Vero Carriers Combined Package Application Form

IMPORTANT INFORMATION
Please read this first
Carrier’s Combined Package
Policy information
The carrier’s combined package allows carriers the flexibility to include transit and carrier’s liability
covers in the one integrated insurance policy. it is structured into separate covers for carrier’s
goodwill, carrier’s indemnity and carrier’s liability, allowing you to select the combination of covers
you require.
All three covers contain the following benefits:
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no underinsurance or average provisions;
rovision to include cover for subcontractors;
p
automatic re-instatement of the sum insured following a claim;
no turnover adjustment required if deposit premium $2,000 or less;
cover for general average, salvage contributions;
plain language policy wordings.
Carrier’s goodwill cover gives you the right to make a commercial settlement to your valued
customers, regardless of your legal liability. You select which losses you want us to settle.
If selected by you, we will, at your request, cover all insured consignments against physical loss or
damage directly caused by fire, explosion, lightning, flood, collision or overturning of the conveyance,
jackknifing, derailment, impact, highjacking or armed hold-up, crashing or forced landing of aircraft,
and war risks for sea and air transits only. If the loss relates to livestock, we also include mustering
and agistment costs, and the reasonable costs to avoid or minimise any further deaths arising out of
the loss.
Cover exclusions are loss or damage that existed or occurred prior to the commencement of the
insured transit, mechanical, electrical or electronic breakdown or malfunction, nuclear risks, loss of
market or consequential loss.
Automatically includes cover for shipping containers, new companies purchased or formed by you.
Accident site clean-up costs, disposal of debris and decontamination of your premises are also
included.
Optional extensions include accidental physical loss or damage during loading or unloading, theft
pilferage and non delivery, malfunction or breakdown of refrigerating machinery (4 hour time excess),
and water and/or hail.
AAI Limited ABN 48 005 297 807 trading as Vero Insurance
V5022 01/03/14 A
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IMPORTANT INFORMATION
Please read this first
Carrier’s indemnity cover gives accidental physical loss of or damage cover, where, in advance of
the insured transit, you have contracted with certain of your customers, in writing, to indemnify them
for accidental physical loss or damage to their goods. It does not allow your named customers to
claim directly on this policy.
The policy includes cover for malicious damage,strikes, riots or civil commotions, and insufficiency or
unsuitability of packing or preparation (unless caused directed or agreed by you, your consignor or the
customer). Air and sea transits are covered for war risks while the goods are on board a ship, vessel
or aircraft.
Automatically includes cover for shipping containers, new companies purchased or formed by you.
Accident site clean-up costs, disposal of debris and decontamination of your premises are also
included.
Cover exclusions include loss or damage that existed or occurred prior to the commencement of the
insured transit, mechanical, electrical or electronic breakdown or malfunction, nuclear risks, loss of
market or consequential loss.
Carrier’s liability cover is only available to those carriers who have consignment notes and/or
contracts containing terms, conditions and exclusions that are approved by us, and who endeavour to
have consignment notes signed or their contract terms imposed as a standard management practice.
Once your consignment note conditions and contract terms are approved by us, we do not exclude or
reduce cover if a consignment note is not signed or issued.
If this cover is accepted, we cover you if an Australian court finds, or we accept, that you are legally
liable to pay compensation for loss or damage to the goods carried by you, in the ordinary course of
transit. We also cover your legal defence costs, claimant’s legal expenses, interest, clean up costs and
any other charges awarded against you.
Important. The above is only a summary of the cover provided under each cover.
Full details of the cover, limitations, exclusions, conditions and other benefits are contained in the
policy. Please retain this section and complete the attached application form in black or blue pen. If
there is insufficient space, attach additional information on a separate sheet of paper.
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Carrier's Combined Package
Application
Section 1 – Information for all covers
Applicants name (include subsidiary companies)
ABN
Address
StatePostcode
Telephone numberFacsimile numberEmail Address
(
)
(
)
Website address
years
How many years has the business been established? Description of the goods/merchandise/livestock carried:
Do you carry goods in your own vehicles?
No Yes
How many vehicles do you own/operate? Specify the geographic area in which you operate and require cover (e.g. anywhere is NSW):
Cover requested
from /
/
to /
/
@ 4:00 pm
From goods that you contract to
Your estimated gross freight earnings carry in your own vehicles
Paid to your subcontractors
When you sub-contract
for other carriers
General cargo: Refrigerated/perishable goods:
Livestock:
Household removals:
Total
$ 0.00
$ 0.00
$ 0.00
Section 2 – Carrier’s goodwill cover
Do you require carrier’s goodwill cover (nominated risks):
▼▼ for goods that you contract to carry in your own vehicles?
No Yes
▼▼ for your subcontractors when they carry for you?
No Yes
▼▼ when you subcontract on behalf of other carriers?
No Yes
▼▼ accidental physical loss or damage during loading and unloading?
No Yes
▼▼ theft, pilferage and non-delivery?
No Yes
▼▼ malfunction or breakdown of refrigerating machinery (4 hour excess)?
No Yes
▼▼ rain, water and/or hail damage?
No Yes
Do you wish to include cover for:
Limit of liability required for any one vehicle?
Do you wish to bear an excess?
$
No For any one event or occurrence?
Yes
If Yes, how much excess?
$
$
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Section 3 – Carrier’s indemnity cover
Do you require carrier's indemnity cover (accidental physical loss or damage cover for named customers that you have agreed to
indemnify?
No Yes
If Yes, complete hereunder:
Name of customer
indemnified by you
Type of goods carried
Limit of Liability
any one load
Estimated gross
freight earnings
$
$
$
$
$
$
Excess required,
per client, per load
$
$
$
$
$
$
$
$
$
Add additional nominated clients by including a separate list.
Section 4 – Carrier’s liability cover
Do you require carrier’s liability cover? No Yes If Yes, complete hereunder:
Do you wish liability cover for goods:
▼▼ that you contract to carry in your own vehicles?
No Yes
▼▼ carried for you by your subcontractors?
No Yes
▼▼ when you subcontract on behalf of other carriers?
No Yes
Limit of liability required for any one vehicle?
$
For any one event or occurrence?
$
$
Amount of additional cover requested for legal defence costs (automatic $250,000)
$
Do you wish to bear an excess?
No Yes If Yes, how much excess?
Do you use consignment notes or conditions of carriage?
No Yes If Yes, please attach a copy to this application.
Will there be any contracts where the standard terms conditions and limitations are materially different to those contained in the consignment
note/conditions of contract supplied?
No Yes If Yes, supply a copy of each of those that differ.
Do you always endeavour to have consignment notes signed by both the forwarder and receiver?
No Yes
If No, please detail reasons
When subcontracting for other carriers, do you accept any liability?
No Yes If Yes, please provide details
Section 5 – Previous insurance (all covers)
Current year
Previous year 1
Previous year 2
Actual gross freight earnings: Value of claims paid and outstanding:
Number of claims:
Amount of policy excess:
Name of insurer:
In the last five years, has any Insurer declined or cancelled Insurance, refused to invite renewal, or imposed any special conditions on any of
the applicants above?
No Yes If Yes to any of these, please supply full details as an attachment.
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Is the property insured:
(a) predominantly, and
(b) ordinarily:
used by the insured, a relative of the insured or any person with whom the insured resides, for:
personal, domestic or household purposes, or commercial, retail, business, or any other purpose not described above?
Section 6 – Privacy statement
AAI Limited trading as Vero Insurance is the insurer and issuer of your commercial insurance product, and is a member of the Suncorp
Group, which we’ll refer to simply as “the Group”.
Why do we collect personal information?
Personal information is information or an opinion about an identified individual or an individual who is reasonably identifiable. We collect
personal information so that we can:
▼▼ identify you and conduct appropriate checks;
▼▼ understand your requirements and provide you with a product or service;
▼▼ set up, administer and manage our products and services and systems, including the management and administration of underwriting
and claims;
▼▼ assess and investigate any claims you make under one or more of our products;
▼▼ manage, train and develop our employees and representatives;
▼▼ manage complaints and disputes, and report to dispute resolution bodies; and
▼▼ get a better understanding of you, your needs, your behaviours and how you interact with us, so we can engage in product and
service research, development and business strategy including managing the delivery of our services and products via the ways we
communicate with you.
What happens if you don’t give us your personal information?
If we ask for your personal information and you don’t give it to us, we may not be able to provide you with any, some, or all of the
features of our products or services.
How we handle your personal information
We collect your personal information directly from you and, in some cases, from other people or organisations. We also provide your
personal information to other related companies in the Group, and they may disclose or use your personal information for the purposes
described in ‘Why do we collect personal information?’ in relation to products and services they may provide to you. They may also use
your personal information to help them provide products and services to other customers, but they’ll never disclose your personal
information to another customer without your consent.
Under various laws we will be (or may be) authorised or required to collect your personal information. These laws include the Anti-Money
Laundering and Counter-Terrorism Financing Act 2006, Personal Property Securities Act 2009, Corporations Act 2001, Autonomous
Sanctions Act 2011, Income Tax Assessment Act 1997, Income Tax Assessment Act 1936, Income Tax Regulations 1936, Tax
Administration Act 1953, Tax Administration Regulations 1976, A New Tax System (Goods and Services Tax) Act 1999 and the
Australian Securities and Investments Commission Act 2001, as those laws are amended and includes any associated regulations.
We will use and disclose your personal information for the purposes we collected it as well as purposes that are related, where you
would reasonably expect us to. We may disclose your personal information to and/or collect your personal information from:
▼▼ other companies within the Group and other trading divisions or departments within the same company (please see our Group
Privacy Policy for a list of brands/companies);
▼▼ any of our Group joint ventures where authorised or required;
▼▼ customer, product, business or strategic research and development organisations;
▼▼ data warehouse, strategic learning organisations, data partners, analytic consultants;
▼▼ social media and other virtual communities and networks where people create, share or exchange information;
▼▼ publicly available sources of information;
▼▼ clubs, associations, member loyalty or rewards programs and other industry relevant organisations;
▼▼ a third party that we’ve contracted to provide financial services, financial products or administrative services – for example:
WW information technology providers,
WW administration or business management services, consultancy firms, auditors and business management consultants,
WW marketing agencies and other marketing service providers,
WW claims management service providers
WW print/mail/digital service providers, and
WW imaging and document management services;
▼▼ any intermediaries, including your agent, adviser, a broker, representative or person acting on your behalf, other Australian Financial
Services Licensee or our authorised representatives, advisers and our agents;
▼▼ a third party claimant or witnesses in a claim;
▼▼ accounting or finance professionals and advisers;
▼▼ government, statutory or regulatory bodies and enforcement bodies;
▼▼ policy or product holders or others who are authorised or noted on the policy as having a legal interest, including where you are
an insured person but not the policy or product holder;
▼▼ in the case of a relationship with a corporate partner such as a bank or a credit union, the corporate partner and any new
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incoming insurer;
Section 2 – Privacy statement (continued)
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the Financial Ombudsman Service or any other external dispute resolution body;
credit reporting agencies;
other insurers, reinsurers, insurance investigators and claims or insurance reference services, loss assessors, financiers;
legal and any other professional advisers or consultants;
hospitals and, medical, health or wellbeing professionals;
debt collection agencies;
any other organisation or person, where you’ve asked them to provide your personal information to us or asked us to obtain personal
information from them, eg your mother.
We’ll use a variety of methods to collect your personal information from, and disclose your personal information to, these persons or
organisations, including written forms, telephone calls and via electronic delivery. We may collect and disclose your personal information
to these persons and organisations during the information life cycle, regularly, or on an ad hoc basis, depending on the purpose of
collection.
Overseas disclosure
Sometimes, we need to provide your personal information to – or get personal information about you from – persons or organisations
located overseas, for the same purposes as in ‘Why do we collect personal information?’
The complete list of countries is contained in our Group Privacy Policy, which can be accessed at www.vero.com.au/privacy, or you can
call us for a copy.
From time to time, we may need to disclose your personal information to, and collect your personal information from, other countries not
on this list. Nevertheless, we will always disclose and collect your personal information in accordance with privacy laws.
How to access and correct your personal information or make a complaint
You have the right to access and correct your personal information held by us and you can find information about how to do this in the
Suncorp Group Privacy Policy.
The Policy also includes information about how you can complain about a breach of the Australian Privacy Principles and how we’ll deal
with such a complaint. You can get a copy of the Suncorp Group Privacy Policy. Please use the contact details in Contact Us.
Contact us
For more information about our privacy practices including accessing or correcting your personal information, making a complaint, or
obtaining a list of overseas countries you can:
▼▼ Visit www.vero.com.au/privacy.
▼▼ Speak to us directly by phoning one of our Sales & Service Consultants on: 1300 888 073 or by
▼▼ Email us at [email protected]
Section 7 – Duty of disclosure
You have a legal duty of disclosure to us whenever you apply for, change or renew an insurance policy.
What you must tell us
You have a general duty to disclose to us everything that you know, or could reasonably be expected to know, is relevant to our decision
whether to insure you, and, if we do, on what terms.
However, your duty does not require you to disclose anything:
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that reduces the risk to be undertaken by us;
that is generally well known;
that we know or, in the ordinary course of our business, ought to know, or;
in respect of which we have waived your duty.
Your general duty applies to renewals and changes
Your general duty applies in full when you renew an insurance policy or change an existing policy (including when you extend or
reinstate it).
Who needs to tell us
It is important that you understand you are disclosing to us and answering our questions for yourself and anyone else you want to be
covered by the policy.
If you do not tell us
If you do not answer our questions honestly or do not properly disclose to us, we may reduce or refuse to pay a claim or may cancel the
policy. If you act fraudulently in answering our questions or not disclosing to us, we may refuse to pay a claim or treat the policy as never
having existed.
Section 8 – Your declaration
(a) To the best of my/our knowledge and belief the information provided in this application is true and correct in every respect and no relevant
information has been withheld.
(b) I/We understand this insurance is not in force until Vero Insurance, accepts this application.
(c) I/We understand that any statement made in this application will be treated as a statement made by all the people to be insured.
This declaration is signed by or on behalf of all applicants.
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Section 8 – Your declaration (continued)
For personal applicants
I consent to:
▼▼ the use of personal information about me for the purposes shown in the Privacy Statement, and
▼▼ you sending me information about other products and services, unless I have declined ‘Other offers’, and the disclosure of personal
information about me to, and obtaining personal information from, other parties, including those shown in the Privacy Statement, for
any of these purposes.
For all applicants
If I have disclosed personal information about any other person, I confirm that I am authorised to:
▼▼ disclose to you personal information about that person and to consent to its use for the purposes shown in the Privacy Statement,
and
▼▼ consent to disclosure to, and obtaining of other personal information about that person from, other parties including those shown in
the Privacy Statement, for any of these purposes.
Signature of applicant(s)
Date Date / /
/ /
Where you can contact us:
New South Wales
GPO Box 3999
Sydney NSW 2001
Telephone 02 8121 0999
Facsimile 02 8121 0949
Queensland
GPO Box 537
Brisbane QLD 4001
Telephone 07 3135 2630
Facsimile 07 3031 2948
Victoria
GPO Box 1509
Melbourne VIC 3001
Telephone 03 9245 8808
South Australia
GPO Box 1619
Adelaide SA 5001
Telephone 08 8205 5175
Facsimile 08 8205 5179
Western Australia
GPO Box B78
Perth WA 6838
Telephone 08 9320 3917
Facsimile 08 9320 3918
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