Livestock/Bloodstock Insurance Quote Request
Quote for 3 Horses
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.
email Address
Confirm email Address
Title
First Name
Surname
House Number/Name
Street
Town
County
Post Code
Country
Tel. Number - Day
Tel. Number - Evening
Where Did You See Us Advertised
Existing Customer (Any Product) YES NO 
First Horse
Horse Name
Age
Sex
Insured Amount
Main Use

List any previous claims made in respect of this animal. (pressing 'enter' at the end of each line)
Present Insurers
Renewal Date
Renewal Premium £
Type of Cover - All Risk of Mortality & Theft, plus:
  
Choose any combination of the following:  
Loss of Use YES NO  
Vet Fees YES NO  
Personal Accident YES NO  
Legal Liability & Third Party YES NO  
Tack YES NO If Yes, Value £
     
Second Horse  
Horse Name
Age
Sex
Insured Amount
Main Use

List any previous claims made in respect of this animal. (pressing 'enter' at the end of each line)
Present Insurers
Renewal Date
Renewal Premium £
Type of Cover - All Risk of Mortality & Theft, plus:
  
Choose any combination of the following:  
Loss of Use YES NO
Vet Fees YES NO
Personal Accident YES NO
Legal Liability & Third Party YES NO
Tack YES NO
If Yes, Value £
   
Third Horse  
Horse Name
Age
Sex
Insured Amount
Main Use

List any previous claims made in respect of this animal. (pressing 'enter' at the end of each line)
Present Insurers
Renewal Date
Renewal Premium £
Type of Cover - All Risk of Mortality & Theft, plus:
  
Choose any combination of the following:  
Loss of Use YES NO
Vet Fees YES NO
Personal Accident YES NO
Legal Liability & Third Party YES NO
Tack YES NO
If Yes, Value £
     
Any Other information/ Comments
Declaration: I declare that the information I have given above is true and complete. I have not withheld any material facts (see IMPORTANT NOTES.) I agree that this proposal shall form the basis of the Contract between me and Shearwater Insurance.
Shearwater Insurance Services Ltd
Registered Office: 2 Bath Place, London, EC2A 3JJ. Registered in the UK Company No: 02701633