Module 2-Filling station - Santam · • Machinery and tools R220 000 • Parts ... Deep fat...

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Filling Station Module 2

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

Copyright © Santam Ltd. 2007 2 Course code: ASSESS123 /Module2

Filling Station Module introduction From time to time some of our current clients expand their businesses or acquire other businesses. In this module, a current client has acquired/bought a filling station. Although the filling station includes various other businesses, he is only interested in the filling station. He continues to let out the workshop, panel-beater and take away sections to its current tenants. All the necessary information regarding the risk will be provided. It will be expected of you to evaluate the risk and identify all information relevant to the part of the risk our client is keeping. It will also be expected of you to give the client advice on the sections he is letting out. The sections applicable to the risk will be limited to the following: Section: General Section: Fire Section: Money Section: Glass Section: Public Liability 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 filling station risk: • General questions continually asked; • 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.


Case Study Motivate your answers with the relevant facts throughout to qualify for the maximum allocation of marks as indicated per question. Case study One of our current clients, L&L Enterprises Ltd., approaches you about its latest business transaction. The owner tells you that they have bought a filling station and would like to arrange for its insurance as soon as possible. Task 1 When visiting the client at his office, he asks the following questions: 1. Aren’t we supposed to save on our premiums if all the businesses on the

premises (filling station, take away business, workshop and panel-beater) take out one joint policy?

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2. Am I responsible to see to the continuous good housekeeping of all tenants? Surely you won’t penalise me when one of them is responsible for a fire?

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2


3. May I insure the glass windows at the front of the take away business on my policy, even though the leasing agreement states that it is the tenant’s responsibility? I am afraid that they will neglect to insure it and that in the event of a claim problems could arise when replacing it.

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4. How often will my premium be increased? May we, as the insurer, increase his

premiums as we see fit?

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5. Even though my primary business is an investment company, I would like to know if I may insure the filling station on that policy. The filling station is registered as a separate company, Koeberg Service Station (Company number 20001015123). L&L Enterprises is registered as a closed corporation (CC number 117788/2001).

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6. In the past, wrongdoers have damaged the buildings and fuel tanks considerably, regardless of a petrol attendant being on duty for 24 hours a day. Will I be covered for this type of damage?

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TOTAL

2

16


Task 2

L&L Enterprises provides you with the following information with regard to their business. They would like to know what their insurance will amount to. Value of building (Including lean-to roofs and a timber tool-shed) R 850 000 Value of underground fuel tanks R 300 000 Value of fuel in tanks R 500 000 Value of signage: • A three metre high signage (*) R 22 500 • Smaller signage at fuel pumps (*) R 20 000 • All other signage, e.g. at take away business, etc. R 10 000

(The insured is responsible for it.) (*) Even though the signage remains the property of Engen, the filling station is responsible for all damages to it. Content of workshop • Machinery and tools R220 000 • Parts R 30 000 Content of take away business (café) • Equipment R 60 000 • Stock R 50 000

Panel-beater’s movable equipment (tools) R 15 000 Money (from fuel sales) • Average in safe (after hours) R 12 000 • In safekeeping of petrol attendants (after hours) R 2 500 Value of glass • Take away business (café) R 7 000 • Rest of the building R 1 000


Use the following tariff structure to determine the premium: Fire: 0,4% Money: 10% Glass: 8% Public Liability (Claims made basis – retrospective date 01/01/2005) R2 500 000 R 1 750 Turnover R1 000 000 (Including defective workmanship of R100 000 – premium R200, excess 10% of claim - minimum R2 000) Insured doesn’t want cover for riot and strike. You inform him that you will have to do a review prior to you being able to quote. Use the site layout and visual material to evaluate the risk.


Site layout

Vul d volgende inspeksieverslae in.

Watter aanbevelings / onderskrywingsmaatreëls sal jy toepas. Kwoteer na-aanleiding van die oorsig en bogenoemde tariewe Voltooi aangehegte aansoekvorm. Daar hoef geen melding gemaak te word van

enige klousulesnommers nie. Meld net die nodige onderskrywingmaatreëls Die kliënt verneem graag van jou ten opsigte van die volgende;

XX YARD WORKSHOP PARTS

TAKE AWAYS

BATHROOM

YARD

STREET

STREET

XXXXX

LEAN-TO ROOF

FORECOURT LEAN-TO/SHELTER

FUEL PUMPS

SIGNAGE

TOOL-SHED

PETROL ATTENDANT KIOSK

FIRE EXTINGUISHER

C O N S T R U C T I O N: WALLS (MAIN BUILDING): BRICKS ROOF (MAIN BUILDING): TIN


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 stal code

Occupation

Area class: ( ) Retention class: Construction class:

GENERAL DESCRIPTION

Locality Industrial Commercial Closed Shopping Centre

Residential

Details (if other)

Construction Roof Reinforced Concrete Corrugated Iron

Thatch Saw tooth Details other

Box guttering Condition of gutters

Skylights Fibre glass

Walls Reinforced concrete

Details other Is building older than 10 years? S

No. of floors No. of basements

Construction of floors C

Condition of premises A

Adjacent exposure A

Rivers/Canals Debris Block-up

Detail (Type of exposure)

Adjacent Risk Communcates

Seperation by

Security Chain link fence 2 Access Control

Street lights 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

Are plug points overloaded? YES NO r

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

None Storage/Retail/Distribution only

Heat Process/Welding/Grinding Flammable liquids Quantity 200

Flammable liquid store – brick under concrete slab YES NO r

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

Is wall block manifold in good condition YES 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 = ……8………………kms from risk

Appliances on Site – hand held YES NO

Size 9kg Number of extinguishes

Service dates marked YES NO Last date

30m Hose Reels YES Number of None

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

Easy Access to appliances YES NO Hydrant ring main YES NO

Automatic Sprinklers YES NO

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

Sprinkler Detail – contact number

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

Water Supply Municipal 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

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.)

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

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 r Poor

Inception Hazard High Medium Low

Spread Hazard High Medium Low

Fire Load High Medium Low

FURTHER COMMENT

If yes, see attached

Risk improvement requirements attached? YES r NO

……………………………………………………………………………….

Surveyor

………………………………………………………

Date


MONEY SURVEY REPORT

SAFES/STRONGROOM

NO. 1 NO. 2 NO. 3

Manufacturer

Located in premises

Serial Number 12345

Date of Manufacture Aug 1973

S.A.B.S. Catergory No category

Number of Locks 1

Types of Locks N.A.

Height (mm) 60mm

Width (mm) 45mm

Depth (mm) 25mm

How secured Bolted

Door plate thickness 5mm

Key storage – day Offoce

Key storage – night Owner’s residence

Max. Cash stored overnight R R R

Overnight “Book” limit R R R

Total number of receptacles (safes/tills)

Safes Cash Tills Est. Values R2 000.00

THE NATIONAL LOTTERY

Surveyors please note the additional cash may be on site as a result of the National Lottery. The following must be provided Is the insured a National Lottery Agent? YES NO r

If yes stateMaximum on hand at any one time for the lottery R ………………………………

Is the existing safe suitable to store Lottery cash PLUS other business takings YES NO r

If NO requirements re new safes MUST be made

S.A.B.S. category drop/chute safe is a standard requirement for this type of risk

HOLD-UP

Maximum amount of cash on site – R 5 000.00 Late night trading YES NO

Drop/Chute safe used YES NO Manufacturer

Serial number 12345 Time Delay locks fitted YES NO r

Keys kept by professional carriers YES NO r Notices on display YES NO

Multi-Tenure Centre YES NO

ALARM COVER YES NO

Radio YES NO r

Installer – name

Siren YES r NO Armed response YES NO

Panic buttons YES NO r S.A.I.D.S.A. Approved YES NO


TRANSIT

Professional carriers used for all banking? YES NO

If Yes, name:

If No, are own staff used? YES NO

If Yes, how many? Males Are they armed? YES NO

Females Are they armed? YES NO

Is cash carrying case used? YES NO

Maximum amount carried – of cash R Of Cheques - R

Cash Cheques - R Credit Card vouchers– R

Copy of deposit slip/cheque and cash details kept at office? YES NO

Wages – cash per week/per month - R

Wage packets made up pn premises/contract sites/other (provide details)? YES NO

If No, by whom (detail security when delivered/kept on-site/premises)

Wage paid directly to staff bank accounts YES NO

All wages paid by cheque YES NO

Wages made up in locked “cash-office” – (if yes, details) YES NO

Are wages paid from cash on hand YES NO

Number of staff paid weekly/monthly by cash Weekly Monthly

Access control to premises? YES NO CCTV used YES NO

Panic buttons available/fitted? YES NO Connected to who?

Distance from bank ………………………..kms

Time of banking varied? YES NO

Route to and from bank varied YES NO Vehicle changed? YES NO

Frequency of banking? Frequency of till clearing?

C.O.D.

How often?

How much cash? R

How many drivers/collectors? Are they armed YES NO

How long in transit before banked/returned to base?

Are townships visited? YES NO How often?

How many carriers per day/week?

See attached risk improvement requirements YES r NO

……………………………………………………………………… Surveyor

……………………15/12/2004……………….. Date

1


Comment and recommendations following on the inspection reports ______________________________________________________________________________

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Quotation

Section Sum insured Tariff Premium

Fire

Money

Glass

Public Liability

(including defective workmanship of

R100 000)

R 2 500 000 - R1 950

Comment and general recommendations ______________________________________________________________________________

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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

Theft of money of the business 2003 R3 000 Santam From the residence Burglary at L&L Enterprises 2004 R1 750 Santam

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

New

Am

ende

d

Can

cel

New

Am

ende

d

Can

cel

New

Am

ende

d

Can

cel

New

Am

ende

d

Can

cel

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

Com

plet

e fo

r

sess

ion

note

d

on it

em

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:


Notes:


MONEY



Additional CPC limit: (exceeding R10 000 included) R……………………………… Premium: R…………………………………… Receptacle limit: (exceeding R2 000 included) R ……………………………… Premium: R…………………………………… • Personal Accident option Premium: R…………………………………… Riot and strike Premium: R……………………………………

ITEM DETAILS

Item Item Item Item

New

Am

ende

d

Can

cel

New

Am

ende

d

Can

cel

New

Am

ende

d

Can

cel

New

Am

ende

d

Can

cel

For an existing policy/item please indicate:

from: / / / / / / / /

Premises no / address:

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

for?) Main Limit: R R R R

Specified safes: YES NO YES NO YES NO YES NO

Make and model number Serial number SABS grading

Limit R R R R Make and model number

Serial number SABS grading

Limit R R R R Seasonal Limit

Start period (DDMM) End period (DDMM)

Premium Description of seasonal

Cover Seasonal Limit

Start period (DDMM) End period (DDMM)

Premium Description of seasonal

Cover

Protection:

Com

plet

e fo

r

cess

ion

note

d

on it

em

Cession/HP

Cession holder:

Cession/HP no.:

Expiry date: / / / / / / / /

Survey number.:

Survey date: / / / / / /

Surveyor:

A B C D E

Yes No


Basic and extensions: Item Item Item Item

Basic Cover: Premium

R R R R

Petrol attendants

Limit

R R R R

Premium

R R R R

Collectors

Limit

R R R R

Premium

R R R R

Crossed cheques exceeding R100 000 free limit

Limit R R R R

Premium R R R R

Alarm condition YES NO YES NO YES NO YES NO

C.O.D. deliveries

Limit

R R R R

Premium R R R R

• PERSONAL ACCIDENT: Option Amount death Amount week Medical A R10 000 R100 R1 000 B R20 000 R200 R2 000 C R30 000 R300 R3 000 D R40 000 R400 R4 000 E R50 000 R500 R5 000

OFFICE USE ONLY Item Item Item Item

Occupation code:

Slip number:

Bordereau number

Total facultative %

Reinsurer

Reinsurer policy number

Reinsurer’s facultative %

Contact person

Clauses applicable:


Notes:


SECTION 8 GLASS



Additional CPC limit: (exceeding R10 000 included) R……………………………… Premium: R……………………………………

ITEM DETAILS Item Item Item Item

New

Am

ende

d

Can

cel

New

Am

ende

d

Can

cel

New

Am

ende

d

Can

cel

New

Am

ende

d

Can

cel


from:

/ / / / / / / /

Premises no / address:

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

Sum Insured: R R R R OF

Square metres: 40 m² m² m² m² Basic and Extensions Item Item Item Item

Basic cover: Premium

R R R R

Special Replacement: Yes No Yes No Yes No Yes No Riot and strike Premium

R R R R

Premises Other costs and expenses exceeding R2 000 free limit Yes No Yes No Yes No Yes No

Limit Premium

Damage to Sanitary ware Yes No Yes No Yes No Yes No Limit

Premium OFFICE USE ONLY

Item Item Item Item Occupation code: Slip number: Excess of loss

Bordereau number Priority

Reinsurance company Reinsurer’s policy number

Participation Contact person

Clauses applicable: Number % Amount Number % Amount

Notes:


SECTION 13

PUBLIC LIABILITY



ITEM DETAILS Item Item Item Item

New

Am

ende

d

Can

cel

New

Am

ende

d

Can

cel

New

Am

ende

d

Can

cel

New

Am

ende

d

Can

cel


from: / / / / / / / /

Basis of cover Claims

made Occurance

Claims

made Occurance

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

OF a basic amount of R R R R

Basic and 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

First amount payable % of claim % of claim % of claim % of claim With a minimum of R R R R


Defective workmanship

Limit R R R R

Turnover R R R R

Premium R R R R




EU Liability:

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


OF a basic amount of R R R R USA/Canada Lability:

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


OF 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/as/asistants Errors/omissions Option

Premium R R R R Hair Salon Option

Premium R R R R Medical treatment Option

Premium R R R R No. of medical officials

OFFICE USE ONLY

Item Item Item Item Occupation code:

Product code: Defective workmanship:

EU Product code: USA/Candaian product code:

Excess of loss: Bordereaux number

Priority Participating company Participating policy no.

Participation Clauses applicable:

Number % Amount Number % Amount Notes:

N.A. N.A.

N.V.T. N.V.T.

N.V.T.

N.V.T.

N.V.T. N.V.T.

40

N.V.T.N.V.T.

ingesluit

N.A.

N.A.

N.A.


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 number 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 At this stage, you don’t have to fill-in any information on the following:

• HSR • MPL • Same risk number

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. The rest of the details needed for completing the application form will follow: Insured: Koeberg Filling Station Company reg. no.: 20001015123 VAT no.: 887766 Telephone no.: (021) 915 7000 Fax no.: (021) 915 7000 E-mail address: l&[email protected] Postal address: PO Box 123 Street address: 1 Koeberg Street Cape Town Cape Town 8000 8001 Contact person: John Smith Banking details: L&L Enterprises

National Bank Cape Town Account no.: 12345678 (cheque account) Branch identification no.: 11223344 Monthly payment (D/O last day before the 1st)

Inception date: 1 January 2005 Current policy number of L&L Enterprises: 631/1000000


Underwriting principles and clauses applicable ______________________________________________________________________________

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Motivate your answers with the relevant facts throughout to qualify for the maximum allocation of marks as indicated per question. Task 3 More questions The insured wants to know what will happen if: 1. One of the tenants decides not to continue with the lease agreement and he finds

another tenant. _________

_________

_________

2. He considers taking over the workshop at a later stage. Should he inform us and will it

have an impact on his premium? _________

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3. The insured installs more fuel tanks.

It will increase the storing capacity of fuel considerably. He wants to do this to enable him to buy as much fuel possible before the next fuel price hike. The level of the fuel tanks could fall considerably over a period of time. Is there a way in which he could pay his premium on the average content of the tanks?

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2

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4. He wants to insure his private vehicles under his business insurance for tax purposes. He is not going to register the vehicles in the name of the business. He only wants to recover it as an expense from his business for tax purposes.

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TOTAL

2

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Module 2-Filling station - Santam · • Machinery and tools R220 000 • Parts ... Deep fat...

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Transcript of Module 2-Filling station - Santam · • Machinery and tools R220 000 • Parts ... Deep fat...