Advice Please! Insurance?

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JackHorseRocks

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I have had myself insured for just third party with petplan since i bought him (January 2012) but got insurance for him with loss of use, 5k vet fees and tack just over 2 months ago. NEVER had any problems - well Needed the vet once in June 2012, for a small kick wound which needed to be cleaned out and medication from the vet, but it costed under £100 and obviously didnt claim (so never claimed with petplan) Apart from that, never had any problems atall with him. In the last couple of weeks he has been acting worse and worse than his usual self (usually abit fizzy) showing back pain, girthy and is unable to work properly, gave 2 weeks off and got (friend vet reccomended) physio out - nothing sore. The vet has said for something like this they need x-rays back (KS) and tests which is hundreds just to diagnose. I do not have the spare money to do this now, after buying all new tack! So i'm in a position.. Will the insurance pay out so soon? If not, what can i try? Months off work, lunging? What?! If i get the vet out, and explain problems - it will instantly go onto his record and may void my insurance? I cant void it, as i've lost my job and currently only have enough for my house and kids, let allown horse! Help! :mad::(
 
Woah there. Your vet is jumping the gun a bit. Of course the issue needs to be investigated, but I would ask for a Bute trial first, and go from there.

As for claiming on insurance and payments etc. they should pay your vet direct.
 
He thinks its something more serious, but i would opt for bute trial first. The question is, will the insurance company pay out so soon? 2 months after starting the insurance...
 
Depends on your insurance, mine only had a two week period where you couldn't claim, after two weeks you could claim for anything as long as it hadn't started before the insurance was taken out or during the two week period.
 
JackHorseRocks said:
He thinks its something more serious, but i would opt for bute trial first. The question is, will the insurance company pay out so soon? 2 months after starting the insurance...
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Yes, they should do.

So the vet has done a thorough examination and wants to explore KS??
 
Spoke to vet via phone, and they basically said it may lead to xrays and be very expensive - if the insurance do not want to pay out. I'm with Petplan, and basically pay £36 a month for everything. A few experianced friends have said the insurance company will try and get out of it, if it leads to something big. So i'm basically unsure if to go all out now, get the vet out for a examination which may lead to claiming, or to wait a couple more months when theres a less chance they'll try and get out of it...
 
I've only ever heard good things about petplan.

And clever vet deciding that your horse has a serious problem without seeing it......... (p.s I'd change vets).
 
amymay said:
I've only ever heard good things about petplan.

And clever vet deciding that your horse has a serious problem without seeing it......... (p.s I'd change vets).
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I was thinking of changing vets anyway, so may just do that. I'm just worried they will refuse to pay and i'll be left with thousands of money in dept..
 
JackHorseRocks said:
I was thinking of changing vets anyway, so may just do that. I'm just worried they will refuse to pay and i'll be left with thousands of money in dept..
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There is absolutely no reason they should refuse to pay out on any claim, providing you follow the correct procedures.
 
I am with petplan and yes, following the correct process with them, I have never had an issue with them and they have never tried to get out of a claim that I have raised. When my horse was kicked and had a suspected hairline fracture to the leg and had to be bandaged/immobilised, they didn't even raise an eyebrow at the cost and amount of bandages used....

They also paid out to my vet directly....
 
JackHorseRocks said:
So i'm basically unsure if to go all out now, get the vet out for a examination which may lead to claiming, or to wait a couple more months when theres a less chance they'll try and get out of it...
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If they WERE going to try to get out of it, they would try regardless of whether you tell them now or a couple of months down the line. Your policy should state that you have to inform them of any injury/illness so really you are best of just telling them now and letting them know there may be a claim. Shouldn't be a problem assuming you have vet records noting that your horse was fine before you added the vet fees etc to the policy. Most policies generally state you cannot claim for any illness (i.e. anything not an accidental injury) which occurs within the first 14 days of your policy however they still may ask for a vet history to check there is no record of back pain/injury previous to you adding the vets fees cover.

If everything is within the conditions of the policy (i.e. problem didn't start before policy) they can't void your policy. They would only void if you commit fraud etc.
 
Cadburys_addict said:
I am with petplan and yes, following the correct process with them, I have never had an issue with them and they have never tried to get out of a claim that I have raised. When my horse was kicked and had a suspected hairline fracture to the leg and had to be bandaged/immobilised, they didn't even raise an eyebrow at the cost and amount of bandages used....

They also paid out to my vet directly....
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How long have you had the insurance for when they paid out? I'm worried they my try and say it was already a issuer before it was diagnosed (when it wasn't) to get out of paying? :/
 
Elbie said:
If they WERE going to try to get out of it, they would try regardless of whether you tell them now or a couple of months down the line. Your policy should state that you have to inform them of any injury/illness so really you are best of just telling them now and letting them know there may be a claim. Shouldn't be a problem assuming you have vet records noting that your horse was fine before you added the vet fees etc to the policy. Most policies generally state you cannot claim for any illness (i.e. anything not an accidental injury) which occurs within the first 14 days of your policy however they still may ask for a vet history to check there is no record of back pain/injury previous to you adding the vets fees cover.

If everything is within the conditions of the policy (i.e. problem didn't start before policy) they can't void your policy. They would only void if you commit fraud etc.
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Ok,
Thank you!
 
JackHorseRocks said:
How long have you had the insurance for when they paid out? I'm worried they my try and say it was already a issuer before it was diagnosed (when it wasn't) to get out of paying? :/
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To be fair, they have to be able to prove the condition existed before you added vet fees cover in order to decline the claim. They can't just decline it on a "hunch" (I work in insurance, trust me!)
 
OP give Petplan a call, explain the situation and that the vet has recommended commencement of investigations which are likely to lead to a claim - confirm what your excess is on the policy (you will have to pay something) and get them to confirm to you exactly what they need from you and from your vet (forms completed, vets history, letters etc.) and to confirm what they will and won't pay for.

Do all of this before you incur any vets fees so you can make an informed decision as to what investigations you want the vet to proceed with.
 
I had something similar to this with Petplan when I insured an 18 yo pony. I had bought him at 16yo so was unable to get full vets fees insurance for him until PP started their policy that allowed full insurance until 20yo.

Less than a month after I insured him he came in mildly lame one day and since he was getting his jabs done that week I had the vet look at him. Agreed to treat with bute and field rest to start with but he didn't improve and the vet wanted to start investigating so I rang PP (fully expecting them to tell me to s&d off!) and they were marvellous :)

Paid out nearly £5K in the next 9 or 10 months with no quibble for xrays, full work ups, drugs (lots of), scans, other treatment and remedial shoeing and would have paid towards physio etc if it had gone that far.

I did say to the vet at the beginning that I was worried that they'd refuse the claim but once he heard who the insurers were he was pretty confident that there wouldn't be a problem.

ETA I would seriously consider carefully which vet practice you use for the investigations - a bigger one will tend to have more facilities/equipment and tend to have an organised admin/accounts dept which really helps with insurance claims. Insurance companies do appreciate prompt billing and clear paperwork which IME some small or one man practices fall down on and this can cause complications with the claim.
 
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Hey jackhorserocks! I don't know about pet plan although I have heard good things but I am with e&l (the insurance with the worst reviews ever ;) ) and so far they have paid out around £2500 in the 10 months I have had my horse with all her various ailments ;) so don't worry it will be fine as long as you follow correct procedure!
Also agree with what others said change your vet!
 
I had a serious accident with my horse 2 months after insuring him. pet plan were brilliant. follow correct process and should be fine. they paid out over 3k on tests for him. ( exclusions afterwards were a different matter but probably reasonable from an underwriting perspective )
 
Some insurance companies have a clause where pre existing conditions are excluded. If it were to turn out to be kissing spines, I doubt they'd pay out.
 
Elbie said:
To be fair, they have to be able to prove the condition existed before you added vet fees cover in order to decline the claim. They can't just decline it on a "hunch" (I work in insurance, trust me!)
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If it is kissing spines, then I'm afraid that just doesn't appear over night. This is just bad luck and timing that its occurred so soon after increasing the insurance. I'd explore all other avenues first before jumping in with expensive treatment at the moment.
Hope it all works out OK.
 
I am with Petplan and have already had one claim paid and am just about to put another claim in which is liable to be quite a big one and ongoing. They paid my vet direct and were really helpful when i rang to inform them of the pending claim. I assume you are covered for 5000 pounds with an excess of 135 pounds?
 
christine48 said:
If it is kissing spines, then I'm afraid that just doesn't appear over night. This is just bad luck and timing that its occurred so soon after increasing the insurance. I'd explore all other avenues first before jumping in with expensive treatment at the moment.
Hope it all works out OK.
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True they don't occur over night, however, insurance will cover for 12 months from the date clinical signs were first noticed so yes maybe the KS may have actually started to develop prior to vets fees being added to the policy, however, if the horse didn't actually exhibit signs of having an issue until after the policy is in force then it should be covered.
 
You won't have to pay the bill if the insurance agree to pay.
You pay your excess, insurance pay the vets directly.
There are a few exceptions to this thought.
You need to speak to insurance company asap though and start claim off.
 
christine48 said:
Some insurance companies have a clause where pre existing conditions are excluded. If it were to turn out to be kissing spines, I doubt they'd pay out.
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YEP!!! This is true!!! I unfortunately experienced this- insurance will not and have not paid out for a rather extensive vets procedure that unveiled KS :( Very distressing and upsetting.
 
I am with PetPlan and have had a large claim with no problems whatsoever in terms of them paying out. My vet wanted an MRI scan to pinpoint the problem and they didn't hesitate to pay out. They said I could do a pre-approval but that wouldn't guarantee the pay out. I opted to just do the scan as would do it whether they approved or not. They paid out everything without question and on time.
My insurance had 14 days at the start when I couldn't claim but I would think you will be fine after 2 months of having the insurance.
Just follow the right procedure and send your forms as soon as you get them.
 
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