Back problem and insurance exclusion - help what do I do?!

B

BeckyD

Well-Known Member
Joined
13 September 2004
Messages
4,213
Location
Milton Keynes
Visit site
I would really appreciate some help if anyone has any experience of insurance exclusions...

Ronnie has had a couple of heavy falls in the field in the last two weeks (pratting about) and has as a result gone lame behind. Had the vet out yesterday who found pain in Ronnie's lumbar region. Suggested referral to Rossdales for investigation and back workup.

PROBLEM: When I bought Ronnie and had him vetted, the vet found "Pelvis - left tuber sacrale higher than right, gluteal muscling even". NFU hence excluded "the pelvis and/or lumbar sacral spine".

Now, the new problem seems in no way related to old problem, which wasn't a problem as such, I mean thousands of horses have one tuber sacrale higher than the other - even my vet book says clinically normal horses can appear uneven there.

Trip to Rossdales likely to cost ~£3,000 which I can ill afford (I would have to take out a loan).

What on earth do I do? Can NFU really exclude something so unrelated?! Should I have done battle at the outset of the insurance policy?

I'm very worried at the expense - even more so as I know damage there can be long term and so I might have a field ornament at the end of it, or worse.
 
Get yourself in a good physio first. A Bowen therapist is who I use on Thumper - and they are very 'kind' in their treatment.
 
It was a vet-referred physio who first identified the problem 2 weeks ago (her trip to see him for something else entirely - clicking shoulder - coincided with his fall in the field).

She said Ronnie's in a lot of pain in that region but she didn't expect that it would be making him lame - but vet thinks otherwise. I'll try to check out her quals.

Thank you for the suggestion.
 
Thank you, I'm a bit broken-hearted, this year has been such a disaster with injury after injury. Insurance co wouldn't tell me whether they will pay for anything until I've filled out claim form and they have reviewed. I assume they'll say no as it is lumbar region for the new site of injury and for some reason they have excluded that due to god knows what.
 
Ah, ok - then Horspital it is.

Sorry
frown.gif
 
Echo AmyMay re seeing someone else before taking him to the vet.

I used a McTimoney practitioner to sort my eventer out, he started stopping (very unlike him) so took him, to a local highly recommended guy, 2 treatments which cost £120 and some strapping from me for 10mins daily has completely sorted him out!!

He was unlevel in his pelvis and it was probably from when he 4 (As I found it noted from an old vetting certificate in his passport...He's 13 now) it had never been treated as far as I can tell and as he has got older it has got sore and he did have uneven muscle.
 
Thank you, but it was a McTimoney physio who first spotted the problem as her unrelated trip to see Ronnie coincided with his fall. She tried to sort out the problem but obviously it wasn't enough. I think she's on holiday at the moment, I know vet was keen to speak to her so maybe worth waiting for her to return. But vet thinks the only way we'll know what's happened is the referral to horspital.
 
NFU are nice people. I had a claim with them last year that initially they said No to.

My vet wrote a report and explained the facts and then they said OK, go ahead.

Get your vet to write brief report explaining the details...
 
Hmm, tricky one here and I am afriad you could be in for a struggle with thid claim when they have ut such a wide exclusion on!

The only thing I can suggest is that your vet advises the insurance company that, in his/her opinion the current problem is in no way related to what was seen on the vetting. That's your onlyhope I would say in them paying out cos there will ask the vet whether they consider it to be related.

They could still get a 2nd opinion vet in to give their views on it though.

The up side is you can say it was as a result of a specific fall and therefore is easier for vet to state it is NOT related to the previous findings. I wish you luck, it can be a bit of luck of the draw to be honest, depends what claim handler you get delaing with your case.

Good luck!
 
Thank you. I wonder i I could get physio to back me up as well - she was here only a month before and the problem wasn't there then.

Ho hum. Still, it's such a lot of money it's go to be worth fighting.
 
I agree with the advice given: your vet's powers of persuasion are your best hope. You are dealing with a reputable insurer so with a good vet's letter I wouldn't give up hope.

But major vibes that it's just a bit of stiffness from the injury that will wear off with field rest (((((Ronnie)))))
 
You poor thing, what an awful position to be in.
I'd try talking to the insurance company, you never know your luck but sadly it does sound as though it would be excluded unless you can get your vet to word the investigation differently.
My TB had bruised soles exclusions due to numerous problems so when investigation was required vets re-worded it. Turned out to be something completely different anyway.
Next time when you renew try arguing - NFU put huge exclusions on my boy (three legs, colic, his back and anything related to it!!!) so I swapped companies and he's insured except for one leg now.
Good luck.
 
Poor you, I'm in a similar position myself with NFU. My horse had mild laminitis several years ago and of course that's now excluded so when he got it this year I didn't claim. However, he's since been diagnosed with cushings and NFU refuse to pay anything as it's "connected with lamitis". I intend to call them once I've calmed down!!
smile.gif
Good luck with yours.
 
!! That's a bit of a loose connection - surely it goes the other way i.e. if he'd had cushings they might exclude laminitis - not the other way round?! Good luck arguing, I do sometimes wonder why we have insurance!
 
Thank you I shall fight
laugh.gif
Just waiting for an appt at Cambridge at the moment. I'm so worried it's going to be something serious, just want to get to bottom of it now. Have entered nervous wreck phase.
 
You must log in or register to reply here.
Top