Food and Drink Product Recall (Quote)

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Agent Details

Instructions to NFU Mutual Agent; please complete the following details:

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Please note that normal business rules apply while using this web site i.e. quotes may not normally be requested unless your client has an existing business relationship as a client of NFU Mutual. If you have any queries or wish to discuss an exception please contact NIS on 01933 303283 or email us on Mutual_Marketplace@nfumutual.co.uk

Important Notice– Please ensure your clients are informed and understand the information below.

In seeking a quotation and/or binding cover via this portal you are agreeing that you will have served the client all relevant regulatory documents.

Fair Representation of the Risk

The information provided here must make a fair presentation of the risk, in accordance with Section 3 of the Insurance Act 2015.
To Summarise, you must:
a) Tell us about every material circumstance which you know or ought to know. Failing that, you must give us sufficient information to make us aware that we need to make further enquiries in order to reveal material circumstances. Information is material if it would influence the judgement of a prudent insurer as to whether to accept the risk, or the terms of the insurance (including premium);
b) Disclose information in a reasonably clear and accessible way; and
c) Ensure that every material representation of fact is substantially correct, and that every material representation of expectation or belief is made in good faith.

For the purposes of the above, you are expected to know the following:
a) If you are an individual, what is known to the individual and anybody who is responsible for arranging his or her insurance.
b) If you are not an individual, what is known to anybody who is part of your senior management; or anybody who is responsible for arranging your insurance.
c) Whether you are an individual or not, what should reasonably have been revealed by a reasonable search of information available to you. The information may be held within your organisation, or by any third party (including but not limited to subsidiaries, affiliates, the broker, or any other person who will be covered under the insurance). If you are insuring subsidiaries, affiliates or other parties, we expect that the Insured will have included them in its enquiries, and that you will inform us if you have not done so. The reasonable search may be conducted by making enquiries or by any other means.

Completion of this form is required by us as part of your duty of fair presentation.

Insurers may cancel cover and/or refuse to pay any claims if the facts provided in this form are incorrect.

Arthur J. Gallagher Insurance Brokers Limited, Arthur J. Gallagher (UK) Limited and their affiliates and subsidiaries "we" or "us" or "Gallagher" collect and process data about individuals. We are insurance intermediaries and part of the Arthur J. Gallagher global group of companies. The Gallagher group company which provides the insurance intermediary service offered to you is primarily responsible for the personal data collected in relation to that service. Information on the Gallagher group companies and their services is available here . We collect and process information about you in order to arrange insurance policies and to process claims. Your information is also used for business purposes such as fraud prevention and detection and financial management. This may involve sharing your information with third parties such as insurers, reinsurers, other brokers, claims handlers, loss adjusters, credit reference agencies, service providers, professional advisors, our regulators, police and government agencies or fraud prevention agencies. We may record telephone calls to help us monitor and improve the service we provide. For further information on how your information is used and your rights in relation to your information please see our privacy notice at https://www.ajginternational.com/Privacy-Policy/. If you are providing personal data of another individual to us, you must tell them you are providing their information to us and show them a copy of this notice.

Client Information

Proposer & Trading Name
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Postal Address

Please enter the post code, or part of the address, or the company name, and then pick the correct entry from the list provided.

Address search

Full Business Description
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What year was the business established
*

Please enter numbers

Current Insurer
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Expiring or Target Premium
*

Please select a valid currency amount

Inception Date Required
*

Company Website *

Industry/Trade Associations
*

Predominant Business Area

Manufacturer

Retailer

Exporter

Wholesaler

Importer

Distributor

Other

Description of Operations

Please provide a breakdown of the business activities including the percentage (%) split of products by sales
*

Short Discription

Please indicate your annual sales in GBP of all products you wish to cover under the insurance policy split between prior year, the current year, and your estimate for the forthcoming year

Total Sales Last Complete Financial Year
*

Please select a valid currency amount

Profit (Loss) Last Complete Financial Year
*

Please select a valid currency amount

Total Sales Estimate for Current Financial Year:
*

Please select a valid currency amount

Profit (Loss) Estimate for Current Financial Year:
*

Please select a valid currency amount

Total Sales Projected Sales for next Financial Year *

Please select a valid currency amount

Profit (Loss) Projected Sales for next Financial Year
*

Please select a valid currency amount

Please state the percentage of your sales into the following territories:

UK/Ireland (%)
*

Please enter a valid percentage

Other European Countries
*

Please enter a valid percentage

Asia
*

Please enter a valid percentage

Australia / New Zealand
*

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USA / Canada
*

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Other
*

Please enter a valid percentage

Please state the number of plants you operate in the following territories:

UK/Europe
*

Please enter numbers

USA/ Canada
*

Please enter numbers

Australia/ New Zealand
*

Please enter numbers

Asia

Please enter numbers

Please split annual sales by branded, own label or non-branded products by %:

Branded

Please enter a valid percentage

Own Label
*

Please enter a valid percentage

Non – Branded Products
*

Please enter a valid percentage

Other
*

Please enter a valid percentage

Please provide details for your five largest customers:
Customer(1)

Customer name
*

Customer Location
*

Percentage of Annual Sales
*

Please enter a valid percentage

Customer(2)

Customer name

Customer Location

Percentage of Annual Sales

Please enter a valid percentage

Customer(3)

Customer Name

Customer Location

Percentage of Annual Sales

Please enter a valid percentage

Customer(4)

Customer Name

Customer Location

Percentage of Annual Sales

Please enter a valid percentage

Customer(5)

Customer Name

Customer Location

Percentage of Annual Sales

Please enter a valid percentage

Product Information

Details
*

Product Category *

Details *

% of Total Sales *

Please enter a valid percentage

Add another product *

Yes

Product Category
*

Details
*

% of Total Sales
*

Please enter a valid percentage

Add another product
*

Yes

Product Category
*

Details
*

% of Total Sales
*

Please enter a valid percentage

Add another product
*

Yes

Product Category
*

Details
*

% of Total Sales
*

Please enter a valid percentage

Add another product
*

Yes

Product Category
*

Details
*

% of Total Sales
*

Please enter a valid percentage

Add another product
*

Yes

Product Category *

Details *

% of Total Sales *

Please enter a valid percentage

Do you purchase raw product/ ingredients/ finished products from suppliers?
*

Yes

Are your suppliers given explicit written specification?
*

Yes

Do you maintain full rights of recourse against these suppliers?
*

Yes

Details of your three largest suppliers

Supplier Name *

Product
*

Annuals Sales (£)
*

Please select a valid currency amount

Country of Origin
*

Supplier Name

Product

Annuals Sales (£)

Please select a valid currency amount

Country of Origin

Supplier Name

Product

Annuals Sales (£)

Please select a valid currency amount

Country of Origin

Is there a quarantine process for all incoming suppliers?
*

Yes

Please describe your supplier selection and management procedures:
*

What is the average length of your relationship with suppliers?
*

Please describe how you test received products to ensure that they conform to your specification and are free from contaminants
*

What features of the finished product make the products ‘food-safe’ (e.g. sterilisation, pH, water activity, pasteurisation)? *

In the next 12 months are you planning to launch a new product?
*

Yes

Please provide a description, projected release date and projected annual sales
*

Quality Assurance

Do you have a fully implemented Quality Assurance (QA) System?
*

Yes

Does your QA system use HACCP (Hazard Analysis and Critical Control Points) for all Products?
*

Yes

When were the HACCP last reviewed?
*

Please explain how your QA is monitored (by whom, last review date)
*

Please explain the testing procedure for your raw material
*

E.g. methods used, quarantine process, laboratory relationships

Have you agreed to indemnify or hold harmless any suppliers of components or raw materials or any other party *

Yes

Please provide details *

What percentage (%) of your manufacturing is contracted out to third parties?
*

Please enter a valid percentage

Please explain how you assess the quality of the products of your contract manufacturers and suppliers
*

e.g. quality tests, review, requirement to use HACCP

Are your contract manufacturers and suppliers contractually obligated to indemnify you in the event of a product contamination caused by their product?
*

Yes

Please provide the contact details and the organisational alignment of the person responsible for Quality Management and customer complaint monitoring
*

Name and Phone Number

Has the applicant, its premises, products or processes been the subject of recommendations or complaints made by any regulatory body, internal or third party audit over the last 12 months or have any fines or penalties been assessed against the applicant by any food or similar regulatory body over the last 3 years?
*

Yes

Please provide details along with any remedial action completed
*

Do all products meet the legal and regulatory requirements regarding product safety in the countries for which they are exported/sold?
*

Yes

Please provide details
*

Batch Control and Traceability

Are all products subject to a specific batch coding system?
*

Yes

Please provide details

Please provide details
*

What Percentage of the products can be identified by the following:

Product Name (%)
*

Please enter a valid percentage

Product Shift (%)
*

Please enter a valid percentage

Hour of Production (%)
*

Please enter a valid percentage

Day of Production (%)
*

Please enter a valid percentage

Batch (%)
*

Please enter a valid percentage

Other (%)
*

Please enter a valid percentage

Are separate production lines dedicated to different products?
*

Yes

How often does cleaning / sanitisation of the production line(s) take place?
*

Are production lines cleaned/sanitised between different products
*

Yes

Is there a written traceability system in place
*

Yes

How far back and how far forward can the products be traced? (E.g. back as far as to the farmer? Forward to the retailer?)
*

Please describe your review process for labels and the parties that are involved in the review (e.g. legal). How often do reviews take place? Are bar code labels checked during processing?
*

Do you use tamper-resistant packaging?
*

Yes

Please describe
*

Are records kept of all product shipments?
*

Yes

For how long?
*

Product tampering/extortion related questions

Have you had incidents like strikes / industrial action, employment disputes or plant closures during the past 5 years?
*

Yes

Please describe
*

Are any redundancies / employee lay-offs or plant closures anticipated over the next 21 months?
*

Yes

Please describe
*

Have you ever been the target of an extremist or specialist group?
*

Yes

e.g. animal rights, environmental activists

Please describe
*

Do you perform any activities which increase your risk of being attacked by a special interest groups?
*

Yes

e.g. animal testing

Please describe
*

Recall Preparedness

What are the estimated costs of a recall of your leading brand?

Maximum (£)
*

Please select a valid currency amount

Average (£)
*

Please select a valid currency amount

Minimum (£)
*

Please select a valid currency amount

Who is responsible for the initiation of a recall and the recall / crisis plan?
*

Name, function and phone number

Do you have a Crisis Management Plan (if yes, please email to NIS)
*

Yes

Do you have a Recall Plan (if yes, please email to NIS)
*

Yes

Are mock drills conducted?
*

Yes

Are crisis and recall plans tested on a regular basis?
*

e.g.dry runs, mock-up recalls

Incident Reporting

Have you had any contamination incidents, recalls, withdrawals or extortions in the last 10 years? *

Yes

List details of all contamination incidents, recalls, withdrawals, and extortion below for the last 10 years for all entities owned or acquired

Product
*

Reason
*

Amount(units) *

Please select a valid currency amount

Date
*

Total Costs (£) *

Please select a valid currency amount

Recall Costs (£) *

Please select a valid currency amount

Loss of Profit (£) *

Please select a valid currency amount

Brand Restoration (£)
*

Please select a valid currency amount

Extra Expenses (£) *

Please select a valid currency amount

What remedial action was taken to prevent a similar incident occurring again
*

Add Another Incident
*

Yes

Product
*

Reason
*

Amount(units) *

Please select a valid currency amount

Date
*

Total Costs (£)
*

Please select a valid currency amount

Recall Costs (£)
*

Please select a valid currency amount

Loss of Profit (£)
*

Please select a valid currency amount

Brand Restoration (£)
*

Please select a valid currency amount

Extra Expenses (£)
*

Please select a valid currency amount

What remedial action was taken to prevent a similar incident occurring again

Add Another Incident *

Yes

Product
*

Reason
*

Amount(units)
*

Please select a valid currency amount

Date
*

Total Costs (£)
*

Please select a valid currency amount

Recall Costs (£)
*

Please select a valid currency amount

Loss of Profit (£)
*

Please select a valid currency amount

Brand Restoration (£)
*

Please select a valid currency amount

Extra Expenses (£)
*

Please select a valid currency amount

What remedial action was taken to prevent a similar incident occurring again

Add Another Incident *

Yes

Product
*

Reason
*

Amount(units)
*

Please select a valid currency amount

Date
*

Total Costs (£)
*

Please select a valid currency amount

Recall Costs (£)
*

Please select a valid currency amount

Loss of Profit (£)
*

Please select a valid currency amount

Brand Restoration (£)
*

Please select a valid currency amount

Extra Expenses (£)
*

Please select a valid currency amount

What remedial action was taken to prevent a similar incident occurring again

Add Another Incident *

Yes

Product
*

Reason
*

Amount(units)
*

Please select a valid currency amount

Date
*

Total Costs (£)
*

Please select a valid currency amount

Recall Costs (£)
*

Please select a valid currency amount

Loss of Profit (£)
*

Please select a valid currency amount

Brand Restoration (£)
*

Please select a valid currency amount

Extra Expenses (£)
*

Please select a valid currency amount

What remedial action was taken to prevent a similar incident occurring again

Do you know of any actual, threatened, or suspected malicious product tampering, or any actual or suspected accidental contamination involving any of your products during the last 5 years? *

Yes

Please provide details
*

Do you, your directors and officers, or any other person known to you have knowledge or information of any fact which may reasonably give rise to a claim under the proposed policy? *

Yes

Please provide details
*

Coverage

Limit of Indemnity required
*

Deductible Required (£)
*

Please select a valid currency amount

Date Cover to Commence
*

Do you have existing product recall insurance?
*

Yes

Please provide details (Including Insurer, Renewal Date, Limit of Indemnity, And Deductible)
*

Checklist

Please confirm that you will send the documents below marked 'Confirmed' to the following email addresses:
London_nfum_ggr@ajg.com
Mutual_Marketplace@nfumutual.co.uk
UK.NFU_Newenquiries@ajg.com

Attached Crisis Management Plan?

Confirmed

Attached Recall Plan?

Confirmed

Attached mock drills conducted document?

Confirmed

Attached Regulatory Compliance Document?

Confirmed

last inspection report issued by a governmental agency (e.g. FDA, USDA)

Important Information

Please read the following carefully:

The questions on this Proposal Form and any other details we specifically request, relate to facts which we consider material to underwriting this insurance. However, because no list of questions can be exhaustive, please consider whether there is any other material information which is known to you which could influence our assessment and acceptance of the risk.
FAILURE TO DISCLOSE MATERIAL FACTS WHETHER OR NOT THE SUBJECT OF SPECIFIC QUESTIONS MAY INVALIDATE YOUR INSURANCE
We recommend that you keep a record, including copies of this proposal, any letters and all information supplied to us for the purpose of entering into this insurance.

ADDITIONAL INFORMATION
Use this space to provide full details if there is any other material information which you should disclose:

Agents of the proposer must be aware that the provision of false or inaccurate information may invalidate your Client’s insurance and you accept and understand that Arthur J. Gallagher shall not be liable for any loss, damage or costs incurred arising as a result of your inputting false or inaccurate information in relation to your Client’s risk details onto this website in order to obtain a policy for your Client.

By ticking this box you are confirming that the proposer has an existing business relationship as a client of NFU Mutual. If you have any queries or wish to discuss any exceptions please contact NIS on 01789 455009 or email us on Mutual_Marketplace@nfumutual.co.uk

Please ensure you tick this box if you agree to the condition.

WhatHappensNextQuote

You can opt out of marketing communications at any time by contacting us: UK.unsubscribe@ajg.com

When this Submit button is engaged the following will happen.

The enquiry will be forwarded to the Underwriter with a copy to NIS and also to Arthur J. Gallagher.
You will receive an email acknowledging that the enquiry has been successfully sent.
You will receive a response to the enquiry within 3 working days.
If terms are offered and acceptable please process the instruction using the SONIC system.
If the terms are accepted please complete the NIS Cross Selling Form and return it electronically to NIS
If there are further queries or issues to discuss please use the ‘Ask the Expert’ facility to communicate them.

Our team of insurance specialists are here to help. Please fill out the form below and we will get back to you.

Your Details

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NFU Mutual Telephone *

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Enquiry Details

Nature of enquiry *

Please provide full details relating to the enquiry you wish to make. This will ensure the issue is raised with the correct department as quickly as possible. If necessary the person dealing with it will telephone you to discuss the matter but, for audit purposes, the response will need to be in writing.

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This form will now be sent to National Intermediary Services team who will respond or escalate dependent upon the nature of the enquiry. They will look to respond to you within a period of 1 working day to either provide an answer or explain to whom the enquiry has been directed and the expected timeframe for resolution.

In the event that you are unable to get the assistance you require, you can call NIS on 01789 455009.

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Arthur J. Gallagher is a trading name of Arthur J. Gallagher Insurance Brokers Limited, registered office: Spectrum Building, 7th Floor, 55 Blythswood Street, Glasgow, G2 7AT. Registered in Scotland. Company Number: SC108909. Authorised and regulated by the Financial Conduct Authority (Firm Reference Number: 311786).www.ajginternational.com

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