Duty of Disclosure of Material Facts (Duty of Fair Presentation)
A material fact is an important fact about you or your circumstances. Fair presentation means that you must have disclosed all material facts, matters and circumstances which you know, which could influence an insurer's or underwriter's decision to accept your insurance. This also applies to facts that you ought to know. You must disclose sufficient information to make the insurers aware that they need to make further enquiries. They can then choose to accept or decline your insurance. If they accept, they may apply certain terms. The duty of fair presentation is a significant obligation placed upon you under the contract of insurance. If you fail to meet this obligation, insurers can take various actions in accordance with the Insurance Act 2015.
Title
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Please Select
Dr
Miss
Mr
Mrs
Prof
Rev'd
Name
*
First name
Last name
Full trading name (if applicable)
Full postal address
*
Address line 1
Address line 2
City
Postcode
Is the risk address the same as the correspondence address?
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Yes
No
Please provide the full risk address
Telephone
*
Please enter a valid phone number.
Email
*
Confirmation Email
Confirm email
Website:
Date of birth
*
/
Day
/
Month
Year
Please select the option which best describes your business:
*
Please Select
Private Individual
Sole Trader
Partnership
Limited Company
Syndicate
Current insurer (if applicable)
Annual renewal date (if applicable)
-
Month
-
Day
Year
Date
Is a joint policy required?
*
Yes
No
Title
*
Please Select
Dr
Miss
Mr
Mrs
Prof
Rev'd
Name
*
First name
Last name
Date of birth
*
/
Day
/
Month
Year
Please select your business activities below:
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Livery yard
Stud farm
Private stables
Competition/Training yard
Horse Shows
Show centres
Cross Country Course and Jump Cross
Rescue Centre
Riding/Driving Club
Equine Masseur/Therapy
Transporter
Course builder/designer
Horsewatch group
Horsedrawn Vehicles/Carriages used for hire & reward
Please provide details of any other business' which are run from the same premises:
How long has your business been established? Please indicate if this is a new venture.
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From what date is cover required?
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/
Day
/
Month
Year
Date
What is your position within the company?
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What is your approximate annual turnover?
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How many years' experience do you have in the equine industry?
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What equine qualifications do you have?
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Do you own or lease the premises?
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Do you do any work outside of the UK?
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Yes
No
What level of public liability cover do you require?
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Please Select
£2,000,000
£5,000,000
£10,000,000
Please state the maximum number of horses at the premises at any one time:
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Please state the number of horses for each section below:
Number or horses:
Horses owned by you:
DIY liveries
Part liveries
Full liveries
Do you require Care, Custody and Control cover for any third party horse in your care?
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Yes
No
If yes, please state the maximum value of any one horse: (Please note: a maximum limit of £100,000 applies in insurance year)
£5,000
£10, 000
£25,000
£50,000
Please state the maximum number of horses in your care owned by other people:
Please state the total acreage of the premises:
Do you have any public rights of way running through your premises?
Yes
No
Please provide full details including the approximate distance of all paths under your control:
What type of fencing surrounds the paddocks?
Are paths fenced off preventing the public from accessing any horses?
Yes
No
How frequently are the fences checked?
How far is the nearest paddock to the public highway?
Are paths adequately signposted the make members of the public aware of grazing horses?
Yes
No
Are there any show(s) held on site attended by the general public?
Yes
No
Are there any show(s) held on site open to existing livery clients only?
Yes
No
If this is a permanent show centre, state any affiliation:
Please state how many attendees are you expecting for each show?
Please state the number of shows organised each year:
Please give details of the activities being undertaken as part of the show:
Do any non-equestrian activities take place as part of the show?
Where will the shows be taking place?
Will the shows involve horse drawn vehicles?
Are any refreshments offered during the show?
If cover is for a single show, please state the date of the event:
-
Month
-
Day
Year
Date
Do you hire out facilities? (e.g. ménage)
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Yes
No
If yes, please state number and type of of facilities:
Do you offer any freelance instruction on site?
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Yes
No
If yes, do you hold an instructor's qualification?
Yes
No
Please state which qualification:
Are you an accredited trainer?
Yes
No
If yes, please state which organisation:
Do you provide any horses for teaching purposes?
Yes
No
Do you require cover for a riding or carriage driving club?
Yes
No
Please state the number of members in the club:
What are the main activities the club undertakes?
Do you require cover for horse transportation?
Yes
No
Please state your annual turnover from this activity:
Please state the countries you transport to/from:
Do you operate vehicles 7.5 tonnes & over?
Yes
No
Do you hold a valid VOSA Operators Licence?
Yes
No
What is the maximum number of horses being transported at any one time?
Please state maximum seating capacity, including driver
Please state the maximum number of horses at the premises at any one time:
Is the centre a sanctuary only with no riding?
Yes
No
What treatments are undertaken?
What equipment (if any) is used?
If equipment is used, please state how frequently it is serviced and whom it is serviced by:
Please tick the appropriate height of the course:
1m and under
Over 1m
Is a Jump Cross course used for schooling and/or training?
Yes
No
Is a Jump Cross course used for competitions?
Yes
No
Please state countries in which you work:
UK
EU
Worldwide
Are you BE approved?
Yes
No
Do you provide advice only for a fee? i.e. where you do not continue to complete the build element
Yes
No
Do you have a written Health & Safety policy with risk assessments in place?
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Yes
No
Do you have an Accident Report Book?
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Yes
No
Does this get updated if an accident arises?
Yes
No
Are your electrical installations checked and maintained in accordance with current Health & Safety regulations?
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Yes
No
N/A
Do you require employers' liability?
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Yes
No
Please note you are legally required to arrange Employers' Liability for paid employees and for paid self-employed persons working under your direction.
Please provide your employer reference number (ERN). An ERN is given to all businesses that register with HMRC as an employer or alternatively please state if you are exempt.
Please provide numbers of all employees. An employee includes the self-employed providing labour, volunteers, persons receiving payment in kind(e.g. riding, lodgings etc.), students/work experience and anyone where there is a master/servant relationship.
Full time
Part time (<25 hours per week)
Managerial / Clerical (not working with horses)
Manual staff (working with horses, including Clerical staff
who ride out)
Casual riders
Stallion handlers
Volunteers (please state approximate number of hours per
week)
Other (Please specify)
Please detail below the qualifications/experience of all staff members:
Do you have written staff induction/training records?
Yes
No
Will Personal Protective Equipment (PPE) be provided?
Yes
No
What items of equipment are provided?
Will the PPE be checked regularly with written records of the checks kept?
Yes
No
Has any insurer in respect of any of the risks to which this proposal refers, declined to insure you, cancelled or refused to renew your insurance or imposed special terms?
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Yes
No
If yes, please provide details:
Have there been any losses suffered, or events occurred which might have resulted in a claim, whether or not claimed for, during the last five years, in respect of any of the activities for which cover is required?
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Yes
No
If yes, please provide details:
Have you or any of your officers, business partners or directors, ever been convicted of any criminal offence other than a driving offence or have any non-motoring prosecutions pending? You only need tell us about any convictions that are unspent under the Rehabilitation of Offenders Act 1974
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Yes
No
If yes, please provide details:
Have you or any of your officers, business partners or directors, ever been declared bankrupt or insolvent?
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Yes
No
If yes, please provide details:
Have you or any of your officers, business partners or directors, ever been investigated or convicted under the Fraud Act 2006, or equivalent legislation?
*
Yes
No
If yes, please provide details:
Important Notice to Policyholders (The 2015 Insurance Act)
As a result of changes introduced under the Insurance Act 2015 your policy terms and conditions have been updated accordingly. Your policy is a contract of insurance between you and the insurers, and you have a duty to make a fair presentation of the risk in accordance with the law. This applies prior to the start of your policy, if any variation is required during the period of insurance and prior to each renewal.
Fair Presentation of Risk
Not making a fair presentation of the risk, or not advising us of any errors in the information provided may result in a breach of the fair presentation of risk. Depending on the nature of the breach and what would have happened had the information been accurate, the insurer may choose to: 1. Declare your policy void (treating your policy as it had never existed), 2. Change the terms of your policy, 3. Refuse to deal with all or part of any claim or reduce the amount of any claim payment or 4. Cancel your policy. If any of the information within the documents provided is incorrect, you must advise us. We reserve the right to change the terms and conditions, premium or withdraw this quotation.
Data Protection Act
By accepting your insurance policy, you consent to us using the information we hold about you for the purposes of providing insurance and handling claims. This may involve processing sensitive personal data about you where it is necessary (for example health information or criminal convictions).This may mean we have to give some details to third parties involved in providing insurance cover. These may include insurance carriers, third party claims adjusters, fraud detection and prevention services, reinsurance companies and insurance regulatory authorities. Where such personal information relates to anyone other than you, you must obtain the explicit consent of the person to whom the information relates. This consent must cover both the disclosure of such information to us and its use by us as set out above. The information provided will be treated in accordance with the UK Data Protection Act 2018. You have the right to apply for a copy of your information (for which we may charge a small fee) and to have any inaccuracies corrected.
How would you prefer to be contacted by Cliverton?
*
Phone
Email
How did you hear about Cliverton?
*
Please Select
Google
Social media
Advert
Trade Show
Family or friend
Affinity partner
Other
SUBMIT
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