cafe module 1 - santam · course code: assess123 / module 1 . case study 1 café module...
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1
Cafe
Module 1
Copyright © Santam Ltd. 2007
Course code: ASSESS123 / Module 1
Case study 1 Café
Module introduction Mr X, a prospective client, is extremely dissatisfied with the current service of SA Insurance Company. As his policy should soon come up for renewal, he approaches us to take over his current policy. We will provide you with the current policy schedule. It will be expected of you to answer general questions, to give an overview with the help of a site layout and CD/video, to determine the premium, to give a quotation, to follow the underwriting principles, as well as to advise the client on possible changes.
The following sections are relevant to this case study:
General
Fire
Theft
Money
Glass
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. The experience gained when working through this case study will provide you with the necessary knowledge and confidence to handle similar queries in future. Module goal The goal of this module is to evaluate your knowledge of the following aspects of a café as risk:
General questions continually asked;
Risk evaluation with the necessary recommendations;
Determining tariffs, giving a quotation and the application of underwriting principles; and
The answering of questions on possible changes in the risk.
Copyright © Santam Ltd. 2010 3 Course code: ASSESS123 /Module1
Case study Motivate your answers with the relevant facts throughout to qualify for the maximum allocation of marks as indicated per question.
Task 1 When visiting Mr X at his café, he inquires about the following aspects: 1. Although he is extremely dissatisfied with the service of his current insurer, he receives
notable discount on his premium. He wants to know if we will blindly accept this premium. ___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
2. Should he insure the total content of his café against fire? Doesn’t our company make
provision to do it on a first-loss basis?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
3. He realises that cigarettes pose a greater risk and therefore, wants to know if it will be covered in its entirety against theft, burglary and robbery.
___________________________________________________________________________
___________________________________________________________________________
4. He also sells Lotto tickets. Will he enjoy cover if he is robbed of the money from its sales? They are responsible by contract. The average sales amount for Lotto tickets is R20 000. ___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
3
2
1
2
Copyright © Santam Ltd. 2010 4 Course code: ASSESS123 /Module1
5. The café is located next to a busy street. Therefore, his current insurer
doesn’t want to provide him with cover for example when somebody scratches the café’s large windows with a sharp object. Will our policy provide cover for this incident? _________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
6. Mr X wants to know whether he will qualify for discount when paying his premiums annually in advance. ___________________________________________________________________________
___________________________________________________________________________
7. His doesn’t have a safe in his café. He wants to know what the limit of his cover will be if the money is kept after hours in a container under the counter.
___________________________________________________________________________
___________________________________________________________________________
8. The insured wants to know if our policy will cover him against food poisoning. He doesn’t know whether his current policy provides cover for it.
___________________________________________________________________________
___________________________________________________________________________
9. The owner of the building equipped all the shops in the complex with air conditioning units. But he keeps every tenant in terms of their lease agreement responsible for damage to the air conditioners. Will he enjoy cover in terms of our policy for damage done by vandals to the external parts of the unit which is in the communal yard? His current insurer couldn’t answer this question. ___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
TOTAL
2
2
1
2
3
18
Copyright © Santam Ltd. 2010 5 Course code: ASSESS123 /Module1
SA VERSEKERINGSMAATSKAPPY
INSURANCE COMPANY Reference 5555 Mr X 110 Durban Road Durbanville 7550 Policy number 123456789 Segers Superette & Take Aways Dear Mr It is our pleasure to include with this a copy of your policy. Yours sincerely Head of Underwriting
Copyright © Santam Ltd. 2010 6 Course code: ASSESS123 /Module1
SCHEDULE
Insurer: SA Insurance Company Product: Multimark III Insured: Segers Superette & Take Aways
110 Durban Road Durbanville 7550
Business: Café and Take Aways Agency: XYZ Brokers Agency number: 00001 Manner of payment: Monthly debit order in advance Institution: Absa Date of payment: 1st day of the month Insured period: 1 January 2004 to 31 January 2004
Any consecutive period of one calendar month to which the company agrees to renew the policy or any section of it.
Office: Durbanville Signed at Durbanville on 3 January 2004.
On behalf of the insurer
SA Versekeringsmaatskappy
Insurance Company
Copyright © Santam Ltd. 2010 7 Course code: ASSESS123 /Module1
SCHEDULE SUMMARY
Effective sections Additional/Refund premium
Renewal premium Monthly Annually
Fire 0,00 R170,00 R2 040,00
Theft 0,00 R333,33 R4 000,00
Money 0,00 R 33,33 R 400,00
Glass 0,00 R 20,00 R 240,00
Public Liability 0,00 R166,67 R2 000,00
Broker’s fee R 15,00 R 180,00
Total premium (14% VAT included) 0,00 R738,33 R8 860,00
After inception of cover, this schedule will become a tax invoice for the payment of the amount due (VAT number: 1234). Prescription date: 01/01/2005
SA Versekeringsmaatskappy
Insurance Company
Copyright © Santam Ltd. 2010 8 Course code: ASSESS123 /Module1
Policy number: 123456789 Insured: Segers Superette & Take Aways Effective date: 01/01/2004 ___________________________________________________________________ Endorsements applicable to monthly policy (Endorsements attached to policy and which form part of it)
Section Reference General 001 Adjustment of premium clause Fire N.A. Theft Money N.A. Glass N.A. Public Liability (Claims made basis) 112 Extension: Products liability 113 Extension: Wrongful arrest and defamation __________________________________________________________________ General provision If, in the schedule of this policy, the sum insured, limit of indemnity or compensation is:
left blank or has no monetary amount stipulated against it;
reflected as nil or not applicable or not covered or no indemnity extended; it means the defined event or circumstance shown in the schedule is not covered by the policy.
SA Versekeringsmaatskappy
Insurance Company
SA Versekeringsmaatskappy
Insurance Company
Copyright © Santam Ltd. 2010 9 Course code: ASSESS123 /Module1
SCHEDULE SECTION FIRE
Policy number: 123456789 Insured: Segers Superette & Take Aways Transaction number: Effective date: 01/01/04 ___________________________________________________________________
Stand no. Details of premises/Item description Sum insured/ Indemnity limit
1 110 Durban Road, Durbanville
Stock in trade R200 000 Equipment R300 000 Signage R 10 000
Construction: Standard Occupation: Café and Take Aways Additional perils: Extension: Earthquake Extension: Special perils Extension: Malicious damage
_____________________________________________________________________________________________
Optional extensions applicable
N.A. __________________________________________________________________________________
Memorandums
N.A. __________________________________________________________________________________
Optional extensions not applicable Extension: Riot and strike Extension: Leakage Extension: Subsidence and landslip Clause: Stock declaration conditions Extension: Escalator clause Clause: Disposal of salvage
SA Versekeringsmaatskappy
Insurance Company
Copyright © Santam Ltd. 2010 10 Course code: ASSESS123 /Module1
SCHEDULE SECTION THEFT
Policy number: 123456789 Insured: Segers Superette & Take Aways Transaction number: Effective Date: 01/01/04 ___________________________________________________________________ Stand no. Details of premises/Item description Sum insured/
Indemnity limit 1 110 Durban Road, Durbanville
First-loss cover R 50 000
Excess 10% of claim min R500
Construction: Standard _____________________________________________________________________________________________
Optional extensions that apply Keys and locks: R2 500 __________________________________________________________________________________
Memorandums Memo 1: Limit on tobacco and cigarettes: R 10 000 Memo 2: Condition 2: Burglar alarm (siren type) __________________________________________________________________________________
Optional extensions that do not apply
Buildings - Increased limit
Copyright © Santam Ltd. 2010 11 Course code: ASSESS123 /Module1
SCHEDULE SECTION GLASS
Policy number: 123456789 Insured: Segers Superette & Take Aways Transaction number: Effective Date: 01/01/04 ___________________________________________________________________ Stand no. Details of premises/Item description Sum insured/ Indemnity limit 1 110 Durban Road, Durbanville
Limit R 3 000
Excess 10 % of claim min R250 _____________________________________________________________________________________________
Optional extensions that apply
N.A. __________________________________________________________________________________
Memorandums N.A. __________________________________________________________________________________
Optional extensions that do not apply Riot and strike extension
Special replacement __________________________________________________________________________________
SA Versekeringsmaatskappy
Insurance Company
Copyright © Santam Ltd. 2010 12 Course code: ASSESS123 /Module1
SCHEDULE SECTION MONEY
Policy number: 123456789 Insured: Segers Superette & Take Aways Transaction number Effective Date: 01/01/04 ___________________________________________________________________ Stand no. Details of premises/Item description Sum insured/ Indemnity limit 1 110 Durban Road, Durbanville
Specific limits/details Indemnity limit
1. Money which is not kept in a locked safe or strongroom (i) While it is on the insured premises, after the insured’s R3 000
trading hours; (ii) While it is in the dwelling of the insured, a partner, R3 000
director or employee of the insured; (iii) While it is on the insured premises, in the safe-
keeping of one or more of the petrol attendants; and R_____
(iv) While (a) It is in the safekeeping of one or more
collectors or delivery people; R_____ (b) It is in the safekeeping of a partner, director or
employee of the insured who is on a business trip R3 000 any place in the world and away from the insured premises.
2. Money kept in a locked safe or strongroom in a building on the insured’s premises after the insured’s trading hours.
i. With regard to the safe or strongroom as described below:
………………………………………………………………… R_______
ii. With regard to any safe or strongroom which is not specified in 2(i) above, the limit in relation to the grading of such a safe or strongroom will be determined as follows:
SA Versekeringsmaatskappy
Insurance Company
Copyright © Santam Ltd. 2010 13 Course code: ASSESS123 /Module1
No SABS grading R 5 000 SABS category 1 grading R 10 000 SABS category 2 grading R 20 000 SABS category 2 grading HD grading D3 R 40 000 SABS category 2 grading ADM grading R 100 000 SABS category 2 grading ADM grading D3 R 125 000 SABS category 3 grading R 175 000 SABS category 4 grading R 350 000 SABS category 5 grading R 500 000
It is provided that the liability of the company for premises affected is always at most limited to the amounts stated below (3).
3. With regard to any other loss of or damage to money during the period described below, the indemnity limit for money related to the specified insured premises will read as follows:
Main limit - during December or any mentioned period R 5 000 - any other period R 5 000
With regard to the loss of crossed cheques, crossed bills or crossed postal orders. (The indemnity limit below is payable above the indemnity limit shown in 1, 2 and 3.) R100 000
Details Indemnity limit/ Compensation
Clothing R3 000 Containers R2 000 Keys and locks R3 000 _________________________________________________________________________________
Optional extensions applicable Personal accident (assault) extension Capital sum R10 000 Weekly sum R 100 Medical costs R 1 000 Number of persons 3
__________________________________________________________________________________
Memorandums Excess: 5% of claim min R500
__________________________________________________________________________________
Optional extensions not applicable Riot and strike extension
Copyright © Santam Ltd. 2010 14 Course code: ASSESS123 /Module1
SCHEDULE SECTION PUBLIC LIABILITY
Policy number: 123456789 Insured: Segers Superette & Take Aways Transaction number: Effective Date: 01/01/04 ___________________________________________________________________ Stand no. Description Indemnity limit 1 110 Durban Road, Durbanville
Claims made basis R2 000 000 Excess 5% of claim min R1 000/ maximum R25 000 Retrospective date: 01/01/2004 _____________________________________________________________________________________________
Optional extensions applicable Products liability R500 000
Products: Take aways and baked products Legal defence costs R 10 000 Wrongful arrest and defamation
per event R 50 000
per annual insurance period R100 000 __________________________________________________________________________________
Memorandums Excess with regard to products liability: 10% of claim min R2 000 and with a maximum of R25 000 __________________________________________________________________________________
SA Versekeringsmaatskappy
Insurance Company
Copyright © Santam Ltd. 2010 15 Course code: ASSESS123 /Module1
SITE LAYOUT
STRAAT
YARD
LEAN-TO
CLOTHING STORE
COUNTER
CELLPHONE DEALER
STORE
KITCHEN
STORE DFGH
STORE
CASE STUDY 1: CAFE
C O N S T R U C T I O N WALL: BRICKS ROOF: CORRUGATED IRON AIR CONDITIONING COMPRESSOR GLASS SLIDING DOOR GLASS WINDOW
xxxxx
Copyright © Santam Ltd. 2010 16 Course code: ASSESS123 /Module1
Task 2 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.
Copyright © Santam Ltd. 2010 17 Course code: ASSESS123 /Module1
FIRE SURVEY REPORT
TO: ………………………………………….…… FROM: ……………………………………………
BRANCH: ………………………………….…… SURVEYOR: ….…………………………...…… DEPARTMENT: ………..……………………… SURVEY NUMBER: ………..…………………. REFERENCE: ………….……………………… DATE: ……..………………….…………………. DATE: ……..……………………………………. Name
Address Postal code
Occupation
Area class: ( ) N/A Retention class: N/A. Construction class:
GENERAL DESCRIPTION
Locality Industrial Commercial Closed Shopping Centre
Residential Other
Details (if other)
Construction Roof Reinforced Concrete Corrugated Iron Tiles
Thatch Saw tooth Details other
Box guttering Condition of gutters Good Poor
Skylights Plastic Fibre glass
Walls Reinforced concrete Brick I.B.R.
Details other Is building older than 10 years? YES NO
No. of floors No. of basements 0
Construction of floors Concrete Timber
Condition of premises Good Average Poor
Adjacent exposure Low Average Poor
Rivers/Canals N.V.T. Debris Block-up
Detail (Type of exposure)
Adjacent Risk Communcates YES NO
Seperation by
Security Chain link fence 2m Wall Access Control
Street lights Floor Lights 24hr Security
Electric Perimeter fence
S.A.I.D.S.A. Corporate Alarm Other Alarm - Name
Copyright © Santam Ltd. 2010 18 Course code: ASSESS123 /Module1
Electrical Municipal supply X Eskom Supply
Contact Breakers Condition appears to be- Good Otherwise
Flexible extenstion leads noted YES X NO
Are plug points overloaded? YES NO X
Process (if major process involved, attach on separate sheet)
None Storage/Retail/Distribution only X
Heat Process/Welding/Grinding Flammable liquids Quantity
Flammable liquid store – brick under concrete slab YES NO
LP Gas installation ons site N/A Number of cylinders Size …………………KG
Is wall block manifold in good condition N.V.T. YES N/A NO X
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 None
Grease extraction filters clean N/A YES NO
Fire Protection
Local Fire Brigade ( ) would attend any ourbreak of fire Fire Station is = …5 Km…………………kms from risk
Appliances on Site – hand held YES NO
Size 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 X
Easy Access to appliances YES NO X Hydrant ring main YES NO
Automatic Sprinklers YES NO
A.S.I.B. Certificate Valid YES N/A NO
Sprinkler Detail – contact number
Edition ……………….…………………………Supply …….…………………………………………Units ………….……………………..
Hazard…………………………………………Stack Height ……N/A……………………………………
Requirements (A.S.I.B.) YES NO Smoke Detectors YES NO
Water Supply Municipal Bore Hole Dam
Copyright © Santam Ltd. 2010 19 Course code: ASSESS123 /Module1
LOSS HISTORY
Date 12 June 2004
Amount – R30 000
Cause Armed robbery
Remedial action Siren alarm with panic buttons
MANAGEMENT & HOUSEKEEPING
General Standard Good Average X Poor X
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 X NO X
Risk separated by fire break wall or detached buildings YES NO
If in your opinion less han 100% supply site plan N/A
Are buildings less than 5 metres apart? N/A YES NO
Seperation of buildings
OPINION OF RISK
Good Average X Poor
Risk acceptable YES X NO
Moral Hazard Good Poor
Inception Hazard High Medium Low X
Spread Hazard High Medium Low X
Fire Load High Medium Low X
FURTHER COMMENT Yes
If yes, see attached
Risk improvement requirements attached? YES X NO
……………………………………………………………………………….
Surveyor
………………………………………………………
Date
MONEY SURVEY REPORT
Copyright © Santam Ltd. 2010 20 Course code: ASSESS123 /Module1
SAFES/STRONGROOM
NO. 1 NO. 2 NO. 3
Manufacturer
Located in premises
Serial Number
Date of Manufacture
S.A.B.S. Catergory
Number of Locks
Types of Locks
Height (mm) N/A
Width (mm)
Depth (mm)
How secured
Door plate thickness
Key storage – day
Key storage – night
Max. Cash stored overnight R R R
Overnight “Book” limit R R R
Total number of receptacles (safes/tills)
Safes Cash Tills Est. Values
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
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
If NO requirements re new safes MUST be made (See question 7 at Task 1)
S.A.B.S. category drop/chute safe is a standard requirement for this type of risk Refer question 7 in Task 1
HOLD-UP
Maximum amount of cash on site – R 30 000 Late night trading YES NO
Drop/Chute safe used YES NO Manufacturer
Serial number Time Delay locks fitted YES NO
Keys kept by professional carriers YES NO Notices on display YES NO
Multi-Tenure Centre YES NO
ALARM COVER YES NO Installer – name ADT
Radio YES NO
Siren YES NO Armed response YES NO
Panic buttons YES NO S.A.I.D.S.A. Approved YES NO
Copyright © Santam Ltd. 2010 21 Course code: ASSESS123 /Module1
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 R30 000 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? N/A siren only
Distance from bank ………………………..kms
Time of banking varied? YES X NO
Route to and from bank varied YES NO Vehicle changed? YES N/A NO
Frequency of banking? Daily Frequency of till clearing? N/A
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 NO
……………………………………………………………………… Surveyor
……………………………………………………………….. Date
Copyright © Santam Ltd. 2010 22 Course code: ASSESS123 /Module1
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.
Copyright © Santam Ltd. 2010 23 Course code: ASSESS123 /Module1
APPLICATION FOR INSURANCE
[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 N/A :……………………………………………………………………………………………………………………………. [Name that will appear on the alphabetical index on computer]
Full Trading name 111222 :…………………………………………………………………………………………………………………………….. [Namae that will print on policy schedule]
Company Reg. No :111222……………………………………………… VAT 1001/2004 No.: ………………………………………………………… Language : Afrikaans English Telephone number : ……915=7000………………………………… Area code: ………………… Int. Code: ……………………… Fax Number : …915 7000…………………………………………… Area code: 021………………… Int. Code: ……………………… Cellular telephone : ……………………………………………… E-mail address : ……[email protected]……………………………………… Postal Address : ……………………………………………… Street address: ………………………………………………………. (Premisesl 1 should ……P.O. Box 1………………………………. (Premises 1) ……………………………………………………….. this be a street address) if diff. from ……Durbanville………………………………… postal address)……………………………………………………….. ……………………………………………… ……………………………………………………….. Postal code : ………7550……………………………………… Postal code ……………………………………………………… Contact person : ………Mr X……………………………………… Responsible area: ………Owner…………………….
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
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
√No Yes
Copyright © Santam Ltd. 2010 24 Course code: ASSESS123 /Module1
POLICY CONTENTS Policy type: Client no.: Inception date: Renewal date: ……../……./…….. ……../……./……..
Mark with Policy Sections
Annual Premium
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 ABSA Bank Durbanville
Institution code Branch code (bank/branch identification number)
1 0 0 1 0 0 1 0
Account number (client idenditifaction number)
1 2 3 4 5 6 7 8 9
Account holder (name of account with institution)
S E G E R S S U P E R E T T E
D/O frequency: Monthly Annual
Monthly debit order collection date:
On, or last working day voor* 29th 30
th 31
st 1
st
On, or first working day na 25th 26
th 27
th 28
th
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
N/A N/A
Copyright © Santam Ltd. 2010 25 Course code: ASSESS123 /Module1
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 %
N/A
Brokers fee R:
Survey number N/A Survey date: N/A
Surveyor N/A
Clauses applicable: (Complete according to survey report)
Number % Amount Number % Amount
Same risk policy number: N/A
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
Copyright © Santam Ltd. 2010 26 Course code: ASSESS123 /Module1
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…N/A…………………………… Premium: R…………………………………… Highest risk item number: …N/A…………………………….
ITEM DETAILS
Item Item Item Item
For exisiting policy/item,
please indicate:
From:
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
/ / / / / / / /
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 N/A
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
ple
te f
or
sessio
n n
ote
d
on ite
m
Cession/HP
Cession holder:
Cession/HP no.:
Expiry date:
/ / / / / / / /
Survey number.:
Survey date: / / / / / / / /
Surveyor:
Column reference is as follows: Type of rent
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
1. Rent receivable
2. Rent payable
3. Rent value
Construction
S – Standard
N – Non-standard
G – Thatch roof
Copyright © Santam Ltd. 2010 27 Course code: ASSESS123 /Module1
Basic and extensions Item Item Item Item
Fire/Light/Expl:
Premium
R N/A R N/A R N/A 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
Riot and strike
Premium
Premises
R R R R
Subsidence/Landslip
Premium
R R R R
Leakage:
Limit
Premium
R R R R
R R R R
Disposal of salvage Yes No Yes No Yes No Yes No
Stock declaration
Basis
Yes No Yes No Yes No Yes No
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 N/A
Total facultative %
Reinsurer
Reinsurer policy number
Reinsurer’s facultative %
Contact person
Clauses applicable:
Number % Amount Number % Amount
Notes:
Copyright © Santam Ltd. 2010 28 Course code: ASSESS123 /Module1
SECTION 6 THEFT
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……N/A………………………… Premium:
R……………………………………
ITEM DETAILS
Item Item Item Item
For an existing policy/item please indicate:
from:
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
/ / / / / / / /
Premises no / address:
Occupation description:
(what is insured and what is it used for?)
First loss limit: R R R R
Spesific description:
Unprotected goods: YES NO YES NO YES NO YES NO
Value of total goods R R R R
Construction description
Roof
Walls
Protection:
Com
ple
te f
or
cessio
n n
ote
d
on ite
m
Cession/HP
Cession holder:
Cession/HP no.:
Expiry date:
/ / / / N/A / / / /
Survey number.:
Survey date: / / / / / /
Surveyor:
Basic and Extensions Item Item Item Item
Basic cover: Premium
R R R R
Alarm condition YES NO YES NO YES NO YES NO
Locks and keys exceeding R2500 free limit
YES NO YES NO YES NO YES NO
Limit R2 500 R R R
Premium R included R R R
Damage to buildings exceeding R5 000 free limit
YES NO YES NO YES NO YES NO
Limit R R R R
Premium R R R R
OFFICE USE ONLY
Copyright © Santam Ltd. 2010 29 Course code: ASSESS123 /Module1
Item Item Item Item
Occupation code:
Slip number:
Bordereau number
Total facultative %
Reinsurer N/A
Reinsurer policy number
Reinsurer’s facultative %
Contact person
Clauses applicable:
Number % Amount Number % Amount
Notes:
SECTION 7 MONEY
Policy number and name (for amendment purpose)
Copyright © Santam Ltd. 2010 30 Course code: ASSESS123 /Module1
[Mark applicable choice with a . Areas marked with grey MUST ALWAYS be completed]
GENERAL SECTION DETAILS
Additional CPC limit: (exceeding R10 000 included) R……………………………… Premium: R N/A…………………………………… Receptacle limit: (exceeding R2 000 included) R …N/A…………………………… Premium: R……………………………………
Personal Accident option Premium: R…Included………………………………… Riot and strike Premium: R……………………………………
ITEM DETAILS
Item Item Item Item
For an existing policy/item
please indicate:
from:
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
/ / / / / / / /
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
ple
te f
or
cessio
n n
ote
d
on ite
m
Cession/HP
Cession holder:
Cession/HP no.:
Expiry date:
N/A
/ / / / / / / /
Survey number.:
Survey date: / / / / / /
Surveyor:
Basic and extensions: Item Item Item Item
Basic Cover:
Premium
R R R R
Petrol attendants R R R R
A B C D E
Yes No
Copyright © Santam Ltd. 2010 31 Course code: ASSESS123 /Module1
Limit
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 % N/A
Reinsurer
Reinsurer policy number
Reinsurer’s facultative %
Contact person
Clauses applicable: (Complete according to survey report)
Number % Amount Number % Amount
Notes:
Copyright © Santam Ltd. 2010 32 Course code: ASSESS123 /Module1
SECTION 8 GLASS
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 R10 000 included) R…N/A…………………………… Premium:
R……………………………………
ITEM DETAILS
Item Item Item Item
For an existing policy/item please indicate:
from:
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
/ / / / / / / /
Premises no / address:
Occupation description: (what is insured and what is it used for?)
Sum Insured: R R R R
OF
Square metres: 20 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 N/A
Other costs and expenses exceeding R2 000 free limit
Yes No Yes No Yes No Yes No
Limit
Premium N/A
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 N/A
Reinsurer’s policy number
Participation
Contact person
Clauses applicable: (Complete according to survey report)
Number % Amount Number % Amount
Notes:
Copyright © Santam Ltd. 2010 33 Course code: ASSESS123 /Module1
SECTION 13
PUBLIC LIABILITY
Policy number and name (for amendment purpose) [Mark applicable choice with a . Areas marked with grey MUST ALWAYS be completed]
GENERAL SECTION DETAILS
ITEM DETAILS
Item Item Item Item
For an existing policy/item
please indicate:
from:
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
New
Am
en
de
d
Can
cel
/ / / / / / / /
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
N/A
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 R1 000 000 R R R
Premium R R R R
First amount payable 10 % of claim % of claim % of claim % of claim
With a minimum of R2 000 R R R
OF a basic amount of R R R R
Defective workmanship
Limit R R N/A
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
OF a basic amount of R R R R
Copyright © Santam Ltd. 2010 34 Course code: ASSESS123 /Module1
EU Liability: Limit R
R N/A 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
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
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
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: N/A
Bordereaux number
Priority
Participating company
Participating policy no.
Participation
Clauses applicable: (Complete according to survey report)
Number % Amount Number % Amount
Notes:
--
Copyright © Santam Ltd. 2010 35 Course code: ASSESS123 /Module1
Motivate your answers with the relevant facts throughout to qualify for the maximum allocation of marks as indicated per question.
Task 3
The insured is still not sure about the following aspects: 1. He is planning to buy the whole complex and let it out to the current tenants. He will
suffer great damages should a fire damage the building and the tenants not pay their rent. Is it possible for him to insure the rent in this event? ___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
2. Suppose he does structural alterations to the building (after he has bought it) and he forgets to immediately notify us. Will he be penalised in the event of a claim?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
3. Mr X is planning to join a supermarket chain which will require changes to all his signwriting. As the signwriting is quite expensive, he would like to know what will happen when the glass on which was written needs to be replaced in the event of a claim. Will the policy cover it or will it be his responsibility? Although it didn’t bother him before, the new costs involved made him change his opinion on it.
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
3
3
1
Copyright © Santam Ltd. 2010 36 Course code: ASSESS123 /Module1
4. Mr X undertakes to hire a security guard from a local security company to be on the premises from 20h00 every evening. This is over and above meeting his current security measures. He is concerned that he could be held responsible for the security guard’s negligence. Will the policy cover him against it? ___________________________________________________________________________
___________________________________________________________________________
5. The insured also wants to know which type of safe he has to acquire to enjoy cover after hours for at least R10 000.
___________________________________________________________________________
___________________________________________________________________________
TOTAL
2
1
10
Copyright © Santam Ltd. 2010 37 Course code: ASSESS123 /Module1