Free Cargo Insurance Claim Template
Cargo Insurance Claim
Claimant Information
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Policyholder Name: |
Jackson Blake |
|---|---|
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Policy Number: |
AJ2050-123456 |
|
Contact Number: |
+1-555-123-4567 |
Shipment Details
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Shipper Name |
Global Shipping Inc. |
|---|---|
|
Consignee Name |
Tech Innovations Ltd. |
|
Bill of Lading Number |
BL2050-987654 |
|
Shipping Date |
July 15, 2050 |
|
Arrival Date |
July 22, 2050 |
Description of Goods: 100 units of high-performance microprocessors, each designed for cutting-edge electronic devices, and 100 custom-designed multi-layer PCBs with integrated circuits for advanced tech.
Loss or Damage Details
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Date of Loss/Damage |
July 20, 2050 |
|---|---|
|
Location of Loss/Damage |
Warehouse #4, New York Port |
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Estimated Claim Amount |
$75,000 |
Description of Loss/Damage
About 50 high-tech components melted and became unusable from extreme heat. Others were heavily damaged by heat and smoke, with warped and discolored circuit boards, while some undamaged units were contaminated by soot, affecting their usability.
Supporting Documents
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Bill of Lading: Detailed document showing shipment details, cargo nature, and transportation terms, confirming origin, destination, and receipt.
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Commercial Invoice: Document listing the total value of goods, including descriptions, quantities, prices, and total amount.
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Inspection Report: Certified inspector's report outlining the extent of damage caused by the warehouse fire.
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Photos of Damaged Goods: High-resolution images showing the extent of fire damage and contamination to the goods.
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Correspondence with Shipper/Consignee: Communication records discussing the damage, response actions, and acknowledgments.
Declaration
I, Jackson Blake, at this moment, declare that the information provided is true and accurate to the best of my knowledge. I understand that any misrepresentation or false statement may result in the denial of my claim.
[YOUR NAME]
[DATE]
