The following is an example of a Master’s protest your insurer may require when investigating your loss.

Assured: White Star Lines
Policy number: 1234567
Effective: January 1, 1912
Expiry: January 1, 1913
Date of Loss: April 14, 1912
Time of Loss: 23:40
Vessel name: Titanic
Description: Steam powered passenger vessel, 882′ LOA, 66,000 Tons
HID or Official # 654321

I/we, the above Assured, owner of the vessel described above, insured by the above policy hereby state that the vessel did sustain loss and/or damage on the date and time mentioned above and further state that all pertinent details thereto are as set forth below, the same being true and correct to the best of my/our knowledge.

Location of loss: 41°46’N, 50°14’W
Course: 240°
Weather: Clear
Condition of seas: Calm
Tide: On the ebb
Cause and origin: Collision with iceberg.
Nature and extent: Damage to Starboard hull below waterline. Vessel sank. 1635 lives lost.
Estimate of loss: $10,000,000

Title and insurance: At the time of the loss/damage the Assured(s) owned the vessel, free and clear with no other interest or encumbrances except (no exceptions) and the only insurance was under the above-captioned policy except (no exceptions).

And I/we have signed this 15th day of April, 1912.