| Please note: No coverage can be
bound via the internet. |
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| Contact Information |
| Contact Name: |
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| Street Address: |
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| City: |
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| State: |
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| Zip: |
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| Tel: |
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| Fax: |
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| Email: |
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| How would you like us to respond to you? |
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| Mortality Coverages |
| Mortality policies are available
in all U.S. states except Alaska and Hawaii.
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| We would be pleased to provide you
with an insurance quote for mortality coverages
for your horse. Please fill out the required fields
below. |
| Horse’s Breed: |
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| Horse's Gender |
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| Horse’s Age: |
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| Horse's Fair Market Value: |
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| Please Note: Value must
be substantiated by recent purchase price, competition
record, breeding record, or professional evaluation
of training level obtained. |
| Horse’s Use: |
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| Please Note: "Halter
Horse" Use is for Quarter Horses, Appaloosas,
and Paints used for breeding halter horses or
raised, shown, or trained as a halter horse. |
| If you selected "Showing (excludes
jumping" from the above Horse's Use drop down
list, please specify type of showing here. |
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Additional
Mortality Coverages
For more information on the following additional
coverages, please see the Coverages
For Your Horse section of this site. |
Major Medical/Surgical (Up to $7,500 limit)
Major Medical/Surgical ($10,000 limit)
Surgical Only
Colic Medical and Surgical
Third Party Liability
Stallion Infertility for AS&D
Full Loss of Use (Available for select uses
only. Completion of the
Full Loss
of Use Vet Certificate is required for coverage
consideration.)
External Injury Only Loss of Use (Available
for select uses only.)
Equine Personal Liability
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| If your horse has any pre-existing
health conditions (including but not limited to
EPM, lameness, recent colic, laminitis, etc.),
please provide details here. |
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Any quote provided is not a guarantee
of coverage. All risks must meet with underwriting
approval based upon completion of the required
application.
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| Liability/Farm
Coverages |
Liability policies are
available in all U.S. states except Alaska and
Hawaii.
Property policies are available in all U.S. states
except Alaska, Hawaii, California, Florida, Louisiana,
and Texas. |
| If you are interested
in a quote for commercial liability for your equestrian
business, event, club or association or a quote
on your equine property, please download the appropriate
application, complete it, then fax or mail it
to our office for a quote. |
| If you have any questions or comments,
please feel free to write them here. |
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| How did you learn about our Company? |
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