Application for horse insurance version 2024

Application ABES horse insurance

1. applicant

Characteristics of the applicant *

Person

Salutation / Gender *

Sex

Title

Name of the applicant *

Vorname

Nachname

First Name and Last Name

Address of the applicant in Switzerland *

Address Line 1

City

State / Province / Region

Address

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E-mail of the applicant *

E-mail

Priority phone number *

Priority phone no

IBAN number for refunds

BAN number for refunds

2. general information about the contract

Desired start date of the contract (if not filled in, immediately after acceptance)

Proposed Start date: (if not filled in, as per acceptance)

Is the horse currently insured? *

Is the horse currently insured?

In the last 5 years, has a contract for the horse to be insured only been accepted under difficult conditions, continued or partially or fully terminated? *

Have you ever been declined insurance or had any such insurance canceled or renewal refused, or had special terms imposed?

Have you had a death of a horse in your ownership in the last 5 years? *

Have you sustained a loss of a horse in the past 5 years?

Is another party financially involved with the horse? *

Is there any other party with a financial interest in the horse?

3. general information about the horse to be insured

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Registered name of the horse in the horse passport *

Name

Race *

Breed

Sex *

Sex

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Identifier

Identity Marking

Color *

Color

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Date of birth *

DOB

Chip no. according to ISO standard

Chip

Location address of the horse *

Address Line 1

City

State / Province / Region

Postal Code

Country

Address

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Distance to the usual veterinarian in KM *

Distance to usual vet

Distance to the veterinary clinic for major operations *

Distance to the nearest veterinary facility for major operations

4. health questions about the horse to be insured

4.a. To your knowledge, has the horse ever suffered from any form of colic or other intestinal or digestive disorders?

To your knowledge, has the above horse ever suffered from any form of colic or other intestinal or digestive disorders?

4.b. To your knowledge, has the horse ever suffered a broken bone, tendon or ligament injury?

To your knowledge, has the above horse ever suffered from any fractures, tendon or ligament injury?

4.c. Has the horse received any veterinary treatment (other than routine vaccinations, deworming, pregnancy, childbirth, shoeing) in the last 12 months? *

Received attention from any veterinary surgeon or alternative therapist for any reason other than routine vaccination or obstetric work including farriery in the last 12 months?

4.d. To the best of your knowledge, is the horse currently in sound condition with regard to posture, eyes, heart and respiratory system, and lameness? *

Is the above horse at present normal in confirmation, eyes, heart, wind and action and in good health?

4.e. Are there other factors affecting the health of the horse that are relevant to the risk being covered? *

Is there any other factor affecting the health of the horse which should be disclosed?

A possible health examination (purchase examination) by the veterinarian is to be carried out according to the separate form. The costs are to be to be borne by the applicant.

5. sum insured and market value

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Purchase price of the horse without taxes in CHF *

Purchase Price in CHF (without tax)

Purchase date *

Purchase Date

Purchase contract or purchase receipt *

Proof of purchase available or follows later

Desired sum insured (different value to the purchase price)

Value of the horse in CHF

Market value of the horse in CHF (relevant value for calculating the premium)

Value of the horse in CHF

6. insurance cover applied for

Select the desired coverage *

Treatment costs and death insurance incl. life-saving operations in case of illness and accident for horses with a market value of more than CHF 5'000.
Pure death insurance and life-saving operations in case of illness and accident
Pure accidental death insurance and life-saving operations in the event of an accident
Treatment costs and disability insurance (loss of use) as well as death insurance incl. life-saving operations
Foal insurance

7. premium overview

Auxiliary fields for calculating death K&U

Aid fields for treatment costs

The premium, may change based on the Answering the application questions change. If this is the case, or the horse can be insured only with a with a reservation, you will be informed before the insurance contract is issued. insurance contract is issued. If the horse can be insured under standard standard conditions, the insurance contract will be issued directly and sent to you electronically. sent to you electronically.

The premium may change due to your following declarations. If so, or if the horse may only be insured with exclusion or with a special condition, you will be informed before the insurance contract is issued. If the horse is accepted at standard conditions, the insurance contract will be issued directly.

If necessary, upload files here such as the purchase contract, proof of payment of the purchase transaction, the purchase examination, x-rays, a copy of the horse's passport, competition results or written confirmation from a recognized horse trainer to determine the market value or other documents.

Click or drag files to this area to upload. You can upload up to 12 files.

Additions and remarks

I confirm that Privacy policy which Cookie guidelinesand in particular the Legal information obligationsbefore completing this application and expressly declare that I agree to this.
I reject the Privacy policy which Cookie guidelineswhich Legal information obligationscollectively or even partially.

The applicant declares that, to the best of its knowledge, it has answered the questions contained in this document. have done so. By signing this application, the applicant confirms that he/she has been informed about the identity of the insurer as well as the essential content of the insurance contract and that he/she has received the relevant terms and conditions of the contract. In connection with the processing of the insurance contract, two data collections are created by the insurer (customer data and claims data). data collections (customer data and claims data). The customer data serves to prove whether insurance exists with the insurer. The claims data is used for claims processing. Recipients of the data are the respective Lloyd's brokers and the insurers, in the event of a claim possibly also the claims settlement insurers and, if applicable, the Swiss Lloyd's UVG Claims Office. Office. Data will only be passed on to other third parties with the consent of the person or persons concerned or based on a law. The data is stored partly electronically and partly in paper form and is destroyed after ten years. destroyed.

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Location *

Place

Date

Signature of the applicant: *

Clear Signature

I am not a robot: *