Contact Amlin Plus

• St Helen's
  1 Undershaft
  London
  EC3A 8ND

• Telephone

• +44 (0)845 605 0233

• Fax

• +44 (0) 845 605 0234

• Email

• askapl@amlin.co.uk
  aplclaims@amlin.co.uk

1. Please fill in your contact details below:

Contact details: First Name Please enter your First Name	Surname Please enter your Surname
address Please enter an address	city
postcode Please enter a Post Code	country Please enter a country
telephone home Please enter a valid phone numberA telephone number is required.Please enter a valid phone number	telephone mobile Invalid format.Please check this phone number is correct
fax number Invalid format.Minimum number of characters not met.	email address Please enter a valid email addressPlease enter a valid email address
Horse information: horse name Please enter the name	horse sex Sex: Colt Filly Gelding Stallion Mare Prospective Foal
breed	use Please enter the use
age Please enter an age If the horse is 1 years old or under, please enter the Sire & Dam names:	sum insured The minimum value Amlin Plus is able to insure is £10,000Invalid format.The minimum value Amlin Plus is able to insure is £10,000

2. Please select the appropriate cover you require:

If you are unsure of the cover you require, please skip this section and go to question 3

Cover options:cover options Thoroughbred coverthoroughbred cover Competition horse covercompetition horse cover

• Please select the thoroughbred cover you require All Risks of Mortality and TheftAll Risks of Mortality and Theft Foal InsuranceFoal Insurance Prospective Foal InsuranceProspective Foal Insurance Mare BarrennessMare Barrenness Stallion Permanent Disability Extension EndorsementStallion Permanent Disability Extension Endorsement Stallion First Season Sub FertilityStallion First Season Sub Fertility Life Saving SurgeryLife Saving Surgery Colic Costs ExtensionColic Costs Extension Unsoundeness of WindUnsoundeness of Wind Operation InsuranceOperation Insurance TransitsTransits 12 Month Extension Clause12 Month Extension Clause Agreed Value ExtensionAgreed Value Extension
• Other coverage's needed please enter it hereOther coverage's needed please enter it here

• Please select the Competition horse cover you require All Risks of Mortality and TheftAll Risks of Mortality and Theft All Risks of Mortality and Theft plus Loss of Use - 75% Full LOUAll Risks of Mortality and Theft plus Loss of Use - 75% Full LOU All Risks of Mortality and Theft plus Loss of Use - 75% Accidental External Injury Only LOUAll Risks of Mortality and Theft plus Loss of Use - 75% Accidental External Injury Only LOU Life Saving SurgeryLife Saving Surgery Colic Costs ExtensionColic Costs Extension European CoverEuropean Cover
• Other coverage's needed please enter it here
• Veterinary FeesVeterinary Fees £3,000£3,000 £5,000£5,000 £10,000£10,000

• For Liability cover please call 0845 605 0233 For Liability cover please call 0845 605 0233

3. Any additional information you require:

Date insurance required from: