Kidnap and ransom

Corporate Information

Company Name *

Activity Of The Company *

Title*

First Name*

Last Name*

Occupation *

Mobile *

Email *

Address *

Website

Financial Information

Annual Sales

Total Assets

Input Employees Information

Total No. of employees

Or Upload Excel Sheet

Employees Excel Sheet

Does the Applicant or any employee utilize any methods of security for personal protection against criminal attacks or kidnapping?If so,Please provide a detailed explanation

Has the Applicant or any employee ever suffered an actual or attempted or threatened kidnapping or extortion or wrongful detention?If so,Please provide a detailed explanation

Employees Residing And Traveling From One Of The Following Countries

Input Employees Traveling And Residing Information

Input the number of employees either residing a country or traveling to a country from the countries in the following list

Or Upload Excel Sheet

Employees Traveling And Residing Excel Sheet

Does the Applicant wish to purchase any of the following additional benefits under the policy

We hereby acknowledge and confirm that all the submitted data above are correct and We did not hide any information related to the risk to be insured. And We authorize Brokerage Insurance Brokerage in executing this insurance request with the concerned insurance company and facilitate the policy issuance, renewals and claims follow-up and communicate specific information about us and our account to third parties if needed, in accordance with the privacy policy. We also accept that this insurance application and approval be the basis of the contract and an integral part of the insurance policy.

Kidnap and ransom