copyright © santam ltd. 2010 1 course code: assess123/ipt ...apply knowledge of short term...


ASSESSMENT CONTRACT

Qualification: SMK 123

NQF Level: 4

Credits: 30

Candidate’s Name and Surname: Candidate’s ID number:

Facilitators Name and Surname:

Facilitators Contact details:

Venue of Pre-Assessment Meeting:

Date received:

Santam welcome you to the Assessment Process

This document serves to familiarize and prepare you in the assessment(s) that you are about to embark in.

It is a map that informs you of the steps involved in the assessment process and will allow you to prepare for

your assessment(s), setting you at ease, and give you an opportunity for success.

Statement/Question

Yes/No

Initial and make any

comments if you answer NO

Were you welcomed and made to feel at ease?

Were the purpose and objectives of the meeting explained?

Were the assessment process and principles of good

assessment explained to you? I.e. Fairness, Validity,

Authenticity, Sufficiency, Currency and Reliability

Were any special assessment needs or barriers identified,

discussed and eliminated?

Were the role and the responsibilities of the learner, assessor,

moderator and verifier been explained to you?


Statement/Question

Yes/No

Initial and make any

comments if you answer NO

Were you informed of: Your rights, The appeals process Re-assessment policies? Remember:

You have the right to appeal against any judgement given as a result of any assessment. (You must have valid reason for doing this)

You have the right to an interpreter if you need one to perform this function. However if one of the learning assumptions for the standard is that you are competent within the language of assessment, you may not have an interpreter.

You can ask that an impartial observer attend any assessment. This observer may not be involved in any part of the assessment.

If you do not agree with the assessment, you have the right to have your assessment internally moderated.

If you still do not agree with the result of the assessment you can ask that the ETQA (Education and Training Quality Assurance) perform an external moderation on the assessment.

If any verification upholds the assessment findings you will be held liable for all the costs of the verifications.

If any verification rules that you have been aggrieved as a result of the assessment, your provider will be liable for all costs of verification

Was the importance of confidentiality in the process (assessment) explained? Each assessment application The outcomes Results and reviews will be treated as a confidential matter by the candidate, assessor and moderator.

Were you provided with a copy of the assessment contract?


Were you informed of the various assessment instruments/tools to be used?

Please take note of the following:

No tipex allowed

No typing allowed

Assignment must be complete in PEN not in pencil – only blue or black pen.

Attach all the necessary documents as requested by facilitator

Please take note of the following: You commit plagiarism when you present someone else's ideas -published or unpublished - as if they were your own. This is unacceptable and if you are found guilty of plagiarism you will not be able to continue with the course or obtain the credits applicable to this course.

Do you understand the process?

You need to complete your Formative

Evaluation and post this to :

Santam : Learner Administration Department

Private Bag X226

Pretoria

0001

You need to do any remediation on your

Formative evaluation within 60 days of receiving

your results letter.

You need to write your Summative evaluation

within 60 days of receiving your Competent

Formative result letter / Notification of

remediation on summative

You will only be allowed two remediations on Formative and Summative assessments, where after

you need to redo the course.


Make sure that you prepare yourself thoroughly for the assessment to avoid re-assessment. You will be allowed one free remediation where after a fee of R200.00 (VAT inclusive) will be payable for the second remediation. You will only be allowed two remediations, if you are found Not Yet Competent on your second remediation you will need to redo the course. Should any remediation not be received within 60 days after you have received your result letter, you will be requested to re-attend the programme and your portfolio will be destroyed. After you have been found Competent on your Formative Assessment, you will have 60 days to write your Summative evaluation (exam). If no summative evaluation (exam) is written within 60 days, you will be requested to re-attend the programme and your portfolio will be destroyed. Should Santam not be able to contact you due to a change in contact details, the same rules will apply. Any deviation of the 60 days limitation (formative) or 60 days limitation (summative) will be dealt with by the assessment centre, and only if proof can be offered. Please do not hesitate to contact us should you have any queries regarding the assessment process. You will receive a SMS or e-mail once your portfolio is received. Thereafter you will receive a provisional results letter within 30 days. Please remember that your provisional results are subject to internal moderation and these results may be overturned by the Moderator. Should this happen a new results letter will be issued. Thereafter an INSETA verification will take place and only after they have approved the batch, a final statement of results be issued. This process is a lengthy process and is outside of our control but we will attempt to finalise your results as soon as possible. Declaration of understanding (please indicate Yes or No)

I understand the importance of this meeting

I declare that the above mentioned points of the pre-assessment document were explained by the facilitator

I declare that I have received copies of the Unit Standards, assessment plan, assessment schedule and copies of the relevant policies and procedures pertaining to my assessment.

I was given the opportunity to clarify any issues relating to the assessment process and my assessment plan.

I have requested this assessment in accordance with my own free will and without duress.

I HAVE READ THE ABOVE AND UNDERSTOOD THE CONTENTS THEREOF

Candidates Signature:

Date:

Facilitator Name and Surname: Facilitator Signature:

Date:


LEARNER INFORMATION FORM

The information completed in this form is used to upload your records to the National Learner Record Database. Please ensure that the information is correct and legible. NB: Should any of your contact details change, please ensure that Santam is informed of this change so that we may be able to contact you in the event of results letter notifications etc.

Attach certified copies of certificates and qualifications and provide contactable references.

Surname:

Full Names:

Maiden Name:

Title (Mr / Mrs / Ms / Dr):

Date of Birth:

Identification Number:

Other Identification (if you do not have an ID): (Driver’s license, Temporary ID, Birth Certificate, Passport)

Type of ID: Number:

Marital Status:

Gender: (Male/Female)

Population Group: (Black/Indian/Coloured/White)

Home Address:

Code:

Postal Address:

Code:

Province:

Phone Number(s): Home:

Work:

Cell:

Fax Number:

E-mail Address:


Other Languages:

Employment Status: (Employed or unemployed)

Are you a SANTAM employee or a Broker?

Nature of Disability (if any): (Please provide medical confirmation of condition.)

Highest School Qualification: (Indicate grade/standard) Please include certificates in your PoE.

Other Qualifications:

Employment History:

References:

1

Certified copy of your ID

PLACE A CERTIFIED COPY OF YOUR

IDENTITY DOCUMENT HERE.

PLEASE MAKE SURE THAT IT IS CLEAR AND THAT THE PHOTOGRAPH

IS VISIBLE.

2

Cafe

Module 1

Copyright © Santam Ltd. 2007

Course code: ASSESS123 / Module 1

Introduction to course This outcome-based course is based on the theoretical training as stated in SMK 1, 2 and 3 which you have already completed. The following sections are relevant:

General

Fire

Buildings Combined

Office Contents

Business Interruption

Theft

Money

Glass

Business All Risks

Goods in Transit

Public Liability

Electronic Equipment

Motor

Motor Traders - Internal Risks

Motor Traders - External Risks This project was specifically compiled to align with the NQF outcome-based principles. It is a practical project, aimed at the application of the theoretical knowledge you have already acquired. With this project, the following aspects will be addressed in certain risks (case studies):

General questions commonly asked when applying for insurance;

Overview of the premises to determine the risk (visual material and site layout);

Application form, accompanied by the necessary underwriting principles / recommendations (consider the risks as acceptable for all practical purposes); and

Questionnaire for changes/amendments to a risk. You have to complete this project within two months, at your workplace. Once completing this project, you will be subjected to an open book evaluation. After the evaluation, you will be able to qualify for 30 credits of the following Unit Standards.

Copyright © Santam Ltd. 2010 4 Course code: ASSESS123 /Module1

Unit Standards Credits Unit Standard number

Underwrite a standard risk in short-term commercial insurance

10 120110

Apply knowledge of business interruption insurance

3 120120

Apply technical knowledge and underwriting of business insurance

10 120115

Apply knowledge of short term insurance to the All Risks section of a commercial policy

2 120122

Apply technical knowledge and understanding of business motor insurance

5 120135

As there is expected from you to complete this project by yourself, you will find a declaration at the end of the assignment to complete and sign. Aids for each risk (case study)

Compact disk or video tape

Site layout(s)

Relevant information for underwriting the risk Objective During this project, you will be evaluated by:

The answering of general questions most commonly asked when applying for insurance;

The evaluation of basic risks;

The completion of an application form along with the necessary underwriting principles/recommendations; and

The answering of general questions most commonly asked in relation to changes/amendments of a risk.


Action plan

1. Café Client approaches us to take over an existing policy

2. Filling station Current client acquires a filling station

3. Office content Renewal

4. Auto-electrical specialists Extension of existing policy

5. Carpentry factory New policy

6. Goods in transit General questions on cover

Please note that in certain case studies where reference is made to SA Insurers, it is the same entity as SA Insurance Company.


Evaluation of Assess123 Evaluation of the assignments for the aforementioned project will take place as follows: The assignments consist of direct questions and answers. The assignments will be evaluated on marks as indicated for each question. The required minimum pass mark for assignments is 70%. Assignments that entail the completion of inspection reports and application forms. These assignments will be evaluated on the basis of competency. The assessor declares the learner competent if he or she can complete 70% of the relevant inspection reports and application forms. The assessment of competency is at the full discretion of the assessor because no marks are awarded as in the case of other assignments. In both cases, the learner will be declared competent if he or he achieves 70% or more.


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.


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


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


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


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


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


Insurance Company


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.


Insurance Company


Insurance Company


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


Insurance Company


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


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 __________________________________________________________________________________


Insurance Company


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:


Insurance Company


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


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 __________________________________________________________________________________


Insurance Company


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


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.


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


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


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


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


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


Quotation form

Section Sum insured Rate Premium

Fire ,375%

Theft 7%

Money 7%

Glass 7%

Public Liability

Product Liability

Legal Defense Cost

Wrongful arrest

R2 000 000 R 500 000 R 10 000 R 50 000

R750 R200 R 50 R 50

Comments and General Recommendations ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________


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.


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


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


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


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


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:


Notes:


SECTION 6 THEFT



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:


(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

Item Item Item Item

Occupation code:

Slip number:

Bordereau number

Total facultative %

Reinsurer N/A



Contact person

Clauses applicable:


Notes:


SECTION 7 MONEY



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

/ / / / / / / /



(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:

A B C D E

Yes No


Basic and extensions: Item Item Item Item

Basic Cover:

Premium

R R R R

Petrol attendants

Limit

R R R R

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



Contact person



Notes:


SECTION 8 GLASS



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

ded

Can

cel

/ / / / / / / /


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 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



Notes:


SECTION 13

PUBLIC LIABILITY



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 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


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



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



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



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



Notes:

--


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


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 1 course code: assess123/ipt ...apply knowledge of short term...

Documents