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Fidelity Garuntee

The document is a proposal form for Fidelity Guarantee Insurance provided by The New India Assurance Company, which indemnifies employers against financial losses due to employee fraud or dishonesty. It outlines the scope of coverage, exclusions, and the basis of insurance, including details required from the employer about their business and employees. Additionally, it includes a series of questions aimed at assessing the employer's internal controls and history of employee conduct.

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16 views3 pages

Fidelity Garuntee

The document is a proposal form for Fidelity Guarantee Insurance provided by The New India Assurance Company, which indemnifies employers against financial losses due to employee fraud or dishonesty. It outlines the scope of coverage, exclusions, and the basis of insurance, including details required from the employer about their business and employees. Additionally, it includes a series of questions aimed at assessing the employer's internal controls and history of employee conduct.

Uploaded by

saurav.datta68
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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The New India Assurance Company Limited

P.O.BOX 2907, RUWI, P.C:112


Sultanate of Oman.

PROPOSAL FORM FOR FIDELITY GUARANTEE INSRUANCE (EMPLOYER)

SCOPE OF COVER
This insurance policy provides indemnity to Employers against any direct financial loss,
including loss of goods, caused by fraud or dishonesty of employees.

Exclusions
This Insurance Policy does not cover any loss :
a) Discovered more than 12 months after the termination either of the guarantee or of the
service of the employee concerned.
b) When there has been any change in the agreed system of check or accounting
precautions without the insurers prior consent.
c) Caused by an employee after discovery of his previous fraud or dishonesty.
d) Such as stock taking shortages, trading losses not caused by fraud or dishonesty.

BASIS OF INSURANCE
Named employees can be selected and guaranteed for specified amount. Employees can be
guaranteed for a total amount overall or for separate amounts in respect of different
categories.

THE FOREGOING IS ONLY A BROAD INDICATION OF THE COVER OFFERRED. FOR


DETAILS PLEASE REFER TO ANY OFFICE OF THE COMPANY.
NOTE: PLEASE ANSWER EVERY QUESTION AND FULLY.

1. a. Name and address of the Employer.

b. Description of Business.
c. Since when established Paid Up Capital (if
applicable) :

2. Details of Employees to be guaranteed.


Names Duties Since Place of Total Amount to Any
when in Employm remuneratio be other
service ent n guaranteed security
taken
3. Is there a system to obtain references from previous Employers? If not, specify practice
followed.

4. Stated the estimate of maximum amount held by any employee at any one time and for how
long?

a) Money: Amount______________ b) Stock: Amount______________


Period _______________ Period _______________

5. Has there been any occasion to question honesty or conduct of any person proposed for
guarantee.

6. a) How often are the employees required to account for money?


b) What independent system is there to check that all sums received by employees
are accounted for ?

7. a. Do employees pay out money or draw cash from employer’s account ?


b. System of operation of Bank account and precautions taken
c. Whether such payments/withdrawals are authorized by a senior employee and
compared with supporting documents ?

8. How often the cash book is balanced, the entries checked with vouchers and Bank’s pass
book and with counterfoils of receipt books ?

9. How often are the Proposer’s books balanced ?

10. a. System followed for purchase of goods and recording deliveries.


b. System followed for authorizing dispatch of goods and ensuring that dispatch is
recorded and charged to the customer.

11. How often and by whom stock verification is done ?

12. System for collecting outstanding accounts?

13. How often will statements of account be furnished by the proposer direct to
customers ?

14.What is the extent and frequency of audit ?

15. Details of losses suffered on account of infidelity of any employees during last 5
years and steps taken to prevent recurrence.

16. Has any company in respect of any infidelity guarantee insurance


a) Declined your proposal ?
b) Cancelled or refused to renew policy ?
c) Accepted your proposal on special terms and conditions.

I/We do hereby declare that the above statements and answers are true and that I/we have
not withheld any information whatsoever regarding this proposal. I/We agree that this
proposal and declaration shall be the basis of the contract between me/us and The New
India Assurance Company Ltd., whose policy for this insurance is acceptable to me/us.
I/we undertake to exercise all ordinary and reasonable precautions as if it were
uninsured.
Place:

Date: Proposer’s signature

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