Marine Cargo Insurance Proposal Form-MOC
Please complete this form to apply for your Marine Cargo Insurance Account with Allianz. Your application will be reviewed within 1-2 weeks. Upon approval, you can conveniently fund your wallet and start booking your insurance with ease.
Estimated completion time:
3 minutes
Insured Details
Provide the legal company name and full contact information of the company applying for Allianz' Marine Cargo Insurance access.
Name of the Company
*
Address and contact details of Insured
*
Email of Applicant
*
Insured Interest
List your common shipments for insurance consideration. Include details on oversized, heavy, dangerous, perishable, or special handling requirements. Add as many as needed by pressing "Add Insured Interest".
Insured Interest
*
Insured Interest
Voyage Pattern
Please provide the primary ports or airports of departure and arrival, and if you have any shipments to Sanction Countries, mention them below.
Mainly From:
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Mainly To:
*
Sanctioned Country shipments?
Kindly indicate if there are shipments to Sanction Countries such as Iran, Iraq, North Korea, Yemen, Africa, Lebanon, Russia, Somalia, Sudan, Syria,Ukraine, Zimbabwe etc
Means of Conveyance
For each mode of transport, enter the corresponding percentage of your annual turnover and the estimated maximum value of cargo you would insure on any single shipment using that mode of transport (plus 10%). Use the remarks column for any special instructions or information.
Means of Conveyance
*
% of Annual Turnover (e.g. 30% of turnover)
Max limit any one Conveyance [Plus 10%] - (e.g. USD100,000 max for one shipment)
Remarks
Air
Sea
Land (Truck / Rail)
Courier / Parcel post
Others: Hand carried etc
Estimated Annual Turnover:
*
Please provide the estimated Annual Turnover of your company.
Type of Cover needed
Institute Cargo Clauses (A) / War / Strikes and Institute Cargo Clauses (Air) / War / Strikes are mandatory fields. Please select these. Specify any additional coverage needed in "Others."
Institute Cargo Clauses (A) / War / Strikes
*
Yes
Institute Cargo Clauses (Air) / War / Strikes
*
Yes
Others = please indicate
By Sea: Vessel Details
If commonly used vessels are 25 years or older, please mention. If nothing out of the ordinary, please disregard this section.
Vessel Details
Type of Vessels, Age, etc. (if available)
Claims Statistics (Last 3 Years)
Please complete this section only if you have filed insurance claims within the past three years. If you have multiple claims, please add a new row for each. If no claims were made, you may leave this section blank.
Claims Statistics Details (last 3 years)
Contact Details
Please enter the details of the individual(s) who will be accessing the Insurance Platform. This information will be used to generate their login credentials. For security purposes, a personal mobile number is mandatory for Two-Factor Authentication (2FA). (IMPORTANT: Please be aware that all users granted access will be able to apply for insurance, which involves associated costs.)
Contact Details (all fields are required!)
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Submit
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