Claims causation form – Pollution

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For every claim incident notified to the Club that requires investigation, a Claims Causation Report Form must be completed by an appointed Correspondent or attending surveyor.  They cover the principal types of claims that can occur. The submission of a completed form to the Club will allow for thorough investigation into the cause of the incident. Please note that a Claims Causation Report Form does not replace a full survey report, which is still required. Also, a completed Claims Causation Report form is to be considered private and confidential in contemplation of litigation.

Pollution claims causation form.

To access the other five causation forms please click here.