Cargo Insurance Application   AUSTRALIA NEW ZEALAND - ASIA PACIFIC MARINE INSURANCE
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Cargo Transit Freight Insurance QUOTE FORM

Thank you for allowing United Marine Insurance the opportunity to arrange a quote for your Cargo Insurance requirements. Completing this Proposal will not obligate you to accept terms offered or pay any fees or charges for these initial services. This proposal is for ‘Single Transit Cargo’ only, which means for a one off shipment of cargo/goods either by Sea, Air, Road or Rail and/or any combination thereof.
 
PROPOSER DETAILS -
Section 1
Name of Proposer
     
If the Goods are being shipped from Australia,
which State will they be shipped from		  
PARTICULARS OF GOODS TO BE INSURED-
YOU CAN HAVE MULTIPLE CATEGORIES OF GOODS IN ONE SHIPMENT
Section 2
HideCategory #1
This section will allow you to specify several categories of goods. Complete details for first category and if you have another, click on Add new category at the bottom.
Please choose the category that most closely matches the goods to be insured
The description of the category of goods to be insured are described above
If you already have an Inventory of the Goods to be shipped and it is convenient for you to attach an electronic copy herewith, please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us at a later date on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
 
Except for Livestock, are the goods to be shipped New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discoloration Yes    No
d. Are there any special packing instructions given to packers,
forwarding agents and carriers for the safe carriage of these good 		Yes    No
Please describe the special instructions given, if any
HideCategory #2
This section will allow you to specify several categories of goods. Complete details for first category and if you have another, click on Add new category at the bottom.
Please choose the category that most closely matches the goods to be insured
The description of the category of goods to be insured are described above
If you already have an Inventory of the Goods to be shipped and it is convenient for you to attach an electronic copy herewith, please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us at a later date on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
 
Except for Livestock, are the goods to be shipped New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discoloration Yes    No
d. Are there any special packing instructions given to packers,
forwarding agents and carriers for the safe carriage of these good 		Yes    No
Please describe the special instructions given, if any
HideCategory #3
This section will allow you to specify several categories of goods. Complete details for first category and if you have another, click on Add new category at the bottom.
Please choose the category that most closely matches the goods to be insured
The description of the category of goods to be insured are described above
If you already have an Inventory of the Goods to be shipped and it is convenient for you to attach an electronic copy herewith, please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us at a later date on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
 
Except for Livestock, are the goods to be shipped New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discoloration Yes    No
d. Are there any special packing instructions given to packers,
forwarding agents and carriers for the safe carriage of these good 		Yes    No
Please describe the special instructions given, if any
HideCategory #4
This section will allow you to specify several categories of goods. Complete details for first category and if you have another, click on Add new category at the bottom.
Please choose the category that most closely matches the goods to be insured
The description of the category of goods to be insured are described above
If you already have an Inventory of the Goods to be shipped and it is convenient for you to attach an electronic copy herewith, please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us at a later date on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
 
Except for Livestock, are the goods to be shipped New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discoloration Yes    No
d. Are there any special packing instructions given to packers,
forwarding agents and carriers for the safe carriage of these good 		Yes    No
Please describe the special instructions given, if any
HideCategory #5
This section will allow you to specify several categories of goods. Complete details for first category and if you have another, click on Add new category at the bottom.
Please choose the category that most closely matches the goods to be insured
The description of the category of goods to be insured are described above
If you already have an Inventory of the Goods to be shipped and it is convenient for you to attach an electronic copy herewith, please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us at a later date on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
 
Except for Livestock, are the goods to be shipped New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discoloration Yes    No
d. Are there any special packing instructions given to packers,
forwarding agents and carriers for the safe carriage of these good 		Yes    No
Please describe the special instructions given, if any
HideCategory #6
This section will allow you to specify several categories of goods. Complete details for first category and if you have another, click on Add new category at the bottom.
Please choose the category that most closely matches the goods to be insured
The description of the category of goods to be insured are described above
If you already have an Inventory of the Goods to be shipped and it is convenient for you to attach an electronic copy herewith, please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us at a later date on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
 
Except for Livestock, are the goods to be shipped New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discoloration Yes    No
d. Are there any special packing instructions given to packers,
forwarding agents and carriers for the safe carriage of these good 		Yes    No
Please describe the special instructions given, if any
HideCategory #7
This section will allow you to specify several categories of goods. Complete details for first category and if you have another, click on Add new category at the bottom.
Please choose the category that most closely matches the goods to be insured
The description of the category of goods to be insured are described above
If you already have an Inventory of the Goods to be shipped and it is convenient for you to attach an electronic copy herewith, please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us at a later date on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
 
Except for Livestock, are the goods to be shipped New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discoloration Yes    No
d. Are there any special packing instructions given to packers,
forwarding agents and carriers for the safe carriage of these good 		Yes    No
Please describe the special instructions given, if any
HideCategory #8
This section will allow you to specify several categories of goods. Complete details for first category and if you have another, click on Add new category at the bottom.
Please choose the category that most closely matches the goods to be insured
The description of the category of goods to be insured are described above
If you already have an Inventory of the Goods to be shipped and it is convenient for you to attach an electronic copy herewith, please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us at a later date on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
 
Except for Livestock, are the goods to be shipped New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discoloration Yes    No
d. Are there any special packing instructions given to packers,
forwarding agents and carriers for the safe carriage of these good 		Yes    No
Please describe the special instructions given, if any
HideCategory #9
This section will allow you to specify several categories of goods. Complete details for first category and if you have another, click on Add new category at the bottom.
Please choose the category that most closely matches the goods to be insured
The description of the category of goods to be insured are described above
If you already have an Inventory of the Goods to be shipped and it is convenient for you to attach an electronic copy herewith, please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us at a later date on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
 
Except for Livestock, are the goods to be shipped New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discoloration Yes    No
d. Are there any special packing instructions given to packers,
forwarding agents and carriers for the safe carriage of these good 		Yes    No
Please describe the special instructions given, if any
HideCategory #10
This section will allow you to specify several categories of goods. Complete details for first category and if you have another, click on Add new category at the bottom.
Please choose the category that most closely matches the goods to be insured
The description of the category of goods to be insured are described above
If you already have an Inventory of the Goods to be shipped and it is convenient for you to attach an electronic copy herewith, please attach using the browse button on the right.: or
(Word, Excel, PDF format or JPG)
Alternatively would you like to Fax an Inventory to us at a later date on toll free (1800 802 956) Yes No    (You will be contacted by our staff)
 
Except for Livestock, are the goods to be shipped New    Second Hand    Combined (new & old)
How will the individual items be packed (e.g. cartons)
Will the goods be shipped in fully enclosed containers Yes No
Are the goods to be insured:
a. Over height or over width and will not fit into fully enclosed containers Yes    No
b. Required to be kept within a specific temperature range Yes    No
c. Susceptible to rust, oxidization or discoloration Yes    No
d. Are there any special packing instructions given to packers,
forwarding agents and carriers for the safe carriage of these good 		Yes    No
Please describe the special instructions given, if any
  
VOYAGE / CONVEYANCES -
Section 3

How will the Goods be shipped Sea Air Rail Road Combined

Shipping Goods from
Destination of Goods  
Date of departure  
Expected date at destination  

Will the Goods be unloaded & reloaded between the port of shipping & port of destination Yes No

Name of freight forwarder and/or shipping agent handling the shipping of these goods

COVER OPTION DETAILS -
Section 4


OPTION A
(Full Cover)
For PROFESSIONALLY PACKED GOODS
only

  • All Risks of loss of or damage to the insured goods from any external cause including Accidental Damage during packing by the carrier.

  • In respect to MOTOR VEHICLES - All Risks of loss of or damage to the Motor Vehicle(s) excluding loss or damage while being driven under own power except while being driven by an authorized employee of the freight forwarder or their agent for the purposes of loading or unloading.

OPTION B
(Restricted Cover) For
OWNER PACKED GOODS
and / or
PROFESSIONALLY PACKED GOODS

Loss of or damage to the insured goods resulting from the following events -
Note: This option B cover does not include accidental damage

  • Fire and/or explosion
  • Collision of vessel, aircraft, or conveyance
  • Overturning and/or derailment of conveyance
  • Crashing and/or forced landing of aircraft
  • Stranding, sinking, or contact of vessel with any external object (ice included) other than water
  • Entry of water into any vessel, hold, container, lift van or place of storage
  • Theft, pilferage or non-delivery

'Exclusions'
RISKS NOT COVERED BY
OPTION A or B

 If the goods are damaged or by any of the following circumstances, it is likley that any claim will be excluded:
  • Delay.
  • Confiscation or detention by Customs or other officials or authorities.
  • Wear and tear, moths, vermin, normal atmospheric or climatic conditions.
  • Inherent vice.
  • Mechanical, electrical or electronic breakdown or derangement unless there is external evidence of the breakdown or derangement having been caused by an insured risk.
  • Non-delivery of owner packed items unless an itemized, valued list of contents is supplied prior to the commencement of transit.
  • Nuclear matter in terms of the Institute Radioactive Contamination Exclusion Clause current at the date of the policy.

Additional exclusions may be imposed depending on the cargo


TYPE OF COVER -
Section 5
Do you require All Risk cover Option A
Yes
In certain circumstances ALL RISK cover may not be available. Our quote will detail the cover we are able to provide
Do you require Restricted Cover Option B   Yes

SUM INSURED, VALUATION AND PREMIUM -
Section 6

Value of Goods to be insured
: $

Do you wish to insure the value of goods,
the cost of freight and insurance (CIF) plus 10%
Yes No

Usually, insurance claims will be settled by the insurance company in one of the following methods:

  • The reasonable cost of repairs or restoration in the event of damage.
  • FULL REPLACEMENT COST for any items totally lost or destroyed, PROVIDED that such items are no more than 5 years old. 
  • INDEMNITY VALUE for any items totally lost or destroyed, if items are more than 5 years old.  For the purpose of this insurance indemnity value shall mean the replacement cost less an assessed allowance for condition, age, wear and tear.

MOTOR VEHICLES are to be valued at the current market value at destination.

The value for which you insure the goods for, must be an accurate value otherwise any claim may be reduced by the effect of co-insurance. An example of co-insurance can be found in below.

EXAMPLE OF CO-INSURANCE

If an Item is valued at $1000 but insured for $500. Cost of repairs is $600.
The Insurers will pay $500 divided by $1000 x $600 = $300
INSURANCE HISTORY -
Section 7
Has the Owner of the goods or the Person requesting the quote ever: -        
         
  a. been refused insurance: Yes No  
  b. had an insurance claim of any type refused or reduced: Yes No    
  c. been charged with a crime of any type: Yes No    
 
If Yes to any of the questions above, please give details:

CONTACT DETAILS -
Section 8
Preferred Method of Contact Phone     Email
 
Best Time to Call:  
Message:

Thank you we will do our best to respond in the next few hours - but we may need to contact you for further information
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