Mortality Applications

For your convenience, here are several applications you can download yourself to complete. All applications are in PDF format and can be read using Acrobat Reader. If you do not currently have Acrobat Reader on your computer, you may DOWNLOAD it for free.

If you do not see an application here for the coverage you are interested in, call our office and we will take care of you either over the phone or by mailing or faxing you an application.

To view our pdf files you will need Adobe Acrobat Readerclick here to download.

Some of these applications are form fill, SAVE before you send it in.  Others must be printed and filled out by hand.

Mortality Applications: 
 

We offer a full line of equine mortality coverages through A rated carriers including Major Medical, Surgical, Loss of Use (both full coverage and external trauma only for performance horses), Guaranteed Extension, Agreed Value, Stallion Infertility, Limited Perils Mortality, International Transit, and Emergency Colic Surgery Extension. Quotes are available right over the phone and vet checks are not required on most horses valued at $100,000 or less. Coverage can be bound immediately via fax/email and ePayment.  Special Mortality Programs available now for Polo Horses, Police and Search and Rescue Horses. Please call for specific applications to be faxed or emailed - available in selected states only.

 

Includes application page, Statement of Health and Veterinary Examination Form. If you are applying for Loss of Use coverage, you must also download the Loss of Use Veterinary Examination Form.  If you wish to insure your horse for more than its initial purchase price, you must also download the Justification of Value form and provide information to show why the horse is now worth more.


Download Mortality Application
Download Mortality Application (for OR, TX and WA only)  
Download Loss of Use Veterinary Examination Form
Download Justification of Value Form

Phone: 714.447.9191 | Fax: 714.525.9191 | Toll Free: 800.97 HORSE info@chevalinsurance.com

P.O. Box 2933, Fullerton, CA 92837-0933

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