Application ABES horse insurance

1. applicant




First Name and Last Name



Priority phone no

BAN number for refunds

2. general information about the contract

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

Is the horse currently insured?

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

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

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

3. general information about the horse to be insured




Identity Marking




Majority type of use


Distance to usual vet

Distance to the nearest veterinary facility for major operations

4. health questions about the horse to be insured

To your knowledge, has the above 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 fractures, tendon or ligament injury?

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?

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

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

Purchase Price in CHF (without tax)

Purchase Date

Proof of purchase available or follows later

Value of the horse in CHF

Value of the horse in CHF

6. insurance cover applied for

7. premium overview

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.

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

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.



Clear Signature
Please print this application before sending it by clicking on the print symbol, or save it as a pdf file.
For data protection reasons, you will not receive a copy of this application by e-mail.