Notify us of a new Equine Insurance claim

Are you the policyholder?

Yes
No

Are you authorised to make amendment to the policy?

Yes
No

Your title:

What is your relationship to the policyholder?

Who would you prefer us to contact regarding the claim?

You
The policyholder

Policyholder's title as shown on policy documents:

Phone number of the person we should contact regarding this claim:

What type of cover do you have?

Standard
Veteran

Discipline(s):

Age of horse:

Is the horse currently on loan?

Yes
No

When did the loan period start?

When was the horse purchased?

Is the registered address of the horse different to the policyholder?

Yes
No

Are you claiming for veterinary fees?

Yes
No

Should your claim for veterinary fees be accepted who you would like payment to be made to?

Policyholder
Vet

Are you eligible to claim VAT costs back from your veterinary bills?

Yes
No

Before you contacted your veterinary surgery, when did the horse start presenting symptoms?

What symptoms is the horse suffering from and what action has been taken? If a diagnosis has already been made please include this.

1300 characters

Has the horse suffered from a similar problem previously?

Yes
No

What problem has the horse previously suffer from?

Have you contacted a vet?

Yes
No

On what date was the vet contacted?

Have any other vets or practitioners been involved in treatment related to this claim?

Yes
No

Who are the other vets or practitioners and what treatments were administered by them?

Has the horse previously received treatment from a vet(s) that is not listed?

Yes
No

Who are the vets not listed from whom the the horse has previously received treatment?

I confirm that the information provided by me as part of this claim form is to the best of my knowledge true and complete:

Yes
No

I agree to NFU Mutual contacting my vet/veterinary practice regarding my claim:

Yes
No

I permit NFU Mutual to divulge information related to my claim to my vet/veterinary practice:

Yes
No

I understand that in order to advance by claim NFU Mutual will share information related to my claim with other organisations and public bodies:

Yes
No

I understand that in order to advance my claim NFU Mutual will have to contact me and that no claims intimation will be made until then:

Yes
No

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