Veterinary Claims

It is our understanding that you have provided veterinary services to a policyholder of ours. In order to make a claim for the renumeration of your fees we ask that you complete the below form.

Once you have completed all of the requested details and submitted the form, you will receive an e-mail requesting that you supply any supporting documentation by way of reply.

*=non-mandatory fields

Policy details

Referral details

Who referred the animal to you?

Condition details

Has the animal suffered from the condition before?

Can this current condition be indirectly or directly related to any previous accident or illness?

Have you referred the horse to another practice for any further diagnostics and/or treatment(s)?

Are there any other ailments contributing to the animal's conditions?

Treatment details

Have you recommended any box rest?

Have you recommended any complimentary treatment(s) (e.g. physiotherapy, farrier)?

Have all treatment(s) been completed?

Diagnosis details

Has the animal passed away or been put to sleep?

Is the condition likely to lead to permanent incapacity?

Is slaughter on humane grounds recommended?

Loss of animal details

Was the animal put to sleep?

Was the animal euthanised in accordance with BEVA guidelines for humane destruction?

Were there any other viable treatment options available?

Could the animal have been retired to paddock with the condition?

In your opinion was the condition referred to above the sole reason for euthanasia?

Did you see the animal before it's death?

Has a post-mortem taken place?

We'll ask you to e-mail the post-mortem to us

After you have submitted this form you will receive a confirmatory e-mail. We ask that you attach the post-mortem that was carried out on the animal to your reply. 

Declaration and veterinary surgeon's details

I hereby certify that I have checked that all of the details submitted are, to the best of my knowledge and belief, true and correct: