Equine Insurance Quote

Request an Insurance Quote

* Indicates required field

Animal Name *

Date of Birth *

Date of Purchase *

Purchase Price *

Requested Limit of Insurance *

Sex *

Breed *

Use *

Primary Stable Location *

How many Animals so that we know? *

Amount of Mortality Coverage? *

Amount of coverage requested for Major Medical? *

Upload pics of all sides of horses and registration *

Max file size: 20MB

Upload BIll of Sales *

Max file size: 20MB

Upload Examination Results *

Max file size: 20MB

Upload any supporting documents Needed *

Max file size: 20MB

Address *

Line 1

Line 2

City

State

Zip Code

Country

Owners Name *

Phone Number *

Email *

ID's *

1. Was a pre-purchase exam completed? *

2. Has the horse been examined or treated by a veterinarian for any accident, injury, sickness, disease, lameness, or other than routine care within the last year? *

3. Is the horse currently free of lameness and healthy without the use of drugs? *

4. Has the horse undergone diagnostic ultrasound, bone scan, or x-rays within the last 36 months? *

5. Does the horse have any known Injury, Disability or condition? *

6. Has the horse been nerved or received any treatment for lameness? *

7. Has the horse received any joint injections, any type of medication long or short term, or any preventative treatments in the last 36 months? *

8. Has the horse had any colic, colic surgery, impaction, or intestinal disorder within the last 36 months? *

9. Is the horse due to foal any time during the requested Policy Period? *

If Yes, please give:

Estimated Foaling Date *

Number of Previous Foals *

Stud fee *

10. Has the horse ever experienced birthing difficulties? (Mares only) *

11. Does the horse have an ancestor known to carry HYPP? If No, please move on to question 12. *

A. Has the horse been HYPP tested? *

12. Will the horses be observed and cared for daily? *

If No, explain: *

13. Are you the sole owner of the horses? *

If No, provide other owner’s % of interest, name and address: *

14 .Are the horses leased to others? *

If Yes, please attach a copy of the lease(s). *

Max file size: 20MB

15. Is there any other insurance on the horses? *

If Yes, provide the carrier name: *

Expiration date: *

Amount of coverage: *

16. Has any insurance carrier ever canceled, non-renewed or refused to insure any horse in which you have or had an insurable interest? *

If Yes, provide details: (Not applicable in MO) *

17. Have you lost any horse in the last 5 years (whether or not insured) or have any medical/surgical or colic claims been filed on the above listed horse? *

If Yes, give date, cause, value and explain: *

Any additional information needed? *

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Equine Insurance Quote

Request an Insurance Quote

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