Crop Insurance Proposal Form

Questionnaire for the technical risk description

1. Policyholder, services provided
1.1. 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

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  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)

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  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

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  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

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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?

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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:

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