NATIONAL INSURANCE COMPANY LIMITED
(A subsidiary of General Insurance Corporation of India)
REGISTERED OFFICE : 3, Middleton Street, Calcutta – 700 071

PROPOSAL FOR MACHINERY INSURANCE

(A) The liability of the Company does not commence until this proposal has been accepted by the
Company and premium paid.
(B) Information given herein will be treated in strict confidence.
PUT A (4 ) MARK WHEREVER APPLICABLE.
a) Proposer’s Name ……………………………………………………………………………………….
b) Proposer’s Trade or Business …………………………………………………………………………..
c) Proposer’s Postal Address……………………………………………………………………………
d) Address where plant to be insuree is located ………………………………………………………..
………………………………………………………..
e) Nearest Railway Station & Distance …………………………………………………………………
1. Do the items listed represent the whole of the plant Yes No
2.
(a) Are you at present Insured ? (a) Yes No
(b) If so, with whom ? (b)
3. Has any Company
(a) declined to insure any of the
machinery now proposed ? (a) Yes No
(b) required an increased premium
or imposed special conditions? (b) Yes No
(c) requested for repairs or made other
special stipulations for risk improvement ? (c) Yes No
4.
(a) Are you aware of any defects/damages
Existing in the machinery ? (a) Yes No
(b) If so, give details thereof. (b)
5.
(a) Has your machinery sustained any damage
From breakdown or other cause during last 3 years ? (a) Yes No
(b) If so, give details of damage’s and repair cost . (b)
6.
(a) Are regular periodical inspections of the
machiner carried out ? (a) Yes No
(b) If so, by whom and on what intervals ? (b)
7. On payment of additional premium do
you wish to cover :- If yes, provide limits of indemnity
(a) Express Freight (excluding Air freight )
Overtime and Holiday rates of wages (a) Rs…………………..No
(b) Insured’s own surrounding property
Extension ? (b) Rs…………………..No
(C) Third Party Liability (c) Rs. …………………No
8. Period of Insurance From To
SCHEDULE OF MACHINERY TO BE INSURED
GUIDE NOTES :
I. Each Machinery should be entered separately with necessary specifications as mentioned in
Schedule Colums No. 3.
II. The Sum Insured must be calculated on the present day new replacement value of the Machinery
to be insured including provision for packing , freight and also value of foundations , erection
costs , customs duty etc. to afford full protection under this Policy.
III. If any of the Machines is a “Stand By” Spare Machinery this fact should be mentioned.
IV. All portable Machines must be so designated. All items in the open must be so described
separately.
V. Separate values for foundations , masonry and brckwork or oil in transformers and other electrical
equipments are to be specified, if cover is required.
Sr.
No.
Quantity Description
Type, Model, Capacity of
Machine/ Serial No. HP/ KVA
Volts, AMPS, RPM
Maker’s name and
country of Origin
Year
of
Make
Sum Insured
1 2 3
4 5 6
I/We the undersigned hereby declare that the above statements and particulars are true and complete and
I/We declare and agree that this declaration and the answers given above shall be held to be promissory and
shall be the basis of the contract between me/us and the Company.
Place……………………..
Dated …………………… Proposer’s Signature…………………………….
PROHIBITION OF REBATES
Section 41 of Insurance Act, 1938 :
1. No person shall 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 of the commission payable or any rebate of the premium shown on the
polcy , 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 punishable with
fine which may extend to five hundred rupees.
Scope of Cover :
The Machinery Insurance Policy covers the insured machineries against sudden and unforeseen loss or
damage occuring whilst :-
(a) The machineries are at work or at rest
(b) The machineries are being dismantled for the purpose of cleaning or overhauling or in the course of
aforesaid operations themselves or when being shifted within the premises or subsequent re-erction
within the same premises.
- Thus the cover embraces loss or damge due to :-
- Faulty material, design, construction or erction.
- Vibration , maladjustment , malalignment.
- Defective lubrication , loosening of parts , abnormal stress , molecular fatigue , self heating ,
centrifugal force , explosion due to internal pressure, implossion due to external pressure or
internal vaccuum.
- Excessive electrical pressure whether due to atmospheric electricity or otherwise, failure of
insulation, short circuits, open circuits or arcing including damage by internal fire so set up.
- Failure of connected machinery or protective devices.
- Lack of skill, carelessness or malice of persons whether in the Insured’s employ or not.
- Falling , impact, collision and the like.
- Obstruction or the entry of foreign bodies.
Standard Exclusions :
This policy is subject to certain Standard Exclusions. Details of the Exclusions may be obtained from our
office, if deemed necessary, before completing and signing this proposal.
Extension of Machinery Insurance Policy.
On payment of appropriate additional premium the policy can be extended to include :-
(a) Damage to the other surrounding property owned by the Insured arising our of indemnifiables
damage to the insured plant.
(b) Liability for damage to property to Third Parties and / or injury to person not in the employ of the
Insured arising out of indemnifiable damage to the insured plant.
(c) Extra charges incurred for overtime, work on holidays and express freight (excluding ari freight )
in connection with admissible claim arising under the Policy.
The damage to the Insured plant and machinery may result in business interruption at the Insured’s
premises. Such loss of profit following breakdown of the insured plant and machinery may be covered
under a separate Loss of profits (Machinery) Insurance Policy.