Fillable Equestrian Commercial Combined Insurance Proposal Form For Equestrian (London Institute of Management and Technology)

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Equestrian Commercial Combined Insurance Proposal Form For Equestrian (London Institute of Management and Technology)

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Equestrian Commercial Combined Insurance Proposal Form

For Equestrian Businesses and Private Yards

IMPORTANT NOTICE: Where we arrange insurance wholly or mainly for purposes related to your trade, business or profession, you have a duty under The Insurance

Act 2015 to make a fair representation of the risk. This means that you must disclose every material circumstance which you and/or your senior management

and/or anyone responsible for arranging your insurance know or ought to know. Alternatively, you must disclose sufficient information which would put the

insurer on notice that it needs to make further enquiries for the purpose of revealing those material circumstances. You are expected to carry out a reasonable

search in order to make a fair representation of the risk and will be deemed to know what should reasonably have been revealed by the search. If any of the

questions in this proposal form have been pre-filled please check they are correct and amend where necessary.

Your duty of fair representation applies at the start of the policy, at renewal and when any variation of the policy is arranged. If you fail to make a fair

representation, the insurer may refuse to pay your claim or reduce the settlement amount, depending on the circumstances

Please complete all questions in ink using block capitals and ensure you read and sign the declaration on the last page. Thank you.

PROPOSER INFORMATION

Proposer(s) Full Name

Proposer(s) Date of Birth

Trading or Company Name

Correspondence Address

Postcode

Home Number

Work Number

Mobile Number

Email Address

Website

Preferred method of communication

POST / EMAIL / PHONE

1. Have you or any proposer, principal, director or partner:

a. Had an insurance declined, cancelled or renewal refused?

b. Had special insurance terms, restrictions or conditions imposed by an insurer?

c. Been prosecuted, or have any prosecution pending, under the Health & Safety at Work Act or similar

legislation?

d. Been declared bankrupt or been disqualified from being a company director?

e. Been involved as owner, director or partner of any company that went into receivership,

administration, liquidation or been investigated by Inland Revenue & Customs?

f. Been the subject of (or have pending) any County Court Judgements or arrangements with creditors

outstanding?

g. Been convicted, or charged (but not yet tried) in respect of any criminal offence other than for

motoring offences?

Any convictions considered to be spent under the Rehabilitation of Offenders Act 1974, do not need

to be disclosed

h. Had any claims made by you?

i. Had any claims made against you?

j. Suffered any incident that could give rise to a claim (whether an insurance claim was made or not)?

IF YOU HAVE ANSWERED ‘YES’ TO ANY OF THE ABOVE PLEASE PROVIDE FULL DETAILS INCLUDING DATES AND THE

CIRCUMSTANCES

DC: R2PFOW v1.0 24/02/2021

ABOUT YOUR BUSINESS

2. Business / Risk Address (s)

3. Please indicate your business description (you can

select more than one);

Livery Yard (including Full, Part, DIY & Grass)

Livery Yard including Freelance

Riding Schools

Racehorse Trainers & Owners

Breaking & Dealing

Competition & Training Yard

Trekking

Hunt

Equine Assisted Therapy/Learning

Stud Farm

Polo

Horse Transport & Self Drive Hire

Thoroughbred Stud Farm

Carriage Driving & Associated Activities

Private Yard

Horse Show Demonstrations

Cross Country Course, Build & Hire

Rescue, Rehabilitation & Sanctuary

Other (please specify)

4. Date from which cover is required:

5. Is this a new venture i.e. a business with no trading history?

If ‘Yes’, please confirm:

a) Previous experience

b) Qualifications

If ‘No’, please confirm:

a) How long have you been trading?

b) What is your annual business turnover?

6. Have you previously been insured for this activity?

If ‘Yes’, please confirm:

i. The insurer

ii. The renewal date

iii. The premium including insurance premium tax

7. Is the business approved by any of the following:

Approval number

a) BHS (British Horse Society) approved establishment?

b) ABRS (Association of British Riding Schools) approved?

c) TRSS (Trekking and Riding Society of Scotland) approved?

d) WTRA (Welsh Trail Riders Association) approved?

e) Any other recognised equestrian association?

If you have answered ‘YES’ to e) please provide details of the

association;

8. Do you own the premises?

If ‘No’, please confirm: Do you have a lease agreement/ contract with the landowner in place?

9. Are the buildings, property, premises and fencing in a good state of repair and in good order?

10. Are there any public rights of way on the land?

If ‘Yes’ are horses fenced off and appropriate signs displayed?

11. Have you identified any asbestos within your premises?

If 'Yes' has an asbestos survey been carried out?

12. Do any other businesses or activities (apart from those being proposed) operate from the premises?

If ‘Yes’ please give details of the business, activities, the insurer and if there are any cross overs with the proposed business:

13. Do you carry out and document regular risk assessments for all elements of the business including

rider registration forms and employee training where applicable

14. Do you or any employee carry out any work in connection with this business outside of the UK?

If ‘Yes’ please state;

The countries you are visiting:

The period of time you are visiting:

15. Do you have a current and valid Riding Establishments License?

16. Have you ever been refused a Riding Establishments License?

PUBLIC LIABILITY

1. Is Public Liability cover required?

2. Please select the Public Liability Limit of Indemnity required?

(Riding Schools should have a minimum of £2,000,000 limit of indemnity but please check this with

the individual licencing authority)

£1,000,000

£2,000,000

£3,000,000

£5,000,000

£10,000,000

3. Please state the maximum number of horses on the premises at any one time in each of the following

a) Tuition and working liveries? (i.e. horses licenced under the riding establishments licence)

b) Private horses (i.e. horses owned by the proprietor but not used for tuition)

c) DIY and Grass Livery Horses

d) Full, Part and Stud Livery Horses

e) Racehorses and point to point horses

f) Any other animals? (please specify; e.g. dogs, cattle, sheep)

4. Do you run any equestrian shows or events for internal clients only from your premises?

If ‘Yes’, please state

a. Number of events per year

b. The type of events/ shows will you be running (i.e. show jumping, dressage, XC) please provide details;

5. Do you run any equestrian shows or events open to the general public to compete in?

If ‘Yes’, please state

a. Number per year

b. Maximum number of competitors per event / show

c. The type of events/ shows will you be running (i.e. show jumping, dressage, XC) please provide details;

6. Do you hire out any of your facilities to third parties?

a. If ‘Yes’ please provide details (for example gallops, grass arena, indoor arena, outdoor arena, XC course)

7. Do you provide any overnight accommodation for staff or students?

If ‘Yes’ please confirm

a. Who the accommodation is for?

b. How many people you provide accommodation for?

8. Do you provide pony rides away from the premises?

a. If ‘Yes’, please confirm the number of days per year?

9. Do you run overnight camps?

a. If ‘Yes’ please confirm the total number of nights

10. Do you provide lessons on a mechanical horse / horse simulator?

11. Do you require cover for Freelance teaching (i.e. teaching third parties on their own horses on

and away from the premises for and on behalf of this business you are proposing)?

If ‘Yes’ please confirm;

a. The number of people Freelance cover is required for?

b. The full names of all instructors

12. Do you carry out the following?

Teaching of Natural Horsemanship techniques

Equine Facilitated Learning/ Equine Assisted Therapies on your premises only

Equine Facilitated Learning/ Equine Assisted Therapies on and away from your premises

Teaching on own Cross country course

Teaching Western riding

Teaching Vaulting

Carriage driving tuition or Carriage rides (enclosed area only)

Carriage driving tuition or Carriage rides including on roads

Teaching Polo

Teaching Polocrosse

Teaching Horseball

Teaching of any pupil under 4 years of age

Teaching of novice riders on horses under the age of 6

Teaching in any other activities, if ‘Yes’ please specify below

13. Do you carry out any of the following activities?

a. Pony/saddle clubs

b. Loan a pony scheme (riding schools only)

c. Unaccompanied hacks (riding schools only)

d. Dog shows

e. Use of swimming pool situated off of the premises

f. Dog / Pet / House sitting services (maximum 8 animals)

g. Dog walking

h. The hire of horses for hunting

i. Dealing, retraining, rehoming or selling of horses

14. Do you carry out and require cover for any of the following activities on the premise?

a. Equestrian retail/ tack shops

b. Quad bike used by any employees or staff

c. Café or snack bar

d. Petting farm

e. Providing use of a swimming pool / hydro therapy pool or gym or exercise area to third parties or

third party horses

f. Any other activities, if ‘Yes’ please specify below

15. Do you transport third party horses AND require liability cover to do this?

If ‘Yes’, please confirm

a. Do you take payment for the transporting of the horses?

b. Do you require care custody and control cover to extend to this activity?

c. How many horse boxes do you use for this activity?

d. Do you use a horse trailer for this activity?

CARE CUSTODY AND CONTROL

Liability insurance for horses that belong to third parties should they be injured whilst in the Care Custody or control of the

business or proprietor

1. Is Care Custody and Control cover required

2. How many horses in your care custody or control that do not belong to you?

3. Please select limit required

a. £10,000 per horse and £100,000 in the aggregate

b. £25,000 per horse and £100,000 in the aggregate

c. £50,000 per horse and £100,000 in the aggregate

EMPLOYERS LIABILITY

Employers Liability insurance will help you pay compensation if an employee is injured or becomes ill because of the work they

do for you. Please note employees can include self-employed persons, labour only, sub-contractors and apprentices who are

carrying out duties on your behalf and under your direction.

1. Is Employers Liability cover required?

2. If ‘Yes’ please confirm the following;

a. Number of employees carrying out clerical duties only

Full time

Part time (Less than 24 hours a week)

b. Number of employees carrying out manual duties

Full time

Part time (Less than 24 hours a week)

c. Number of Stallion men

d. Number of students/work experience staff/volunteers who work

Less than 14 days a year

Between 15-90 days a year

Between 91-186 days a year

187 days or more a year

e. Number of family members working for the business

Full time

Part time (Less than 24 hours a week)

2. Due to legislation we require your Employee Reference Number (ERN). An ERN is given to every business that registers with

HM Revenue and Customs as an employer. It is often referred to on tax forms as an employee PAYE reference. If you do not

have an ERN then please confirm you are exempt below

a) Do you have an ERN?

b) If ‘Yes’ please confirm your ERN number

COMMERCIAL LEGAL EXPENSES

This cover gives up to £100,000 worth of legal advice and fees for scenarios such as employment disputes, land disputes and

contract disputes in connection with your business where there is a reasonable prospect of success

1. Do you require cover for this section?

If ‘Yes’ please confirm your estimated annual turnover

PLEASE CHECK YOUR PROPOSAL CAREFULLY AND THEN SIGN THE DECLARATION BELOW BY ALL APPLICANTS/ DIRECTORS

To the best of my knowledge and belief the information provided in connection with this proposal, whether in my own hand

writing or not, is true. I understand that I have a duty to ensure I have made a fair representation of the risk and have disclosed

every material circumstance which myself and/or my senior management and/or anyone responsible for arranging your insurance

know or ought to know. I have disclosed sufficient information which would put the insurer on notice that it needs to make further

enquiries for the purpose of revealing those material circumstances and I have carried out reasonable searches in order to make

a fair representation of the risk. I understand that my duty of fair representation applies at the start of the policy, at renewal and

when any variation of the policy is arranged and I will advise my broker or insurer of any changes to the information provided. I

understand that if I fail to make a fair representation, the insurer may refuse to pay a claim or reduce the settlement amount,

depending on the circumstances.

By signing this Proposal Form I/We hereby consent to any information you may have about me/us being processed by you for the

purpose of providing insurance and claims handling which may necessitate you providing such information to third parties.

Signature

Name

Position

Date

Data Protection Act 2018

It is understood by the Proposer that any information provided to the Underwriters regarding the Proposer will be processed

by the underwriters, in compliance with the provisions of the Data Protection Act 2018, for the purpose of providing insurance

and handling claims, if any which may necessitate providing such information to third parties.

SEIB Insurance Brokers Ltd, South Essex House, North Road, South Ockendon, Essex RM15 5BE

E-Mail: enquiries@seib.co.uk

Website: www.seib.co.uk

SEIB Insurance Brokers Ltd are authorised and regulated by the Financial Conduct Authority.

COMMERCIAL EQUESTRIAN PROPERTY (Material damage)

1. Do you require commercial property cover?

a) Please provide the full address of the premises to insure below.

Address

Postcode

If you have more than one premises you require cover for please complete the details on a separate proposal form

b) Are your electrical installations inspected at least every five years by a qualified electrician and all

defects remedied accordingly?

c) Do you have a fire risk assessment undertaken at the premises at least every five years?

d) Are the premises heated by any means other than gas, electricity or oil fired central heating?

e) If ‘Yes’ please confirm details:

f) Is a no smoking policy enforced within the premises & stable area?

g) Is the property ever unoccupied for more than 30 consecutive days?

h) Have the premises previously suffered from flooding or situated within 250 meters of a

watercourse or canal, lake, reservoir or dam, seafront or promenade, cliff or similar?

i) Has the property ever suffered or shown damage from subsidence or been underpinned?

j) Do you require cover for subsidence?

Please note a separate subsidence questionnaire may need to be completed for cover to be

considered

k) Is the premises protected by a 24 hour monitored CCTV?

l) Is there a whole-time fire brigade in service within 20 minutes of all buildings to be insured?

WE CAN NOT GIVE ADVISE ON WHAT VALUE YOU SHOULD INSURE YOUR PROPERTY (BUILDINGS AND CONTENTS) FOR, PLEASE

CONTACT A PROFESSIONAL (FOR EXAMPLE FOR BUILDINGS A BUILDER OR SURVEYOR) TO GET ADVICE IF YOU ARE UNSURE. THE

VALUE OF THE BUILDING(S) SHOULD INCLUDE THE COST OF REMOVAL OF DEBRIS, ARCHITECTS, SURVEYORS, CONSULTING AND

LEGAL FEES ETC THAT COULD BE INVOLVED IN THE COSTS SHOULD THE BUILDING(S) NEED TO BE REBUILT. UNDER INSURANCE

OR WHERE THE SUM INSURED IS INADEQUATE WILL RESULT IN THE INSURER REDUCING THE AMOUNT THEY PAY OUT FOR

BOTH THE BUILDINGS AND CONTENTS.

Please complete the sections below that you require cover for

2. BUILDINGS TO BE INSURED

Description of buildings to

be insured (please list

individually where

possible);

Construction of

walls and roof

Percentage

flat roof

Age

Listed -

Open Sided

Sum insured

For example - Stables

Standard

construction

(brick walls with

tiled roof)

££££

Portacabins

Static Mobile Homes

A standard construction building is one where walls are built completely of brick, block, stone or concrete. A nonstandard

construction building would be one made of any other material such as timber or metal. Full details of the construction of the

walls and roof must be provided.

Only open sided Barns and Field shelters that are permanent fixtures/ secured to the ground can be covered

If the building is of non-Standard construction and over 10 years old then storm damage is automatically excluded however this

can be reviewed with photographic evidence. If cover is required for this then please forward clear photos of the buildings for us

to review.

Solar panels and arena mirrors

Outdoor riding arena including the surface

Tenants Improvements (Improvements made to the buildings such as fitting a new kitchen, or

refurbishing an arena and facilities)

Rent Payable (money payable by you to a landlord)

3. CONTENTS TO BE INSURED Please note that for the contents to be insured minimum security requirements must be adhered

to please refer to the policy wording and policy schedule for details of this.

Sum insured stored in a

building of standard

construction

Sum insured stored in a

building of non-

standard construction

Sum insured stored in

the open

a. Stock (including hay, straw, bedding and

feed)

b. Jumps and Judge boxes

c. Horse trailers, trailers and Horse Drawn

Vehicles / Carriages

d. All other contents (including non-

motorised machinery, rollers, harrows,

general tools and wheel barrows)

e. Agricultural Vehicles * (including quads, gators, tractors and ATV’s). Please complete the details below

Description of item

Sum insured stored in a

building of standard

construction

Sum insured stored in a

building of non-

standard construction

Sum insured stored in

the open

Continue on a separate sheet if more items are required

*Please note that any vehicle that is road registered and/ or used on any public highway can not be insured under this policy.

Sum insured stored in a

building of standard

construction

Sum insured stored in a

building of non-

standard construction

Maximum value taken

off site

f. Office Equipment

g. Tack and Saddlery

Security questions below must be answered if Tack & Saddlery required:

Does the tack room have a five lever mortise deadlock on all final entrances and exits?

If ‘No’ to ii) please specify the types of locks on all final entrances and exits:

Is the tack room protected by an intruder alarm system?

If ‘Yes’ to iii) please state the type of alarm

If ‘Yes’ to iii) Is the alarm linked to a security company / the police?

If ‘Yes’ to iii) is the alarm maintained by a company approved by the National Security Inspectorate

(N.S.I)?

If ‘Yes’ to iii) please state method of signaling (if known):

Are there any other notable security features on the tack room or premises, if ‘Yes’ please specify below:

Do you or any other persons live on the premises?

Please confirm the construction details of the building where the Tack and Saddlery is kept

17. Equine Material Damage and Fatal Injury

Sum Insured

Do you require cover for Equine Material Damage?

Equine Material Damage Sum insured *

Including fatal injury**

*For horses up to a maximum value £5,000 any one animal and an overall aggregated limit of £50,000.

Livestock Material Damage Insured Perils: Fire, Lightening, Explosion, aircraft and other aerial devices or anything dropped from

them, Earthquake, Subterranean fire, Accidental electrocution, Theft, Spontaneous fermentation, Worrying of livestock by dogs,

foxes or vermin, Riot, civil commotion, labour and political disturbances, strikes and damage by malicious persons and impact with

the property from any cause.

**Fatal Injury (Any accident that results in the death of the horse within 30 days of the date of the injury): Any accident away from

the premises, any accident whilst being loaded on conveyed by or unloaded from any motor vehicle or trailer.

18. BUSINESS INTERRUPTION COVER (standard 12 month indemnity period)

Sum Insured

a) Do you require cover for loss of revenue?

If ‘ Yes’ please confirm your annual business turnover

b) Do you require cover for loss of rent receivable (money payable to you by tenants)

If ‘ Yes’ please confirm your annual rental income

c) Do you require an indemnity period over the standard 12 months?

If ‘Yes’ please confirm the Indemnity period required (for example 24 or 36 months)?

19. MONEY COVER

a) Is loss of business money cover required?

b) The standard limit for money during business hours is £2,500 is a higher limit required?

If ‘Yes’, please confirm the amount

20. TERRORISM COVER

Is cover required for this?

Please note a separate quotation will be provided if Terrorism cover is required. This extension is for items included in the

commercial property section and includes business interruption if included. The extension can only be provided for buildings

and property used for commercial purposes