Proposal Forms

Commission Insurance Form

ITIC Ltd, International House, 26 Creechurch
Lane, London EC3A 5BA.
Tel. +44 (0)20 7338 0150 Fax +44 (0)20 7338 0151
E-mail ITIC@thomasmiller.com
Website www.ITIC-insure.com

[Download this form in Word 6/95 format]

1. General Information

Company Name:

ITIC Member No.:

Address:

Telephone:

Fax:

E-mail:

Insured activity for which insurance required (Please tick):

Chartering broker:

Sale and purchase broker:

Ship manager:

2. Estimate of annual commission / management fee earned

Please indicate currency e.g. US$

a) This financial year:

b) Next financial year:

Please list the three largest commissions you earned last year:

US$

3. Claims History

Have you ever suffered a loss of commission due to:

(a) total loss or constructive total loss of a ship: yes no

(b) as a result of a marine peril (fire, heavy weather etc): yes no

If "Yes" to any of the questions please give full details separately by fax, mail or alternatively, if you have it electronically attach your file here. †

†

4. Limit of cover required

We can offer a wide range of limits per claim and in the aggregate; please indicate your requirement.

US$

per claim and in total each year US$

This proposal form must be completed by a person who is authorised to bind the proposer.

Name:

Position in company:

Date:

† The total aggregate size of all your attached files should not exceed 1Mb.

Commission Insurance

Loss of commission insurance has been available to shipbrokers from the traditional insurance markets for some time. ITIC decided that its Members might be better served by a policy more specifically tailored to ship brokers' and ship managers' needs, offered as an attachment to Members' existing liability insurances.

Cover is offered either on an individual declaration of a charter, sale, purchase, or management contract or, annually for all fixtures or management contracts concluded throughout the year. In the latter case there is no need to make any further individual declarations as they are automatically covered.

Loss of commission insurance can be considered an essential cover, similar to business interruption and loss of profits insurances which routinely cover any other business. The losses caused by, for example, the last minute cancellation of a period time charter could seriously disrupt a broker's income.

Cover can be arranged in a number of different packages - ranging from total loss only to loss of commission through a marine peril such as heavy weather, fire, piracy, collision, engine breakdown, and negligence of master or crew. The only circumstance which cannot be covered is loss of commission resulting from financial default.

Only brief underwriting information is required. Simply complete a proposal form and return it to your underwriter at ITIC, or your insurance broker, to obtain a quotation. The cover is only available to Members of ITIC.

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