A product recall insurance proposal form is a document signed by companies in order to insure themselves in case a product needs to be recalled due to faults and damages. By filling up this form, the company is offered insurance protection during the recall of the insured’s company’s product, which also includes coverage for expenses incurred for the recall process and also includes liability to third parties. In spite of adequate testing and analysis, companies may have to recall products which can be a very expensive process involving media campaigns to inform customers, disposal of the product, sometimes lawsuits, replacement of the faulty parts or compensating them with money and so on.

Sample Product Recall Insurance Proposal Form:

Name of company proposed to be insured: ________

Date when company was established: _________

Address: _________

Phone: ___________

Email ID: __________

Website: _____________

Description of products and activities: ____________

Does the company have an R&D department? ________________

Estimated annual turnover: __________

Previous year’s turnover: _________

Date of first marketing: _________

Has any new product been introduced in the market in the past one year? If yes, please mention type and name of product. ____________

Name and amount of last three big contracts: ____________

What is the average contract size? ___________

Please specify the failure rate of products after they have been launched in the market. ___________

Please specify if there has been any significant incident and what were the reasons for the failure. ___________

Mention the company’s quality control and inspection procedures. ___________

Name and signature of head of company:

Date:

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