This section captures all critical shipment identification and routing data required to establish the chain of custody and contractual baseline for the claim. Accurate completion is essential for claims processing and carrier liability determination.
Master Bill of Lading (MBL) Number
House Bill of Lading (HBL) Number
Container Number(s)
Seal Number(s) at Origin
Booking Reference Number
Purchase Order (PO) Number
Commercial Invoice Number
Origin Location (Port/Airport/Terminal)
Final Destination Location
Intermodal Transshipment Points
Cargo Loaded at Origin Date/Time
Estimated Arrival at Final Destination
Actual Arrival at Final Destination
Vessel/Voyage Number (Ocean Leg)
Rail Carrier & Train Number (if applicable)
Trucking Company & Vehicle ID (if applicable)
Air Waybill Number (if applicable)
Commodity Description
Total Number of Packages
Packaging Type
Total Gross Weight (kg)
Total Volume (CBM)
HS Code(s)
Total Declared Value for Customs
Currency Code
Insurance Policy Number
Incoterms 2020 Rule
Upload Original Bill of Lading (PDF/Scanned Copy)
Upload Packing List
Upload Commercial Invoice
This section documents the physical condition of the container and cargo upon arrival at the destination facility. Detailed inspection data is critical for determining when and where damage occurred during transit. All observations must be supported by photographic evidence.
Inspection Date/Time
Inspection Location (Facility Name & Address)
Inspector Name & Employee ID
Inspector Role/Title
Was the container seal intact upon arrival?
Was the container structurally sound (no holes, dents, or door damage)?
Were there any signs of water ingress or moisture damage?
Were there any signs of temperature excursion (for temperature-controlled cargo)?
Was there any evidence of odor, contamination, or hazardous substance exposure?
Overall Cargo Condition Upon Opening Container
Total Number of Damaged Packages
Total Number of Undamaged Packages
Damage Severity Classification
Total Loss (100% value destroyed)
Major Damage (50-99% value loss)
Minor Damage (1-49% value loss)
Cosmetic Damage Only (minimal value impact)
Types of Physical Damage Observed (select all applicable)
Crushed/Compressed
Torn/Punctured
Water/Moisture Damage
Stains/Contamination
Broken/Fragmented
Disfigured/Deformed
Missing Items
Other
Detailed Description of Damage by Package/Item
Specific Location of Damage Within Container
How consistent is the damage pattern with typical handling/shipping stress?
Highly Inconsistent (suspicious)
Somewhat Inconsistent
Neutral
Somewhat Consistent
Highly Consistent (expected)
Upload Container Exterior Photos (all sides, doors, seal)
Upload Container Interior Photos (overall condition, damage close-ups)
Upload Individual Damaged Package Photos
Upload Inspection Checklist or Report
Upload Temperature Logger Data File (if applicable)
This section quantifies the financial impact of the damage, including original value, depreciation, salvage potential, and ancillary costs. All valuations must be supported by commercial documentation and market research where applicable.
Cargo Value & Damage Assessment by Line Item
Item/SKU Number | Description | Quantity Shipped | Quantity Damaged | Unit Cost | Total Original Value | Damage Percentage (0-100) | Estimated Loss Value | Salvage Value per Unit | Net Loss (after salvage) | |
|---|---|---|---|---|---|---|---|---|---|---|
SKU-001 | Bluetooth Headphones | 1000 | 150 | $25.50 | $25,500.00 | $80.00 | $20,400.00 | $5.00 | $19,650.00 | |
SKU-002 | USB-C Cables | 500 | 50 | $8.75 | $4,375.00 | $60.00 | $2,625.00 | $2.00 | $2,525.00 | |
$0.00 | $0.00 | |||||||||
$0.00 | $0.00 | |||||||||
$0.00 | $0.00 | |||||||||
$0.00 | $0.00 | |||||||||
$0.00 | $0.00 | |||||||||
$0.00 | $0.00 | |||||||||
$0.00 | $0.00 | |||||||||
$0.00 | $0.00 |
Total Original Shipment Value
Total Estimated Loss Value
Total Estimated Salvage Recovery Value
Net Claim Amount (Loss minus Salvage)
Are there any potential duty/tax recovery amounts?
Inspection & Survey Costs
Additional Storage Costs Due to Damage
Repackaging/Sorting Costs
Disposal/Destruction Costs for Unsalvageable Items
Expedited Replacement Shipment Costs
TOTAL INCIDENTAL COSTS
GRAND TOTAL CLAIM AMOUNT (Net Loss + Incidental Costs)
Salvage Disposition Plan
Sell as-is to secondary market
Return to supplier/manufacturer
Donate for charitable write-off
Destroy/dispose with certificate
Hold for insurance inspection
Other
Justification for Salvage Valuation Methodology
Upload Commercial Invoice for Proof of Value
Upload Salvage Buyer Quotations (if applicable)
Upload Repair Estimates (if applicable)
This section investigates the root cause and attribution of liability among all parties in the intermodal chain. Detailed factual evidence is required to support any carrier liability claim and to determine contributory negligence factors.
Primary Ocean Carrier Name
Rail Carrier Name (if applicable)
Trucking Carrier Name (if applicable)
Freight Forwarder/NVOCC Name
Carrier Booking/Reference Number
Date/Time Damage First Discovered
Date/Time Carrier Was Notified
Carrier Notification Method
Carrier Representative Name & Contact
Presumed Damage Occurrence Segment
Pre-Loading at Origin
Ocean Voyage
Transshipment Port Handling
Rail Transport
Final Trucking Leg
Destination Unloading
Cannot be Determined
Multiple Segments
Did the carrier acknowledge receipt of damage notification?
Was a joint survey conducted with carrier representative present?
Potential Causes of Damage (select all applicable)
Improper Loading/Stowage at Origin
Rough Handling by Stevedores
Inadequate Securing/Lashing
Vessel Rolling/Heavy Weather
Reefer Equipment Malfunction
Contamination from Previous Cargo
Theft/Pilferage
Container Structural Failure
Fire/Explosion
Collision/Accident
Acts of God (General Average)
Other
Detailed Incident Narrative & Timeline
Were there any deviations from the contracted route or schedule?
Did the carrier issue any exception notices or cargo care clauses during transit?
Is there evidence of contributory negligence by shipper (e.g., inadequate packaging)?
Have you reviewed carrier's terms & conditions (Hague-Visby Rules, COGSA, etc.)?
Strength of Evidence Supporting Carrier Liability
Very Weak (speculative)
Weak (circumstantial)
Moderate (some direct evidence)
Strong (clear evidence)
Very Strong (indisputable)
Estimated Percentage of Liability Attributable to Carrier (0-100%)
Upload Carrier Terms & Conditions (Bill of Lading Back Clause)
Upload Correspondence with Carrier (emails, letters, survey reports)
Upload Vessel Voyage Data (if obtained)
This final section ensures proper authorization and review by senior management and claims professionals. All claims must be validated for accuracy, completeness, and compliance with internal governance before submission to carriers or insurers.
Originator Name (Logistics Manager)
Originator Employee ID
Originator Email
Originator Submission Date/Time
Has all supporting documentation been attached?
Has the claim been entered into the internal claims management system?
Head of Global Supply Chain Name
Head of Global Supply Chain Employee ID
Head of Global Supply Chain Title
Does the Head of Global Supply Chain approve this claim submission?
Head of Global Supply Chain Digital Signature
Head of Global Supply Chain Approval Date
Claims Adjuster Name (if internal)
Claims Adjuster License/Registration Number
Has the Claims Adjuster reviewed and validated the claim valuation?
Claims Adjuster Digital Signature
Claims Adjuster Review Date
Final Disposition Decision
Proceed with Carrier Claim Filing
Submit to Marine Insurance
Write-off as Business Loss
Hold for Further Investigation
Refer to Legal Counsel
Consolidate with Other Claims
Executive Summary for Leadership Review
Does this claim require escalation to Legal Department?
Has this claim been reported to external Marine Insurance?
Upload Internal Approval Email/Document Trail
Upload Final Compiled Claim Package (PDF)
Upload Insurance Policy Document (if claim filed)