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MARINE CLAIM NOTIFICATION

Policy details

Insured

Policy number

Transport details

Voyage (from - to)

Mode of transportation

Date of departure

Terms of delivery

Consignor

Consignor contact details

Consignee

Consignee contact details

Carrier

Carrier contact details

Was the carrier held liable for the loss?

When?

(Letter of protest)
Was the loss notified to the police?

When?

Total value of the shipment

Loss details

Damaged/lost item

Quantity

Detailed loss description

Claimant

Location of the damaged item

Contact person at the site, contact details

Estimated loss amount

Does the damaged item bear any salvage value? How much?

When did the delivery reach destination?

When was the damage noticed?

Company

Contact person

Address

Zip code

Tel. number

Fax number

City

Email

Claimed amount

Account number

Company

Contact person

Address

Zip code

Notified by

Tel. number

Fax number

Signature

Enclosures

Insurance company
contacts

City

Email
Date and place

waybill

repair invoices / receipts

bill of lading

reclamation made to the carrier

CMR

custom documents

commercial invoice and packing list

other, please specify

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