Personal / License Information
Marine Casualty/Incident History
Primary Coverages Requested
Unlimited License Defense - Included
Fully paid legal representation and defense by experienced maritime attorneys if you are involved in a shipping casualty or incident that leads to action against your marine licenses. There are no co-insurance clauses and no hidden deductibles.
Professional Instruments and Equipment Coverage - $3,000 Limit Included *
MOPS will provide limited coverage on work-related computer equipment listed below, including, but not limited to: laptops, tablets, etc., at no charge up to a maximum coverage of $500.00. (Original proof of purchase may be requested.)
Personal belongings such as cell phones, eyeglasses, hearing aids, clothing, rain gear, etc. are not considered professional equipment or instruments and, therefore, will not be covered.
Please list all job-related items for which coverage is requested in the Item Description and Original Purchase Price boxes below. Failure to provide list in advance may void coverage.
Do you want Professional Instruments and Equipment Coverage?
Foreign Port - $2,000 Limit Included
Approved attorney fees and expenses if you are ordered to attend, either as a party or witness, any inquiry of a foreign court concerning a shipping casualty or incident involving your vessel.
Optional Coverages (check coverages requested)
5. Civil Penalties Legal Defense
Paid legal defense if you are charged with a civil penalty by the U.S. Coast Guard or any other entity within the United States, its territories, or a foreign court or administrative entity authorized to impose a civil penalty or fine resulting from a covered shipping casualty or incident involving your vessel. Please note that this coverage is DEFENSE only; it does NOT cover payment of the penalty/fine. (Coverage up to $10K.)
6. Criminal Acts Defense
Paid legal defense by experienced criminal attorneys if you are charged criminally in connection with a covered shipping casualty or incident that results in allegations or charges related to federal (OPA-90) and/or state water pollution laws and/or regulations. (Coverage up to $25K.)
UPON REVIEW AND APPROVAL OF THIS APPLICATION, THE UNDERWRITER WILL CALCULATE AN ANNUAL PREMIUM BASED UPON THE INFORMATION LISTED BY THE APPLICANT HEREIN.
By checking this box, I hereby warrant that the above particulars and statements are true and complete, that I have not omitted or misstated any material fact, and that at the present time I have no reason to anticipate any charges being brought against either me or my United States Coast Guard or state pilotage license(s) for any intentional or unintentional misconduct or negligence. I agree that this application form shall be relied upon and shall be the basis on which any Certificate of Insurance may be issued by the Company and shall be deemed a part thereof. I understand and agree that failure to disclose or misstatement of any information requested in this application may result in the Company denying all coverage in the event of a claim.
Thank you! Your MOPS premium quotation will be processed shortly.