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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