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Equine and Livestock

INSURANCE QUOTATION FORM:

Thoroughbred Horses

PLEASE COMPLETE AND SUBMIT THIS INSURANCE QUOTATION FORM 

All fields marked with an asterisk (*) are required. If a question does not apply, enter 'N/A' as your response.

You must take care in answering all the following questions which are relevant to us in providing this insurance and setting the terms and premium. Please contact us if you do not understand the question or the nature of the information required or please seek guidance from your broker. Failure to provide information or the provision of incomplete or inaccurate information may result in the loss of cover or other remedies.

You must in completing this proposal form make full and proper enquiry of all relevant parties in relation to the answers given and all information and/or documentation supplied with or in relation to any question raised in this proposal form.

You must tell us as soon as practicably possible about any changes to the information you have provided to us which happens before or during any period of insurance. We will tell you if such change affects your insurance and if so, whether the change will result in revised terms and/or premium being applied to your policy. If you do not inform us about a change it may affect any claim you make or could result in your insurance being invalid. 

 YOUR CONTACT DETAILS

HORSE DETAILS FOR QUOTE

(TO BE SIGNED BY THE OWNER OR PERSON RESPONSIBLE FOR THE HORSE). Please read this form carefully. If you are in doubt, submit a current veterinary certificate. Complete this section by ticking the Yes or No box and giving full details where necessary on a separate page.

PLEASE ENSURE THAT YOU HAVE CHECKED WITH YOUR REGULAR VETERINARY SURGEON / TRAINER / PERSON RESPONSIBLE FOR DAY TO DAY CARE OF THE HORSE BEFORE SIGNING AND SUBMITTING THIS FORM.

Name

Sire/Dam

D.O.B

Sex

Breed

Majority Location Postcode

Use

Sum insured (INCL GST)

Name

Sire/Dam

D.O.B

Sex

Breed

Majority Location Postcode

Use

Sum insured (INCL GST)


From 1 October 2016 all sum insured’s limits, excesses and premiums include GST. This will be shown on your invoice and policy schedule. Please ensure the sum insured reflects the GST inclusive amount. If you are GST registered for your horses, please advise Marsh of your GST registration number and update the name of the insured if required.

DUTY OF DISCLOSURE

INSURED’S DUTY OF DISCLOSURE

The duty of disclosure is an important legal requirement that applies to insurance.

When you apply for insurance you have a legal duty of disclosure. Before we can consider providing cover, you must disclose to us everything known to you which is relevant to:

  • our decision to insure your animal/s;
  • the terms on which we insure you.

The duty applies to each Insured.

The duty also applies when you seek to enter into, renew, change or reinstate a policy.

Examples of information you may need to disclose include:

  • any change in the animals use or activities;
  • any cancellation, refusal to renew insurance, or imposingof special terms by another insurance company;
  • any change in the animal’s health or injuries suffered;
  • any insurance claims you have made in the past.
  • any criminal offence;

What happens if you fail in your Duty? If you don’t make this disclosure Insurers may:

  • refuse or reduce a claim;
  • cancel the Cover;
  • in some cases, treat the Cover as having never operated.

If you are in doubt it is better to give us the information rather than take the risk of failing in your duty of disclosure.

YOUR DUTY OF DISCLOSURE: You must take care when answering any questions we ask by ensuring that all information provided is accurate and complete. You have a duty to disclose to us all material facts that we may rely on when setting the terms of the policy or accepting coverage.

IF YOU DO NOT TELL US SOMETHING: If we establish that you have failed to comply with this duty of disclosure or provided us with incorrect or incomplete information that we have relied upon when accepting this coverage, we may refuse to pay your claim or reduce the amount payable to you. If the non-disclosure is fraudulent then we may treat your policy as if it never existed and decline all claims.

VETERINARY CERTIFICATES

Veterinary Surgeon’s Certificate of Health on the NZVA recommended Certificate format is required for:-

1. a HORSES – All  Sport Horses valued over $57,500 and/or aged over 16 years of age.

1. b HORSES – All Standardbred and Thoroughbred horses valued over $287,500  and/or  aged over 13 years of age.

2. FOALS – Under 45 days of age. Foals from 24 hours to 7 days old also require an IgG test to be done. 

NB – Veterinary Certificates are not required on animals purchased at auction that are insured from fall of hammer

YOUR ONUS OF PROOF

The onus of proof that the insured animal was fit and in good health at the time that the insurance cover commenced lies with you (the Insured) under the terms of this insurance.

CLAIMS – 24 HOUR SERVICE

In the event of death or any life threatening lameness, illness, accident, disease, you or your Representative or any person who has care, custody or control of your animal/s should give immediate notice to:

Marsh, PO Box 547, Cambridge, New Zealand 

Telephone: 0-7-827 7071 

Mobile: 021-241-4772 

Fax: 0-7-827 7072

Email: equine.livestock@marsh.com

POST MORTEM

In the event of the death of an animal, it is a Policy requirement that a Post Mortem/Autopsy be immediately carried out at the Insured’s expense. To assist with identification, registration number, colour etc. should be noted.

OPERATIONS - Any surgical procedure must be carried out by a registered Veterinary Surgeon.

(a) Castration, Bone Chip etc. All operations must be notified at least 24 hours prior to the operation being performed.

(b) Life Saving Operations Must be performed as quickly as possible and notification given immediately. A second veterinary opinion should be obtained.

BINDING AUTHORITY STATEMENT

Marsh are acting in an underwriting capacity on behalf of Certain Underwriters at Lloyds who, under an Underwriting Agency Agreement, have given Marsh authority to act on their behalf in respect of this insurance.


DECLARATION

I/We have read and understood the Duty of Disclosure as set out in this form and I/We hereby certify that to the best of my knowledge and belief the above particulars are true and correct and that no information which would materially affect this insurance has been withheld.

I HAVE READ, UNDERSTAND AND AGREE TO MARSH'S TERMS OF ENGAGEMENT AND DISCLOSURE STATEMENTS. *