ACORD 192 (7/98) – Equine Insurance Application
Use this form to apply for insurance on horses such as thoroughbreds and racing horses.
ANIMAL INFORMATION
Complete all items to provide important information about each animal to be insured. Space is provided for four animals.
COVERAGE/LIMITS
Enter each coverage limit desired. Use the Remarks section to request coverage not shown.
ACCOMMODATIONS
For each animal, indicate whether the horse is kept in a stall, corral, open pasture or other accommodation.
GENERAL INFORMATION
Answer all questions. With the exception of questions 5, 14, 15 and 16, explain all “yes” responses.