BEVA criteria for PTS

K

kez1001

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Looking for some advice from anyone with some experience in this area.

I had my mare put to sleep on vets reccommendation following horrific accident when riding in an arena that she landed on a 6 inch nail that went up the cleft of her frog and perforated her navicular bursa, DDFT and reaching into her coffin joint. I was told there was a proceedure that could be "tried" to irrigate/flush out the joint but it was a very poor prognosis with a 30% chance of it working and a huge risk of hoof infections and septiciamia. Plus as they would have to wash the joint out by going in through the DDFT so therefore causing more damage and probably making the best outcome her being 2/10 sound. I will add also she was only 10yo and a fit TB, about to compete at her second BE event.

Now i trust my vet and wanted the best for my mare, i feel this was a very hard selfless decision to make but one i made on her best interests. My problem is my insurance company, it has been six weeks and i feel they are really giving me a run around :mad:
They wrote to me 10days after claim form sent in to say it was received and not to contact them, then a furhter 10 days later to ask for proof of ownership, original receipt for horse and further vet report!! Furious as i have paid my premium for 4 years, never late and they have never wanted proof of ownership or receipt before. So today i received another letter saying claim is being passed to consultant vet??? why? there were 3 vets in attendance, injury happened out of hours and i took their advice? i feel as though i must be missing something. My vet estimated that cost of treating injury would have been around 10k by the time they operated etc and recovery expenses, whch insurance company would of had to pay out and surely if vets seen nice big cheque for that coming thier way they would have advised that?? My girl was only insured for 2k but she was worth more and priceless in my eyes.

Sorry for being over emotional just feel as though i have somehow done the wrong thing by puttins her to sleep as surely you insure against these kind of accidents i.e freak ones that are so cruel. Any advice guys or similar experiences? thanks
 
i think the trouble is, there was a chance that with surgery she could have come right. this means it's falls into the grey area. with a situation like a broken femur where there is 100% no treatment available and PTS is most definitely the only option they should pay out no probs, but with your situation there was that small chance that with surgery she might have been ok and you had to make a choice to PTS. i'm not saying PTS was the wrong decision in any way, but you had to make that decision and there was another option. they will normally only pay out on mortality claims if there is absolutely no other option but to PTS (it is totally daft as treating certain problems, or trying to, will often cost more, but that is the way it works)

so sorry you had to experience such a horrible accident :(
 
yeah i know what you mean - it is just making me feel as though i had a choice! When tbh i knew my horse, and she would not have coped with the necessary box rest and if 2/10 sound was her best outcome at age 10 then she could of been in pain for another 20 years! Just maddening that although there was a very small chance of fixing it the reality of the situation is that even if they fixed it for 4 months the chance of infection recurring would have been huge. I was speaking to a farrier who told me one of his clients horses had had a similar injury where it had perforated navicular bursa and they decided to try and treat but 5 months later they PTS as horse had septiciamia and infection was oozying out the back of the horses knee. my girl had sustained a much more traumatic injury!

Sorry i'm not meaning to sound as thought im ranting at you i just find this so hard to deal with :( and i have no one to talk too, my OH just doesnt get it :( i miss my little horse :(:(:(
If i really thought it would work i would of tried :(
 
I had something not dissimilar with Pet Plan some years ago though as it was a chronic problem rather than an emergency pts they ummed and ahhhed for days. I have nothing to offer except to contact your vet and the vet hospital and ask them if they can help you. Mine did- they wrote a really snotty letter. Out of the blue I got a cheque for the full amount he was insured for but no apology or explanation for their attitude, which frankly made an awful situation even worse.
I remember reading your post when you lost your horse and I was full of admiration for your decision. So sorry for your loss. We lost one a couple of weeks before you and it does hurt so much you just dont need this.
This time KBIS were fab and sent me a little note saying sorry for my loss which was just nice...not essential but still nice.
 
i think i will contact my vet - even just for someone to tell me i did do the right thing. I am truly hurt to think that they see fit to question my vets decision. I didnt find the decision an easy one and i am still beating myself up about making it just "in case" she would of been the miracle one who would have survived. My insurance is underwritten by same company and pet plan :mad:

So sorry for your loss too but how lovely to hear of KBIS sending you a card :) my vet also wrote to me and it was comforting to know he cared :)
 
Don't beat yourself up - you hurt enough already. I suspect that the insurance company is just covering its bases but I remember how I felt when Pet Plan did it to me. I ended up crying on the phone trying to make them see that if I had a choice I would not be doing this thing:( It still upsets me now 8 years later:(
KBIS were just so much easier to deal with - if they had queries they certainly did not bother me with them, not even when paying all my vet bills. I will continue to use them for our youngster as they were so nice - even when I cried.
 
you would have put her through an awful lot more with a very slim chance of success if you hadn't PTS. they are just being difficult. your vet should be able to persuade them. i'm often asked to write letters to insurance companies so that clients can get payouts. it's normally just to clarify things so fingers crossed you will get it all sorted.
 
thanks guys i will def try contacting my vet. like you have both said it could persuade and surely there professional opinion is more important as they were there at the time. Plus they are a very very well respected vet practice so it wont do any harm.

thanks for listening it means a lot :)
 
Firstly I'm sorry that you've had to go through such an awful situation.

I'm afraid though insurance is not an emotion driven business. For a death claim to be paid out by the insurance company the euthansia of the horse in question must meet the BEVA criteria for humane destruction.

The criteria are strict and to the point: the horse must have a condition requiring immediate euthansia for which there is no further treatment option available.

The treatment option does not have to be able to render your horse sound enough to compete or meet any athletic performance, just be within welfare guidelines.

In your case there was a treatment option available. It carried a poor prognosis but it was available and that all the insurers need. It seems crackers to me that you have to go through 1000's of pounds of fees and put a horse through invasive and often painful and risky procedures to meet the guidelines, but they are clear and set in stone.

IME the insurers are unlikely to budge. A post-mortem will also have been required to prove the cause of death too. I'm sure your vets ( as I would) will do two things. one they will assure that for the horse's welfare you made the right decision and that is the most important thing. they will also (I'm sure) write an appeal letter for you to help with the claim. If lucky you may get a partial settlement. If you're really lucky they may settle. I would be cautious in your expectation though. They could be difficult, stick to their guns and pay out nothing. :(

Sorry to be such a gloomy news bearer. I honestly hope I'm wrong in this case.
The very best of luck,
Imogen
 
Hi K - what a terrible thing to have had to go through.

Thought I'd tell you Sullivan's story to show you that insurance companies can be understanding...sometimes. Worth you pressing on. My adored Highland x Sullivan was diagnosed with severe DJD and navicular syndrome in both front feet. It was so bad that, although he hardly appeared lame, just stumbling now and then, when one foot was nerve blocked, he was immediately horrendously lame - almost hopping lame - on the other foot. Long story short, he couldn't be mended and he started to lose weight and got frantic to the point of being dangerous if his best buddy wasn't either in the field with him or in the next door stable. His buddy kept him safe from the other horses who were starting to bully him. It was so desperately sad. RIP Sully. I had to help him and the only answer was pts. The wonderful vet who did the lameness work up totally agreed. I contacted insurers - same problem as yours. Although pts was the correct humane decision, it wasn't seen as an emergency euthanasia. So they wouldn't pay up. My vet was incensed and wrote to them and phoned them on my behalf explaining exactly what poor Sully was enduring. They very, very kindly made a goodwill gesture and paid me 60% of his insured value. I appreciated that small kindness then and I still do today. It's really worth getting your vet to write to your insurers, even though you know their decision is technically correct. They may find it in their hearts to offer some payment. Good luck x
 
Regardless of there being a potential treatment option if your vet is happy to say it was to severe and the prognosis was hopeless - and if you have a second opinion too then as far as I can see you have a very good case. All your vet has to say is that the combo of damage to the DDFT was just too severe. Anyway you can't tell the vet what to say but it sounds like they have already done that. You do not need a post mortem because the vet can say unequivocably why the horse was PTS - I have done this for people many times. I suggest you contact the insurance ombnisman (sorry i don't know how to spell that word!) and you will find your insurance company suddenly gets its arse in gear!
 
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