Competitive insurance for Horse and Pony owners on the Isle of Wight and throughout England and UK

Vectis Insurance
Services Limited

Horse and Pony Quote Request Form

Your Name :
Address:
Post Code:
Telephone:
Email Address:

Horse/Pony Name:
Purchase Price:
Insured Value:
Colour:
Height:
Age:
Breed:
How long owned:
Gender:	Male Female

Used for which activities: You can select more than 1 by holding down the CTRL key.
If other please state:

Is the horse...
Micro-chipped:	Yes No
Freeze Marked:	Yes No
Branded:	Yes No

Are you a member of a Registered Society, Breed Society, Riding Club?	Yes No

Cover Required	Note: (Death is covered as standard)

Personal Accident:	Yes No
Liability:	Yes No
Theft and Straying:	Yes No
Veterinary Fees:
Permanent Loss of use:	60% 100%
Saddlery and Track:	(minimum £500)
Horse Drawn Vehicle:

Current Insurers:
Next Renewal date:

Are you aware of any injuries, diseases or illnesses whether covered by insurance or not or any situation that could have given rise to a claim had insurance cover been in force Yes No