Equestrian Liability Insurance
Tel: 01992 707318
Horses Grazing
To obtain a quote, please complete the following, and press the "Submit Request" button at the bottom of the form. We will contact you by telephone or email with a quote.
E-Mail Address
Confirm email Address  
Title
First Name
Surname
Tel. Number - Day.
Tel Number - Evening
E-mail Address  
Where Did You See Us Advertised
Existing Customer (Any Product) YES NO 
Address of Property to be Insured:  
House No./Name
Street
Town
County
Post Code
Country
   
Correspondence Address: if different  
House No./Name
Street
Town
County
Post Code
Country
   
This section to be completed for Public/Employers Liability cover  
Number of Liveries
Number of Your Own Horses
Number of Staff Employed
Annual Wage Roll £
Annual Turnover £
Does Instruction Take Place on Your Premises
Are You a Riding School

If Yes, Please Provide Details of Who Will be Teaching

(pressing 'enter' at the end of each line)
Do You Require Care, Custody & Control Cover (Custodial Liability)
If 'Yes', Please give the Highest Required Horse Value £
Number of Shows Held
Are You BHS or ABRS Approved  
BHS ABRS Neither
Date Your Present Cover Is Due For Renewal
Renewal Premium £
Current Insurer

Please give Details of any claims that you have had in connection with this business

(pressing 'enter' at the end of each line)
   

Additional Information/Comments

(pressing 'enter' at the end of each line)

Declaration:

I/we agree that if this insurance contract is completed , then I/we will immediately notify Underwriters if any details isolated by this questionnaire are changed, modified or altered.

The information provided in connection with this questionnaire, whether in my/our hand or not, is true and I/we have not withheld any material facts. I/we understand that non-disclosure or misrepresentation of material facts will entitle underwriters to void the contract.

I/we understand that completing this questionnaire does not bind me/us to complete the insurance contract. However I/we agree that should a contract of insurance be completed, then this questionnaire and declaration made herein shall form an integral part towards the basis of the contract (see IMPORTANT NOTES.)