Horse Insurance « Horse Insurance with Smith-Embry

Add additional Horses (Optional)

If you have additional horses please enter them below.

Name of Horse

Breed of Horse

Sex

Age of Horse

Exact or Intended use of horse

Amount of Insurance Requested

if amount exceeds purchase price, complete Substantiation of Value Form

Value Substantion Support Form

Complete Value Substantiation Support Form

International Travel?

Yes

Will your horse be traveling out of the United States or Canada during the policy term?

Country

Include Major Medical

Major Medical Annual limit cannot exceed the Mortality Sum Insured.

Include Stallion Permanent Disability

Available for Breeding Stallions

Include Surgical Only

Major Medical Annual limit cannot exceed the Mortality Sum Insured.

Include Loss of Use

Coverage is only available for specific Show Use of your horse

I would like to get a quote on another horse

Name of Horse

Breed of Horse

Sex

Age of Horse

Exact or Intended use of horse

Amount of Insurance Requested

if amount exceeds purchase price, complete Substantiation of Value Form

Value Substantion Support Form

Complete Value Substantiation Support Form

International Travel?

Yes

Will your horse be traveling out of the United States or Canada during the policy term?

Country

Include Major Medical

Major Medical Annual limit cannot exceed the Mortality Sum Insured.

Include Stallion Permanent Disability

Available for Breeding Stallions

Include Surgical Only

Major Medical Annual limit cannot exceed the Mortality Sum Insured.

Include Loss of Use

Coverage is only available for specific Show Use of your horse

I would like to get a quote on another horse

Name of Horse

Breed of Horse

Sex

Age of Horse

Exact or Intended use of horse

Amount of Insurance Requested

if amount exceeds purchase price, complete Substantiation of Value Form

Value Substantion Support Form

Complete Value Substantiation Support Form

International Travel?

Yes

Will your horse be traveling out of the United States or Canada during the policy term?

Country

Include Major Medical

Major Medical Annual limit cannot exceed the Mortality Sum Insured.

Include Stallion Permanent Disability

Available for Breeding Stallions

Include Surgical Only

Major Medical Annual limit cannot exceed the Mortality Sum Insured.

Include Loss of Use

Coverage is only available for specific Show Use of your horse

I would like to get a quote on another horse 2

Name of Horse

Breed of Horse

Sex

Age of Horse

Exact or Intended use of horse

Amount of Insurance Requested

if amount exceeds purchase price, complete Substantiation of Value Form

Value Substantion Support Form

Complete Value Substantiation Support Form

International Travel?

Yes

Will your horse be traveling out of the United States or Canada during the policy term?

Country

Include Major Medical

Major Medical Annual limit cannot exceed the Mortality Sum Insured.

Include Stallion Permanent Disability

Available for Breeding Stallions

Include Surgical Only

Major Medical Annual limit cannot exceed the Mortality Sum Insured.

Include Loss of Use

Coverage is only available for specific Show Use of your horse

Comments / Questions

Instructions

Questions? Call Smith-Embry Insurance Associates, Inc. (502) 493-9911

Request a Quote