Marine Kidnap and Ransom Insurance Questionnaire

Contact Information

Contact Name
Address
City	State	Zip/Postal Code
Country
Phone Number	Email

Assured Information

Please provide a detailed list of the Assureds and their interest in the vessel/subject matter insured:

What is the maximum sum insured limit requested (please specify currency)?

Vessel Details

Name of vessel	Type	DWT	GRT

Age	Value	Flag	Class

Freeboard (laden and unladen)		Speed (normal and maximum)

Who owns the vessel(s)?

Who manages the vessel(s)?

Is H&M, P&I and War Risks insurance in place for the intended duration of the Kidnap and Ransom cover?

Yes No

Cargo

Type of cargo	Load / discharge ports	Cargo - owned or third party? Please state name of owner	Value of cargo

Voyage Details

Intended voyage	Route	Policy inception (dd/mm/yy)	Policy expiry (dd/mm/yy)

Security Measures

Please provide full details of any security measures to be taken, such as razor wire, citadel, armed guards, etc.

Is the Assured registered with UKMTO and / or MS CHOA*?	UKMTO MS CHOA
Is the Assured fully compliant with BMP3 (Best Management Practice 3)*?	Yes No

Crew

Please provide full crew information including the number and nationalities of those on board, as well as any details including collective bargaining agreements they are employed under (i.e. POEA, etc)

Number of crew	Nationalities	Employment agreements	Any other information

Other Information

Have there been any prior incidents of kidnapping or detention?	Yes No
Has there been any threat or attempt to kidnap or detain on any voyage?	Yes No

Please provide any further information that may be material to the insurers:

Please provide the following

Company		Name
Date		Position

Important Note: The questions contained in this form are designed to give insurers information regarding your business. It may not address every aspect and it is your duty to disclose all material information to insurers that may affect the premium or conditions.

*UKMTOhttp://www.mschoa.org/Links/Pages/UKMTO.aspx
The UK Maritime Trade Operations (UKMTO) office in Dubai acts as the primary point of contact for merchant vessels and liaison with military forces in the region. UKMTO Dubai also administers the Voluntary Reporting Scheme, under which merchant vessels are encouraged to send regular reports, providing their position/course/speed and ETA at their next port whilst transiting the region bound by Suez, 78°E and 10°S. UKMTO Dubai subsequently tracks vessels and the positional information is passed to CMF and EU headquarters. Emerging and relevant information affecting commercial traffic can then be passed directly to ships, rather than by company offices, improving responsiveness to any incident and saving time.

For further information or to join the Voluntary Reporting Scheme, please contact UKMTO Dubai or MSCHOA. Email: ukmto@eim.ae

MSCHOA www.mschoa.org
The Maritime Security Centre � Horn of Africa (MSC-HOA) is an initiative established by EU NAVFOR with close co-operation from industry. The MSC-HOA centre provides 24 hour manned monitoring of vessels transiting through the Gulf of Aden whilst the provision of an interactive website enables the Centre to communicate the latest anti-piracy guidance to industry and for Shipping Companies and operators to register their movements through the region.

A further initiative is the introduction of Group Transits where vessels are co-ordinated to transit through high risk areas overnight when attacks are reduced. This enables military forces to �sanitise� the area ahead of the merchant ships. MSCHOA will also identify particularly vulnerable shipping and coordinate appropriate protection arrangements, either from within EU NAVFOR, or other forces in the region.

BEST MANAGEMENT PRACTICES 3 http://www.mschoa.org/bmp3/Documents/BMP3%20Final_low.pdf
The purpose of the Industry Best Management Practices (BMP) contained in this booklet is to assist ships to avoid, deter or delay piracy attacks off the coast of Somalia, including the Gulf of Aden (GoA) and the Arabian Sea area. Experience, supported by data collected by Naval forces, shows that the application of the recommendations contained within this booklet can and will make a significant difference in preventing a ship becoming a victim of piracy.