Advice needed to help with my claim

cellie

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My horse had surgery 8 weeks ago for hock surgery and e and l said they would cover I phoned them before I went ahead.When my renewal form came through in oct they asked what activites he was used for and I circled all the ones I wanted to use for the next year this was before i knew he needed surgery.I circled xc although he has never done this activity and now they are saying his claim is being refudicated on these grounds.This horse has had tendon ligament and cannon bone bruising as has not been fit enough to do anything but a light hack .I just wanted to make sure he was covered for future months.He did one training day for xc 2 years ago.I will get a letter from my vet and instructor .Does anyone have any other ideas to back up my claim.The xc is covered under a different group for insurance purposes.
 
Did u have any exclusions on the policy before hand?
Pm me if you want some help used to work at a vets dealing with all the ins companies.
 
E & L
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If I am correct, you are saying you used e&l. I do not know anyone who has had good service from this company and my own vets always says don't use them. They don't pay out.

The only good thing about them is their price.
 
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E & L
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My thoughts exactly
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They will wriggle out of anything if they can find the smallest opportunity. I don't suppose you asked for a name, or better still a call reference when you phoned them before the surgery? They should have recorded the call.

Once this is behind you, I would switch to Petplan or NFU.

Best of luck.
 
i'm sorry but i cannot see what his 'class of use' has to do with that claim, what a load of rubbish.. i think they are trying to wriggle out of it.. don't back down.!!
 
if he wasn't insured for XC because it was in the next class of use up (and therefore would have meaned paying a higher premium for this cover) then they obviously think you've been doing XC and that's why he's lame and have every right not to want to pay. You need to convince them that you haven't done any XC.

E&L are awful at paying out and will do anything possible to get out of it. You might have a battle on your hands, but stick with it.
 
Yes he had exclusion put on after ligament injury 2 years ago.I will send appeal but its so frustrating hes had ongoing injuries and I cant change companies midway through the claim.I went with hock surgery for spavins to give him best chance of recovery hes 7 this may so very young a tb ex racer.
 
Yes Star that is the case .What happened was that several months after renewal they sent a form with claim form which I thought said what do you intend to use this horse for I mistakenly circled xc thinking that when he came right after his injury my daughter who does pc might try him for xc (it must have said what do you use this horse for)She is outgrowing her loan pony.I did a training day 2 1/2 years ago before any injuries but I have never taken him because of the rest period needed to recuperate properly after his injuries.I can back this up with a letter from vet and instructor.I tried to be to honest and it has backfired he hasnt ever done anything apart from jumping clinic proir to ligament problems then hacking out to recondition.I know what eveyone thinks about e and l but midway through claims you cant change.The bill is for £3600 at moment .
 
I have recorded every date and person I spoke to .I cant switch until claim is settled and like the year before when he did his ligament you have a year sometimes before all documents and settlement is in place.Its a Minefield arghhhhh
 
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E & L
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My thoughts exactly
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They will wriggle out of anything if they can find the smallest opportunity. I don't suppose you asked for a name, or better still a call reference when you phoned them before the surgery? They should have recorded the call.

Once this is behind you, I would switch to Petplan or NFU.

Best of luck.

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DITTO DITTO< but i use NFU
 
Have they not paid each month's invoices /claims as intermin payments? That's what NFU did for us in a 3 month case.

I suspect thye are using it as a get-out and will say he was not covered for XC.
Threaten them with Watchdog, if they don't pay, after you confirm that he had not done XC YET! , as they have been on it before.
 
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Yes he had exclusion put on after ligament injury 2 years ago.

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What, exactly, was the exclusion?
 
E & L usually pay out for death as its very hard to wiggle out of that diagnosis.... I would be interested if anyone has been paid promptly (without a fight) for Vets fees / stolen tack....
 
It was for tendon and ligament on hind legs.I was hoping to get it removed because he was scanned for the all clear .
 
Ill bear that in mind but will go for appeal then ombudsman first.I have to wait for my letter first as I was told about refudication by telephone , the vets are waiting for payment its a nightmare.
 
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