Crop Insurance Proposal Form
Questionnaire for the technical risk description
1. Policyholder, services provided1.1. Name and address of policyholder:
1.2. Address of premises to be insured:
1.3. Does the policyholder own or manage other farms? If so, where are they located?
1.4. What professional training or experience does the policyholder have?
2.1. What type of plants are cultivated (incl. variety)?
2.2. How is the geographical distribution of this risk (information in hectares)?
· total acreage of the farm?
· acreage of the insured crop?
· number of plots / locations
· average acreage of a plot and distance between them
2.3. Topography of the area
[] rolling hills
[] flat plain
[] valley
[] steep hills
2.4. Cropping pattern
· What is the cropping pattern of the crop to be insured?
· Is it a monoculture?
2.5. Temporal distribution of the risk
· date of seeding or transplanting
· latest date of reseeding or replanting (of the same variety)?
· duration of the vegetation period
· description of the vegetation period
· average and latest date of harvest
2.6. Components of the yield
· yield per plant in kg
· number of plants per hectares
2.7. Definition of the Sum Insured
· Can the insured choose freely the Sum Insured within a given benchmark?
[] yes [] no
What are the limits?
upper:
lower:
· production cost (with detailed list)
· how much do the cost of harvesting bear to the total cost
· gross margin per hectare
· market prize of the harvest (on what criterias of quality is the prize based)
· average, highest and lowest price of the last three years (referred to kg or tonnes and according to the grade of quality)
· contractually pre-agreed sales price
· what are the criterias for a lower prize due to downgrading
2.8. What are the risk management tools that the farmer employs today to avoid damage of the insured perils?
2.9. Against which risks should the crop be insured?
[] hail
[] frost
[] wind
[] other
3. In case of frost insurance please answer the following questions
· What are the critical growth stages?
· What is the critical temperature level?
· Duration of the exposed period
3.1. Definition of the event
· Where is the trigger measured?
· How is the trigger measured?
· How does the frost affect the crop?
[] regarding quantity
[] regarding quality
3.2. Risk limitation
· Are there irrigation sprinklers on the farm that can fight the frost? What is the water capacity to exercise those frost sprinkling?
· Does the farm have windmachines or are helicopters available?
· What is the prevailing soiltype in the region?
· How deep is the soil profile?
4. In case of flood insurance please answer the following questions
· Which are the most sensitive growth stages of the crop regarding stagnant water and flood?
· Up to what water level?
· What period of submerging is detrimental to the crop?
4.1. Definition of the event
· Where shall the flood be measured?
· How can it be measured?
· How does the flood affect the crop?
[] regarding quantity
[] regarding quality
· Are the insured locations in flood prone areas such as
[] rivers, lake, sea
[] irrigation canals
[] dams
[] others
5. In case of wind / storm insurance please answer the following questions
· What are the most sensitive growthstages of the crop regarding storm and wind?
· Up to what windspeed can they resist?
5.1. Definition of the event
· Where shall the windspeed be measured?
· How shall the windspeed be measured?
· What are the effects on the crop?
[] regarding quantity
[] regarding quality
· Which systemic diseases weaken the plant and increase the damages caused by storm?
5.2. Limitation of the risk
· Which measures are undertaken to diminish the risk?
[] growthregulators
[] windbreakers
[] propping installations
[] others
6. What kind of data's are available?
6.1. What meteorological statistics are available according to the event definition?
6.2. What data are available as insurance loss history?
7. How is the loss adjustment organised?
7.1. How many trained people are involved?
7.2. What are the cost per day for them?
7.3. Where are the loss adjuster manuals which can be inspected by the insurers?
7.4. Is there a preliminary and a final loss adjustment or is it only made once?
7.5. Within what timeframe does the Insured have to notify the loss to the insurer?
How quickly will the loss adjuster visit the field?
7.6. Is there any salvage potential?
[] yes [] no
If yes, how can it be quantified?
This description of the risk forms the basis for the insurance policy. If any of the above questions are answered incorrectly, the insurer may be entitled in the event of a claim to refuse indemnification or to cancel the policy.
Date:
Policyholder's signature:
Crop Insurance Page 6