Money Insurance Proposal Form

Here is a brief summary of the cover provided by our Money Insurance policy. We will be pleased to discuss details of the cover that is best suited to your needs, and will supply a specimen policy which sets out he full terms and conditions in details which alone will govern any contract of insurance.

The Cover

The Company insures money: -

In transit between the insured's premises and bank or post office.
In custody of collectors whilst in transit until delivered at premises or bank.
Other specified transits.
In the office during business hours.
In locked safe or strong room out of business hours.
Please select the country/city where the form is to be submitted
1 Name of the Proposer
2 Address
3 Telephone No:
4 Fax No:
5 E-mail
MONEY IN TRANSIT Limit of Liability Maximum amount carried any one time. Estimated Annual Carrying
A Bank to Premises
(1) Money drawn from Bank and/or Post Office for payment of wages and salaries
(if wages and salaries are not paid away on the day drawn from the Bank and/or Post Office, state maximum amount of such moneys held in locked safe or strong room out of business hours (if none, state "NIL")
(2) Money (other than wages and salaries) drawn from Bank and/or Post Office
B Premises to Bank Money in transit from Proposer's Premises to Bank and/or Post Office
C Travellers and Collectors Money (other than A and B above) collected by employees for delivery to Proposer's Premises or Bank subject to delivery being made on the same day as received
D Other Transits

Money on the Premises (other than under A)
E During Business Hours Money (other than described in Section A (1) above) whilst contained in the Proposer's Office Premises during business hours, State maximum amount.
F Outside Business Hours Money (other than described in section A (1) above) whilst contained in a locked safe or strong room in the Proposer's premises out of business hours. Give total sum

Please give particulars of safe and strong rooms in which money is contained out of business hours.
Maker's Name and Number Size and Weight Whether marked "Thief Resisting" Whether fixed to floor or wall Value of Safe Maximum amount of money therein

1 Please state for Transists A and B
(a) The Frequency of the journeys
(b) Method of conveyance
(c) Maximum distance
(d) Number of employees engaged at any one time.
2 What precautions are taken to ensure the safety of money on the premises during business hours?
3 .Are the Premises occupied at night? If so, by whom?
4 Do you hold any Fidelity Guarantee on your employees? If So, with whom ?
5 Have you ever sustained the loss of any money? If so, please give details.
6 Have you had an insurance in respect of loss of money declined, Cancelled or subjected to special terms by an Insurer? If so, please give particulars.

Declaration
I/We declare that the above statements are true and that I/we have not withheld or concealed any material information, and I/we hereby agree that this proposal and declaration shall form the basis of the contract between me / us and Compagnie Libanaise de Assurances S.A.L and I / we agree to accept a policy subject to the terms, conditions prescribed therein. The liability of the Company does not commence until the acceptance
of the proposal has been intimated by the Company.
 
 

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