Proposal Form For Cattle/Livestock Insurance

NATIONAL INSURANCE COMPANY LTD.
(A Subsidiary of General Insurance Corporation of India)
Regd. Office : 3, MIDDLETON STREET, CALCUTTA – 700 071

PROPOSAL FOR CATTLE INSURANCE
(This proposal must be accompanied by a certificate given by a qualified Veterinary Surgeon)

BENEFITS OF THE POLICY

The insured cattle are covered against death occurring anywhere in India or such other country or countries as the
Company may agree to due to accident (including of fire and/or lighting, flood, cyclone and famine) or disease (including Rinderpest,
Blackquarter, Hemorrhagic, Septicaemia, Anthrax, Foot & Mouth disease and Theilariasis) or surgical operation or strike, riot &civil
commotion but excluding death directly or indirectly due to or resulting from :
1. Malicious or wilful injury or neglect, over-loading, unskillful treatment or use of cattle for purposes other than stated in the
policy without consent of the Company in wirting.
2. Disease contracted prior to commencement of risk or risks.
3. International sloughter of the cattle except in cases where destruction is necessary to terminate incurable suffering of
human consideration on basis of certificate issued by qualified veterinary surgeon or in case where destruction is resorted
to by order of lawfully constituted authority.
4. (a ) Transport by air and sea.
(b ) Transport on road by conveyance beyond 25 Kms. from place of stabling.
(c ) Transit by foot beyond 50 Kms. from place of stabling.
5. Plueropneumonia in respect of Cattle in Lakhimpur and Sibsagar District of Assam.
6. War, invasion, act of foreign enemy, hostilities (Whether war be declared or not) civil war, rebellion , revolution,
insurrection, mutiny, military or usurped power or any consequences thereof or attempt thereat.
The indemnity or compensation provided by this policy shall not apply to nor include :-
(i ) Any accident, loss, destruction damage or legal liability directly or indirectly caused by or contributed to by or arising
from Nuclear weapons/materials.
(ii) Theft or clandestine sale of the insured cattle.
(iii) Permanent total disability, including permanent incapacity in conceiving or yielding milk.
INSURANCE ACT – 1938
Section 41 of the above Act reads as follows :-
1. No person shall allow or offer or allow, either directly or indirectly as an inducement to any person to take out or renew or
continue an insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the
commission payable or any rebate of the premium shown on the policy, nor shall any person taking out or renewing or
continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectuses or
tables of the Insurer.
2. Any person making default in complying with the provisions of this section shall be punishable with a fine which may extend to
five hundred rupees.
1. Name of proposer(s) :
2. Address :
3. Occupation :
4. Give the following particulars in full of each of the cattle proposed for Insurance :
Cattle’s
Number or
Mark and
How
Indentifiable
Species
And
Breed
Sex, Colour & full
distinguishing marks
(such as ear marks
scars, defects etc.)
Age
In
Year
Height
Date of purchase
by the proposer
and cost price
to the proposer
Present
Market
Value
Sum for which
Insurance is
Required
5. (a ) State for what purpose the cattle will be used.
(b ) Number of Calvings.
(c ) Date of last Calving.
6.(a ) Location of the Farm or Place, where the cattle
are houses.
(b ) Give full particulars of the construction of
the place where cattle are housed.
(c ) It is under your sole occupation ? If not,
whose other cattle are stabled in it ?
7.Is/Are the cattle in the stable sound and healthy
and free from vice ? It not, give full particulars or
defects and animals, if any.
8. Veterinary Services available :
(a ) Whether own veterinary Service available
or dependent of Government veterinary
services.
(b ) Number of qualified veterinaries whether
part time or whole time or on retainer basis.
(c ) Number of cattle covered by each
veterinary Surgeon.
(d ) Total area covered by each veterinary
Surgeon.
(e ) Distance from veterinary dispensary.
(f ) Annual budget sanction for Drugs, Vaccines,
etc. of the entire dispensary.
(g ) Storage condition for Drugs, Vaccines etc.
(h ) Details of Veterinary check-up that Insured
Cattle get as part of routine veterinary
attention.
9. (a) Have you lost any cattle during the last three years ? If so, state particulars:
Year
Cause of Loss
Number of cattle lost
(b ) Previous Cattle Insurance Claims experience (for the last three years).
Year
Policy No.
Name of the Insurer
Claim Amount
Whether claim settled in
full or in part of outstainding
or repudiated
10. Have any of the cattle proposed for insurance been
ill or incapacited through injury/ies during the
past 12 months ? If so, give particulars and state
whether a Veterinary Surgeon was in attendance.
11. (a) How many other cattle do you own ?
(b ) Are they Insured and where ?
(c ) If not, why are they not proposed for
insurance now ?
(d ) Are they insured previously and if so, where ?
12. Are any of the cattle now proposed for Insurance
or have any other animals belonging to you been
previously insured ? If so, state name of Company
or Underwriter.
13. (a ) What is the mode of Branding/Marking the
cattle for the purpose of Identification as
indicated under question(4) above
(b ) Are the other animals owned by the proposer
but not proposed for Insurance hereunder
also similarly Branded/Marked ?
14. Has any Company or Underwriter
(a ) declined insurance of any of your animals, or
(b ) refuse to renew their insurance, or
(c ) Increased your premium or imposed
special conditions on renewal ?
15. For what period is insurance required ?
Period ………………….months from……………………….
16. (a ) Are you the owner of the cattle ? If not,
state name and address of owner and also
nature of your interest in the cattle.
(b ) Is any bank or other financing institution
interested in the cattle ? If so, state (i) name
and address of the bank.
(ii) Amount of loan outstanding.
(c ) Is/Are the animals proposed for insurances
covered by SFDA/MFAL project ? Is so state
(i) Address of SFDA/MFAL Agency.
(ii) Amount of subsidy obtained from
SFDA/MFAL Agency.
I/We hereby propose to insure the above mentioned cattle owned by me/us with NATIONAL INSURANCE COMPANY
LIMITED subject, to the terms, conditions and exclusions of the Company/s Policy. I/We warrant that the answers to the above
queries are true and that all the animal/s are correctly described are sound, in good health and free from vice and that they are shall be
used solely for the purpose above sated. I/We declare that no information material to the insurance has been withheld and agree that
this proposal shall be the basis of the contract between me/us and the Company.
Date……………….20 Signature of Proposer………………………………………………
Proposal Introduced by…………………………………………….Proposal form completed by………………… ……………………..
Name and Signature of Agent/Inspector Name & Signature
___________________________________________________________________________________________________________
Premium rate will be quoted on application.