Loss of Profit Insurance Proposal Form
Here is a brief summary of the cover available under each of our Consequential Loss policies. We will be pleased to supply specimen policies, which give further information about the covers and set out the full terms and conditions will govern any contract of insurance.

The Cover.

You insurance against Fire and additional perils will provide compensation for destruction or damage to your property, but it will leave you unprotected against financial loss resulting from the consequent interruption to your business.

When properly arranged, a Consequential Loss policy will put your business in the same financial situation it would have enjoyed had the destruction or damage not occurred.

Besides making good the loss of net profit following an interruption to trading, the policy also pays for:


Continuing overheads (or standing charges)

These are expenses, which must be paid regardless of any interruption to trading and will not vary in direct proportion to any reduction in business activity e.g. rent, rates, loan interest, etc.

Wages and salaries to retained employees.
Payments (where necessary) to discharged employees.


Increased cost of working These are costs, which are reasonably incurred to help maintain turnover, such as use of temporary premises, overtime working, or contracting work to other companies

Auditors' or accountants' charges incurred in producing information needed by us to complete a settlement.

Please select the country/city where the form is to be submitted
  Full Name of Proposer
Postal Address
Tel. No
Fax No.
E-Mail
What business or trade do you carry on at the premises?
Period of Insurance:    From
Period of Insurance:    To
1 How long have you been in the same business?  
(a) At these premises?
(b) Elsewhere?
2 When does the financial year of your business close?
3 Do you keep proper books of account, which are regularly and independently audited by professional accountants?
4 If not, what are your accounting arrangements?
Please give the name of your Auditors
7 Please give address of your Auditors
If the insurance of the buildings &/or contents is not placed with Compagnie Libanaise d'Assurances. S.A.L, please answer the following questions.
1 Details of insurance on Buildings &/or Contents: -
 (a) Name of Insurer
 (b) Sums Insured
 (c) Perils Covered
2 When were the buildings constructed?
3   What is the construction of: -
(a) External walls?
(b) Roof?
(c) Floors?
4   What external woodwork is there apart from doors and shutters?
5 Are the buildings in a good state of repair?
6   What is the method of?
(a) Lighting?
(b) Heating?
7 What manufacturing processes are carried out?
8 Is the machinery (if any) powered solely by electricity?
9 (a) What fire extinguishing appliances are there on the premises? (i.e. number and type)
(b) How often are these serviced and by whom?
10 Do you occupy the whole of the Premises?
If not, what other businesses or trades are carried on?
11 (a)  When are the premises left unoccupied?
(b) Is a watchman employed at all times whilst they are unoccupied and
if so, how are his rounds controlled?

12 How far is the nearest full time and adequately equipped Fire Brigade?
13 Please provide the following information in respect of adjacent Buildings: -
(a) Construction
(b) Occupation
(c) Separation from your premises
The following questions should be answered by all Proposers by deleting either "YES" or "NO". If the answer is "YES", please give the fullest possible details in the space provided.
1 Are there any other Consequential Loss insurance in force in respect of the same property?
2 Is any of the property especially liable to damage by any of the perils to be insured  against? 
3 Have you ever sustained a loss at these or any other premises by an of the perils to be insured against ? 
4 Has any insurer ever cancelled or refused to renew any insurance, declined to insure you, or required special terms or conditions?
5 Do you wish to cover any financial loss you may incur following any interruption caused by the insured perils at:
Premises of suppliers?
Premises of customers?
Premises where your property is stored? 
Premises of principal electric / gas / water suppliers? 
6 Do you require any other extensions to your cover? 
Additional Perils
Do you require any other extensions to your cover? 

If your Fire policy covers you for additional perils you may similarly extend your Consequential Loss policy. Please tick the perils required.
1 Explosion 2 Aircraft and aerial devices
3 Earthquake fire 4 Earthquake shock
5 Windstorm 6 Flood
7 Burst pipes and over flowing water tanks 8 Impact by road vehicles, horses or cattle
9 Any other additional perils (please give details below)    

Growth / Inflation Guide

It is important when calculating the sums to be insured that you allow for INFLATION and FUTURE GROWTH of your business. The following Guide is designed to assist you to complete the sums insured section overleaf.

Annual Rate of Inflation/ Growth %

1 Years %

2 Years %

3 Years %

4 Years %

5 Years%

 

10

110

121

133

146

161

11

111

123

137

152

169

12

112

125

140

157

176

13

113

128

145

164

185

14

114

130

148

169

193

15

115

132

152

175

201

16

116

135

157

182

211

17

117

137

160

187

219

18

118

139

164

194

229

19

119

142

169

201

239

20

120

144

173

208

250

25

125

156

195

244

305

30

130

169

220

286

372

35

135

182

246

332

448

40

140

196

274

384

538

How to use the Guide:
1 Fix the rate of growth / inflation by adding together:

• Your estimate of the annual rate of inflation

• The annual level of real growth anticipated in the business, ignoring the effects of inflation.
2 Fix the number of years by adding together:

• The length of the indemnity period

• One year for the current period of insurance

• The period since the end of the financial year covered by the last accounts.

3 Refer to the table to find the correct percentage an apply this to the appropriate annual Gross Profit figure.
4 For Wages and salaries the same procedure is followed, although of course calculations should be based on the anticipated average percentage increases in Annual Wage roll.
Note: Do not be afraid of selecting too high a sum insured. At the end of each year of insurance we ask for a declaration of the actual trading figures for that year. If it is found that the sum insured selected has been to high, a rebate of 50% of the premium paid will be allowed.
Sums to be Insured.
Indemnity Period
Please state the maximum period, which would be needed for the business to return to full earning capacity following a major fire
months,
Item 1. Gross Profit
This should be calculated as follows:
(a) Net Profit(for last financial year)
Less: any Dividents recieved &/or any rent recieved    Total(a)
  Plus
(b)Standing Charges

(i.e. those expenses which will still have to be paid regardless of any reduction in turn over)
Amount last financial year
  Rent 
  Rates
  Electricity, Gas and Water
  Other fuel and heating costs
  Maintenance of buildings, plant and motor vehicles    
  Depreciation on buildings, plant and motor vehicles. 
  Office and Trade Expenses  
  Loan interest  
  Bank Charges  
  Taxes 
  Hire Purchase payments.
  Duties and Licenses 
  Donations and Subscriptions 
  Insurance Premium
  Auditors' and Accountants' Fees
  Legal Charges
  Bad Debts reserve
  Salaries (incl. Insurance contributions)
  Director's Fees
  Pensions
  Salesmen's commission
  Wages (incl. Insurance contributions, bonuses, holiday pay, etc.) if insured as a standing charge
  Other charges (not specified above)  
  (a)
  (b)
  (c)
  If required, you may include an additional amount for miscellaneous standing charges, upto 5% of the above specified charges.
  Total (b)
  ANNUAL GROSS PROFIT for the purpose of the policy for the last financial year, i.e. Total (a) plus Total (b)
  Where an Indemnity Period of more than 12 months is selected the Annual Gross Profit figure should be increased proportionately to:
  Gross Profit figure should then be increased to allow for anticipated growth and inflation over the whole of the chosen Indemnity Period (please refer to Guide overleaf) to provide a realistic GROSS PROFIT SUM INSURED of:
  Item 2. Wages and Salaries
(if not insured as Standing Charges)
 
  The sum to be insured is the total Annual Wage roll (including insurance contributions, bonuses, holiday pay, etc.)
Where the Indemnity Period of more than 12 months is selected the Annual Wage roll should be increased proportionately to
The figure should then be increased to allow for anticipated increases and inflation over the whole of the chosen Indemnity Period (please refer to Guide overleaf) to provide a realistic WAGES SUM INSURED of




  B. If DUAL BASIS wages cover is required  
  (i) How many weeks are to be covered 100%
  (ii) What percentage is to be insured for the remainder of the Indemnity Period?
  Item 3 Auditor's Charges
To cover the COST OF AUDITORS producing and certifying details required in connection with a claim:
Declaration

I/We declare that the answers given in the Proposal are true to the best of my/our knowledge and I/we have withheld no information, whatever which might influence the decision of the Insurer regarding the Proposal.
I/We agree that the Proposal be incorporated in and shall form the basis of the contract between me/us and the Insurer and I/We shall accept a policy in the form issued by the Insurer for the insurance now proposed.
I/We agree to inform the Insurer of any material change in risk.
N.B. Cover does not commence until the Proposal is accepted by the Insurer.

 

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