Duty of Disclosure of Material Facts (Duty of Fair Presentation)
A material fact is an important fact about you or your circumstances. Fairpresentation means that you must have disclosed all material facts, matters andcircumstances which you know, which could influence an insurer's orunderwriter's decision to accept your insurance. This also applies to factsthat you ought to know. You must disclose sufficient information to make theinsurers aware that they need to make further enquiries. They can then chooseto accept or decline your insurance. If they accept, they may apply certainterms. The duty of fair presentation is a significant obligation placed uponyou 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
*
Please Select
Dr
Miss
Mr
Mrs
Prof
Rev'd
Name
*
First name
Last name
Full trading name (if applicable)
Address
*
Address line 1
Address line 2
City
Postcode
Is the risk address the same as the correspondence address?
*
Yes
No
Please provide the full risk address
Telephone
*
Please enter a valid phone number.
Email
*
Confirmation Email
Confirm email
Website (if applicable)
Date of birth
*
/
Day
/
Month
Year
What is your position?
*
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)
From what date is cover required?
*
/
Day
/
Month
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
How many years' experience do you have in the equine industry?
*
What equine qualifications do you have?
*
What is your main business activity?
*
Are any other activities carried out?
*
Yes
No
Please provide full details
Are any other businesses run from the same premises? If yes, please provide details.
*
How long has your business been established?
*
What is your annual turnover?
*
Do you own or lease the premises?
*
Own
Lease
If lease, do you have a written contract in place with the landlord to stipulate who is responsible for fences/hedges etc?
Yes
No
Do you do any work outside of the UK?
*
Are you approved by any of the following?
*
BHS
ABRS
TRSS
N/A
If you have selected any of the above, please provide your membership number:
What level of public liability cover do you require?
*
Please Select
£5,000,000
£10,000,000
Please state the maximum number of horses for each category below:
The maximum number of horses in use at any one time
*
Tuition horses on-site (excluding working liveries)
*
Working liveries on-site
*
Full or part liveries on-site
*
Privately owned horses for the proposers own use on-site
*
Other:
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Please state the total acreage of the premises?
*
Are there any shows held on site attended by the general public?
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Yes
No
If this is a permanent show centre, please state any affiliation:
If yes, please state how many are held each year
If you need cover for a single show, please state the date:
-
Month
-
Day
Year
Date
How many attendees do you expect for each show?
Where will the shows be taking place?
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?
Are any refreshments offered during the show? If yes, please give details including any suppliers (if not supplied by you)
Are there any shows held on site open to existing livery clients only?
*
Yes
No
If yes, please state how many are held each year
How many attendees do you expect for each show?
If you need cover for a single show, please state the date:
-
Month
-
Day
Year
Date
Where will the shows be taking place?
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?
Are any refreshments offered during the show? If yes, please give details including any suppliers (if not supplied by you)
Do you hire out any of your facilities? (e.g. ménage)
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Yes
No
If yes, please give details of number of facilities and facility type:
Do you arrange pony camps?
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Yes
No
How many camps are organised and run each year?
Do you provide accommodation for individuals attending the camps?
Yes
No
If yes, please state the maximum number of nights per camp
Is overnight stabling provided for horses/ponies attending the camps?
Yes
No
Maximum number of attendees per camp:
Are there livestock kept at the premises? (sheep, cattle etc.)
*
Yes
No
If yes, please provide numbers and details of the livestock:
Do you require cover for the livestock or is alternative cover in place?
Do you offer any hacking or trekking?
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Yes
No
Do you operate hacks/treks off the road?
Yes
No
Do you operate hacks/treks on the road?
Yes
No
Do you operate hacks/treks at the beach?
Yes
No
What is the maximum number of hacks/treks undertaken per week?
Are all hacks/treks accompanied by a qualified member of staff?
Yes
No
If no, what percentage of hacks/treks are unaccompanied?
What is the maximum number of riders on any hack/trek?
What is the maximum number of riders per instructor?
Do you have documented risk assessments in place for your various routes for hacking/trekking?
Yes
No
Do you provide accommodation for students, employees, riding school guests?
*
Yes
No
How many are catered for?
Please provide details of accommodation provided:
Are meals provided?
Yes
No
Do any of the paddocks have a public right of way running through them?
*
Yes
No
Please provide full details including the approximate distance of all paths under yourcontrol:
What type of fencing surrounds the paddocks?
Are the 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 to make members of the public aware of any grazing horses?
Yes
No
Do you require Care, Custody and Control cover for any third party horse in your care?
*
Yes
No
If yes, please advise the maximum value of any third party horse in your care.
Please select the maximum amount of cover below (a maximum limit of £100,000 applies in insurance year):
£5,000
£10,000
£25,000
£50,000
Do you ask all new clients to complete a questionnaire form?
*
Yes
No
Do you capture and keep records of their riding experience and ability and details of any medical conditions that could be aggravated by riding which you need to be aware of?
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Yes
No
If equipment is used, please state how frequently it is serviced and who it isserviced by:
*
What is the minimum age of acceptance for pupils:
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Ratio of pupils to employees/instructors:
Have you assessed and documented the suitability of horses in relation to the abilities of riders? (i.e. novice, intermediate, advanced)
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Yes
No
Are horses under 4-6 years of age used for riding instruction?
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Yes
No
Please provide details:
Are novices permitted to ride any animal under 6 years?
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Yes
No
Please provide details:
Do you hold a valid licence?
*
Yes
No
Are you aware of your obligations under the Health & Safety Act 1974? (see www.hse.gov.uk)
*
Yes
No
Do you have a current DBS Check?
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Yes
No
Do you have an Accident Report book?
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Yes
No
Is it updated if an accident arises?
Yes
No
Are your electrical installations checked and maintained in accordance with current Health & Safety regulations?
*
Yes
No
Do you have a written Health & Safety policy with risk assessments in place?
*
Yes
No
Are your risk assessments reviewed regularly?
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Yes
No
Have full risk assessments of the horses/ponies been carried out, with written records kept?
*
Yes
No
Have any of the horses/ponies ever shown any signs of abnormal behaviour? (for example but not limited to: kicking, biting, bucking, bolting etc.)
*
Yes
No
Please provide full details:
Do you have any employees (paid or voluntary)?
*
Yes
No
If applicable please provide your Employer Reference Number (ERN) or state that you are exempt. An ERN is given to all businesses that register with HMRC as an employer.
Please provide numbers of all employees:
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)
Freelance grooms and
instructors
Students and Work Experience
(please specify)
Volunteers (please state approximate number of hours per
week)
Other (Please specify)
Please note you are legally required to arrange Employers' Liability for paid employees and for paid self-employed persons working under your direction.
Please detail below the qualifications/experience of all persons engaged in riding/hacking instruction or accompaniment:
Do all persons engaged in riding instruction or leading/accompanying hacks/treks hold a suitable BHS or ABRS qualification or similar standard/experience?
Yes
No
Do you have written staff induction/training records?
Yes
No
Do you have documented risk assessments in place for general activities within the stable environment, including the handling of hazardous substances?
Yes
No
Do you have documented risk assessments in place for working with or near horses?
Yes
No
Have you communicated all risk assessments to your staff?
Yes
No
Will you provide Personal Protective Equipment (PPE) for your employees? ?
Yes
No
What items of equipment are provided?
Will the PPE be checked regularly with written records of the checks kept?
Yes
No
Do you ensure you have sufficient qualified first aid staff available at all times?
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?
*
Yes
No
If yes, please provide full 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?
*
Yes
No
If yes, please provide full 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.
*
Yes
No
If yes, please provide full details:
Have you or any of your officers, business partners or directors, ever been declaredbankrupt or insolvent?
*
Yes
No
If yes, please give full 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 full details:
How would you prefer to be contacted by Cliverton?
*
Phone
Email
How did you hear about Cliverton?
*
Please Select
Google search
Facebook
Instagram
TikTok
Horse & Rider magazine
Horse and Hound magazine
National Equine Show
BETA
The Equine Index
Equine 24/7
Family or friend
Word of mouth
Other
If 'other', please state where:
*
Would you like to receive news and updates from Cliverton?
*
Yes
No
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 theinformation we hold about you for the purposes of providing insurance andhandling claims. This may involve processing sensitive personal data about youwhere it is necessary (for example health information or criminal convictions).This may mean we have to give some details to third parties involved inproviding insurance cover. These may include insurance carriers, third partyclaims adjusters, fraud detection and prevention services, reinsurancecompanies and insurance regulatory authorities. Where such personal information relates to anyone other than you, you mustobtain the explicit consent of the person to whom the information relates. Thisconsent must cover both the disclosure of such information to us and its use byus as set out above. The information provided will be treated in accordancewith the UK Data Protection Act 2018. You have the right to apply for a copy ofyour information (for which we may charge a small fee) and to have anyinaccuracies corrected.
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