Equestrian Liability Insurance
Tel: 01992 718666
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.)

Shearwater Insurance Services Ltd
Registered Office: 2 Bath Place, London, EC2A 3JJ. Registered in the UK Company No: 02701633