

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

5. The insured is, regardless of the answers you have provided, still not sure about the

above-mentioned aspects. He wants to know if he could take out cover for possible penalties due to a breach of contract.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

TOTAL

4

2

12

woodwork factory module 5 - santam

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