P&I Club Claim Notice

P&I CLUB CLAIM NOTICE

FROM:

[SHIPOWNER / OPERATOR NAME]
[Company Address]
[City, State/Country, Postal Code]
Tel: [Contact Number]
Email: [Contact Email]
Fax: [Fax Number]

DATE: [__/__/____]

TO:

[P&I CLUB NAME]
Claims Department
[Club Address]

CC:

[Club Correspondent Name]
[Correspondent Port Address]
Tel: [Correspondent Contact]
Email: [Correspondent Email]

NOTICE OF CLAIM

Re: NOTICE OF CLAIM — Vessel [_______________________________], Voyage [__________], Entry Year [________]

1. MEMBER AND ENTERED NAME DETAILS

2. VESSEL PARTICULARS

3. CLUB ENTRY DETAILS

Deductibles (per Class of Cover):

4. NATURE OF CLAIM

Third-Party Liabilities Covered:

☐ CARGO

• ☐ Damage or shortage
• ☐ Delay in delivery
• ☐ Wet damage / water ingress
• ☐ Contamination
• ☐ Theft / pilferage
• ☐ Shortage / overage
• ☐ Other: [_______________________________]

☐ CREW

• ☐ Injury or illness
• ☐ Death
• ☐ Repatriation / travel expenses
• ☐ Wage claim / unpaid salary
• ☐ Overtime or bonus claims
• ☐ IMO disciplinary / criminal proceedings
• ☐ Stowaway / refugee crew claim
• ☐ Other: [_______________________________]

☐ PASSENGER

• ☐ Personal injury
• ☐ Death
• ☐ Luggage / property damage
• ☐ Other: [_______________________________]

☐ COLLISION (excess over H&M's three-quarter reciprocal deductible)

• ☐ Own vessel damage covered by H&M
• ☐ Third party vessel liability

☐ FIXED AND FLOATING OBJECTS (FFO)

• ☐ Damage to buoys, nets, fishing gear
• ☐ Damage to floating structures
• ☐ Port infrastructure damage
• ☐ Other: [_______________________________]

☐ POLLUTION

• ☐ Oil spill (bunker fuel)
• ☐ Cargo spill / leakage
• ☐ Hazardous substance spillage
• ☐ Anti-fouling paint incident
• ☐ Bilge water discharge
• ☐ Sewage / garbage discharge violation
• ☐ Other: [_______________________________]

☐ WRECK REMOVAL / SALVAGE CONTRIBUTION

• ☐ Total loss requiring wreck removal
• ☐ Salvage claim liability
• ☐ Port state control wreck removal order
• ☐ Other: [_______________________________]

☐ FINES AND PENALTIES

• ☐ Customs / immigration violation
• ☐ Pollution / environmental fine
• ☐ Safety / SOLAS / MARPOL violation
• ☐ Port state control detention costs
• ☐ Stowaway-related fine
• ☐ Other: [_______________________________]

☐ STOWAWAYS / REFUGEES

• ☐ Disembarkation / repatriation costs
• ☐ Legal proceedings
• ☐ Port authority detention orders
• ☐ Other: [_______________________________]

☐ TOWAGE AND TOWING LIABILITIES

• ☐ Third party vessel towed
• ☐ Emergency towage fees / salvage
• ☐ Tow-line damage to third party
• ☐ Other: [_______________________________]

☐ QUARANTINE / SANITARY

• ☐ Quarantine flag detention
• ☐ Medical inspection costs
• ☐ Sanitary defect fines
• ☐ Other: [_______________________________]

☐ OTHER THIRD-PARTY LIABILITY (describe): [_______________________________]

5. INCIDENT PARTICULARS

6. FACTUAL NARRATIVE

[____________________________________________________________]

[____________________________________________________________]

[____________________________________________________________]

[____________________________________________________________]

[____________________________________________________________]

[____________________________________________________________]

[____________________________________________________________]

7. ESTIMATED QUANTUM

Estimated Loss Range:

Basis of Estimate: [____________________________________________________________]

Potential for Significant Escalation? ☐ Yes ☐ No

If yes, explain: [____________________________________________________________]

8. IMMEDIATE ACTIONS TAKEN

Vessel / Safety Actions:

• ☐ Master's incident report obtained (date: [__/__/____])
• ☐ Crew statements / witness interviews conducted
• ☐ Vessel damage assessed for seaworthiness
• ☐ Safety inspection completed
• ☐ Class surveyor notified
• ☐ Deviation / emergency procedures documented
• ☐ Bridge logs / voyage data recorders preserved
• ☐ Engine room logs / black box data preserved

Third-Party & Authority Notifications:

• ☐ Port State Control notified (date: [__/__/____])
• ☐ Local maritime authority notified (date: [__/__/____])
• ☐ Flag State authority notified (date: [__/__/____])
• ☐ Counterparty / third party contacted (date: [__/__/____])
• ☐ Police / coastal guard report filed (date: [__/__/____])
• ☐ Customs / immigration informed (date: [__/__/____])
• ☐ Environmental agency notified (if pollution) (date: [__/__/____])

Insurance & Loss Management:

• ☐ Hull & Machinery (H&M) insurer notified (date: [__/__/____])
• ☐ Counterparty liability claim received? ☐ Yes ☐ No (date: [__/__/____])
• ☐ Local counsel engaged (name/firm: [_______________________________])
• ☐ Marine surveyors / investigators appointed
• Name: [_______________________________] Tel: [___________________]
• ☐ General average (G.A.) declared? ☐ Yes ☐ No
• ☐ Salvage agreement executed? ☐ Yes ☐ No

Cargo / Cargo Holder Actions:

• ☐ Cargo survey / inspection arranged (date: [__/__/____])
• ☐ Cargo holds / spaces photographed/video recorded
• ☐ Bills of lading / manifest retained
• ☐ Cargo receivers notified (date: [__/__/____])
• ☐ Cargo insurer contacted (date: [__/__/____])

Documentation Preservation:

• ☐ All incident-related documents assembled
• ☐ Photographs / video footage taken
• ☐ Electronic records backed up (logs, email, VDR, etc.)
• ☐ Chain of custody maintained
• ☐ Attorney-client privilege flagged on communications

Personnel Actions (if crew injury/death):

• ☐ Injured crew member(s) hospitalized (facility: [_______________________________])
• ☐ Medical treatment documentation obtained
• ☐ Medical examiner / post-mortem ordered (if death)
• ☐ Crew insurance claims submitted
• ☐ Repatriation arrangements made
• ☐ Family / next of kin notified (date: [__/__/____])

Other Actions Taken:

• ☐ [____________________________________________________________]
• ☐ [____________________________________________________________]

9. CORRESPONDENTS AND LOCAL AGENTS

10. REQUEST FROM CLUB

We respectfully request the following from [P&I CLUB NAME] within 48 hours of receipt:

• ☐ Acknowledgment of receipt of this notice and confirmation that the incident is covered under the entry
• ☐ Confirmation of cover: Nature of claim covered / subject to any limitations
• ☐ Reserve confirmation: Preliminary reserve amount for accounting purposes
• ☐ Approval of local counsel: Confirmation that counsel selected (name: [_______________________________]) is acceptable, or direction to alternative counsel
• ☐ Authorization for surveyor: Approval to proceed with marine surveyor / investigator (name: [_______________________________])
• ☐ Guarantees / Letters of Undertaking (LOU): Authorization to provide LOUs to port authorities, third parties, or salvors to secure release of vessel / prevent arrest (estimated LOU amount: $[_____________])
• ☐ Interim loss prevention guidance: Recommendations on mitigation steps or further documentation
• ☐ Appointment of claims manager / handler: Designation of club claims handler as primary contact
• ☐ Reserve advice: Written confirmation of reserve for member's accounting records

Urgent Authority Required?

• ☐ Yes: LOU or security required to prevent vessel arrest (estimated amount: $[_____________])
• ☐ Yes: Emergency salvage/towage authorization (estimated cost: $[_____________])
• ☐ No / Not anticipated

11. DOCUMENTS TO FOLLOW

The following documents will be provided within [7 / 10 / 14 / 21 / 30] days (select one):

Charter Party & Contracts:

• ☐ Time/Voyage Charter Party (certified copy)
• ☐ Bills of Lading (originals or certified copies)
• ☐ Sea Waybills (if applicable)
• ☐ Cargo Manifest
• ☐ Insurance certificates (H&M, Cargo, Charterer's liability)
• ☐ Protection & Indemnity entry certificate

Vessel Documentation:

• ☐ Classification society certificates (current)
• ☐ International Maritime Organization (IMO) documentation
• ☐ Tonnage certificate
• ☐ Inventory of ship's equipment
• ☐ Last vessel inspection / survey reports

Incident Records:

• ☐ Master's written incident report (signed and dated)
• ☐ Crew statements / interviews (signed)
• ☐ Deck log extracts (12 hours before / 48 hours after incident)
• ☐ Engine room log extracts
• ☐ Noon reports (3 days before / 3 days after incident)
• ☐ Bridge equipment maintenance records
• ☐ Voyage data recorder (VDR) download / transcript
• ☐ Automatic Identification System (AIS) records for incident period
• ☐ Electronic Chart Display and Information System (ECDIS) track record
• ☐ GPS / Radar data
• ☐ Weather routing / meteorological reports for incident date/time

Investigation & Survey:

• ☐ Marine surveyor's preliminary / formal report
• ☐ Underwater survey report (if required)
• ☐ Photographs / video footage (incident scene, damage, vessel, cargo)
• ☐ Investigator's full report (when available)

Medical Records (if crew injury/death):

• ☐ Medical examination certificate
• ☐ Hospital discharge summary / treatment records
• ☐ Death certificate (if applicable)
• ☐ Post-mortem examination report (if applicable)
• ☐ Crew member's contract of employment
• ☐ Wage / benefit documentation

Third-Party Liability Documentation:

• ☐ Counterparty demand letter / claim notice
• ☐ Counterparty's incident report
• ☐ Counterparty vessel / property damage photographs
• ☐ Salvage agreement (if applicable)
• ☐ Port authority / government correspondence
• ☐ Police / Coast Guard report

Financial Records:

• ☐ Invoices for emergency repairs / towage / salvage
• ☐ Port authority/harbor master bills
• ☐ Surveyor / investigator fees
• ☐ Legal counsel invoices
• ☐ Cargo receiver claim correspondence
• ☐ Proof of payments made (bank transfers, receipts)

Regulatory / Compliance:

• ☐ Port State Control inspection report (if applicable)
• ☐ Flag State authority correspondence
• ☐ Environmental agency notices (if pollution)
• ☐ Customs / immigration documentation
• ☐ Safety / SOLAS compliance certificates

12. MEMBER'S DUTY OF CARE AND COOPERATION

By submitting this notice, the Member acknowledges and confirms:

1. Duty to Mitigate: The Member has taken, and will continue to take, all reasonable steps to mitigate the loss and prevent further damage.

2. Full Disclosure: All material facts relating to the incident have been disclosed honestly and completely. No misrepresentation or concealment has been made.

3. Compliance with Club Rules: The Member has complied with, and shall continue to comply with, all Club entry conditions and rules applicable to the covered vessel and the incident claimed.

4. Vessel Compliance: The vessel has been maintained in accordance with all classification, statutory, and regulatory requirements. Any defects or deviations are disclosed herein.

5. Documentation & Cooperation: The Member shall provide all requested documents, statements, and information within the timeframes specified by the Club.

6. Evidence Preservation: All evidence relating to the incident has been preserved and shall not be destroyed or altered without Club approval.

7. Authority Cooperation: The Member shall cooperate fully with Club appointed surveyors, investigators, lawyers, and all third parties as directed by the Club.

8. No Settlement Without Consent: The Member shall not settle, admit liability, or incur defense costs exceeding $[_____________] without prior Club written authorization.

9. Subrogation Rights: The Member acknowledges the Club's right to subrogate and recover against third parties responsible for the loss.

10. Confidentiality: The Member shall maintain confidentiality of all Club communications and privileged advice, and shall instruct all appointed professionals to do likewise.

13. SIGNATURE AND DECLARATION

DECLARATION BY MEMBER / REPRESENTATIVE

I/We hereby certify that the foregoing information is true and correct to the best of my/our knowledge and belief. I/We understand that any material misstatement may result in loss of cover under Club rules.

WITNESS / CO-SIGNATORY (if required):

APPENDICES (if attached)

• ☐ Appendix A: Master's Incident Report
• ☐ Appendix B: Crew Statements
• ☐ Appendix C: Photographs / Video Footage
• ☐ Appendix D: Preliminary Surveyor Report
• ☐ Appendix E: Port Authority Correspondence
• ☐ Appendix F: Casualty Map / Track Record
• ☐ Appendix G: Third-Party Demand / Correspondence
• ☐ Appendix H: Medical Records (if crew injury)
• ☐ Appendix I: Invoices / Expense Documentation
• ☐ Other: [_______________________________]

SOURCES AND REFERENCES

• International Group of P&I Clubs – Overview of the IG Club system and member resources
• American Club – Claims procedures and forms
• Gard P&I – Protection & Indemnity cover rules
• Skuld P&I Rules – 2026 P&I Rules
• London P&I Club Rules – Club entry and cover terms
• NorthStandard Marine Insurance – Vessel search and claims guidance
• How P&I Clubs Work - MarineInsight – Procedure for accident response
• Gard Guidance on Maritime Claims and Insurance – Comprehensive claims guidance handbook
• P&I Insurance Coverage - ShipLawMatters – Comprehensive P&I coverage guide
• Marine Insurance Claims: P&I and H&M Procedures - MarinePublic – Master's guide to claim procedures
• BIMCO – Standard maritime contracts and clauses