CARGOINSURE Online Program Application

Note that fields with an * are mandatory

"*" indicates required fields

Basic Information

Policy Holder Street Address*
Estimated annual value of cargo to be insured.*
Last Year
Current Year
Note: whole number only, with no currency symbol.
Estimated number of shipments insured.*
Last Year
Current Year
Note: Whole number only

Annual Percentage (%) Breakdown of Shipments

Percentages must equal 100%. If none, please enter 0
(Please note all HGPE require prior approval)

If other interests and / or Specific Projects Shipments are your only business, you will have to complete another section of this site. However, Please continue completing this application. We will contact you in due course giving you details as to how you should proceed.

Have you had any single losses in excess of $1000 $USD over the last five years?
Have you ever had cargo insurance refused or had any special terms imposed ?
Maximum Value any one shipment in $USD.
By Sea
By Air
By Land
Any one Location
Percentage of total cargoes handled*
% by Full Container Load *
% by Less Container Load *
% by Breakbulk *
Percentage Methods of Shipment*
% By Sea *
% By Air *
% By Land *

Please Attest

I / We agree that this insurance is subject to English Law, Practice and Jurisdiction

I / We certify that the information given above is correct to the best of my / our knowledge

Disclosure Notice: Every proposer must disclose any material facts or information which might influence insurers in deciding whether or not to accept the risk, what the terms should be or what premiums to charge. Failure to do so may render any insurance contract voidable from inception and enable the insurer to repudiate all liability

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