blanket exclusion insurance question - can they do this?

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LouLou3

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Sorry everyone am sure this question has been done before but couldn't find any threads...

I've just claimed for coffin joint arthritis and rebalancing in the fore limbs - they paid up. Just had my renewal certificate back and there is a blanket exclusion on all arthritis. I called them to ask if this could be narrowed to the forelimbs, in particular the coffin joints but they said No - its blanket exclusion on arthritis anywhere in the body for ever, they will never consider narrowing. I'm totally shocked - I can understand it to some extent for 12 months after the claim but to never allow a claim for arthritis again seems OTT. I have read other threads in the past from people saying they don't bother with insurance because of exclusions but didn't realise just how it all worked.

I can of course continued to claim for up to a year after the claim date - wonder if I put in a claim for arthritis for somewhere else in the body before the time runs out if they would say it was only limited to the coffin joints in forelimbs?

Great news is my boy is making a great recovery
 
Yes, they can do this - KBIS slapped an exclusion on an entire system of the body with my horse and would not consider making it a more sensible exclusion.

Try AmTrust - they underwrite themselves and so have a much more sensible approach to exclusions, they were perfectly happy to exclude just the one, very specific and entirely cured, issue which I had claimed for with KBIS. They were £200 cheaper for a better level of cover too.

Can't complain about KBIS, they paid up promptly no questions asked, but can't recommend them any more either as the exclusion was laughable - it would have excluded the poor animal's teeth for goodness sake, which were entirely unrelated to the issue which he'd had, and yet were part of the same system of the body, so covered by their exclusion.
 
Im with Petplan and can only recommend them. My 31 yo - who they still insure for accidental/external injury, has bashed his legs up a few times. They only excluded treatment to that injury should problems have continued with it. Theyve paid up 3 times now on his legs! My young one had sarcoid treatment which they have now excluded, but i expected that!
 
SpottedCat said:
Yes, they can do this - KBIS slapped an exclusion on an entire system of the body with my horse and would not consider making it a more sensible exclusion.

Try AmTrust - they underwrite themselves and so have a much more sensible approach to exclusions, they were perfectly happy to exclude just the one, very specific and entirely cured, issue which I had claimed for with KBIS. They were £200 cheaper for a better level of cover too.

Can't complain about KBIS, they paid up promptly no questions asked, but can't recommend them any more either as the exclusion was laughable - it would have excluded the poor animal's teeth for goodness sake, which were entirely unrelated to the issue which he'd had, and yet were part of the same system of the body, so covered by their exclusion.
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I'll try them thanks - guess I have to stay with my current provider incase he needs anymore treatment...
 
smiffyimp said:
Im with Petplan and can only recommend them. My 31 yo - who they still insure for accidental/external injury, has bashed his legs up a few times. They only excluded treatment to that injury should problems have continued with it. Theyve paid up 3 times now on his legs! My young one had sarcoid treatment which they have now excluded, but i expected that!
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Yes they said if he had arthrtitis as a result of a bash or direct injury they would still insure but as its degenerative (opps if spelt incorrectly) then they blanket the entire disease for anywhere in the body...seems extreme to me.
 
LouLou3 said:
Yes they said if he had arthrtitis as a result of a bash or direct injury they would still insure but as its degenerative (opps if spelt incorrectly) then they blanket the entire disease for anywhere in the body...seems extreme to me.
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Arthritis is a systemic condition so they are within their rights to put a whole body exclusion :(
 
When my horse was vetted the vet noted that her pelvis was slightly lower (millimeters) one side than the other - no horse is perfect. Nonetheless she passed the 5-stage vetting however; as this note was made about her pelvis in the report sent to the NFU, who I insure with, they excluded her pelvis and lumber region when there wasn't even a clinical problem and we hadn't even made a claim. They did oblige when we maxed out a £5000 claim on surgery on both her stifles during 2009 though. This would obviously then have been excluded from the policy, but sadly she had to be put to sleep in July. :(
 
Inky_and_Sunny said:
Arthritis is a systemic condition so they are within their rights to put a whole body exclusion :(
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Ah I see - so if I did have his back legs looked at and they needed treatment for arthritis before the 12 months is up they should have no problem paying out - am I right or getting the wrong end of the stick?
 
LouLou3 said:
Ah I see - so if I did have his back legs looked at and they needed treatment for arthritis before the 12 months is up they should have no problem paying out - am I right or getting the wrong end of the stick?
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Wrong end of the stick :( It sounds like they have already excluded all bones. The problem with arthritis is it doesn't just affect on bone/pair of limbs, eventually it will affect all. So if they have paid out once for it they are likely to exclude all arthritic conditions.

How old is your horse? Did you not consider claiming for LOU? You wouldn't have got future arthritic bouts paid for but the value of the horse would have gone towards the long term care...
 
Thats actually a tricky one... I'm not sure you have got the wrong of the stick as previously said. The insurance should pay out for all vet fees relating to a specfic illness for 12 months after the problem was first noticed (not when vet was first out/or diagnosed). usually if you say a problem with one front foot they would pay for all treatment to that front foot relating to that diagnoses for 12 months, at some point within that 12 months your insurance renewal will come through and that is when they update exclusions, whether this is 3 month or 11 months after your "say problem with front foot" they will still pay for the whole 12 months even if your new policy has an now exclusion for "front feet lameness" on it. Now as your insurance is classifying the arthritis as one condition they should pay out for any arthritis treatment for 12 months, however they probaly do have some way around that, knowing isurance compaies.... but that is how I see it and how my insurance has worked in the past.
 
Inky_and_Sunny said:
Wrong end of the stick :( It sounds like they have already excluded all bones. The problem with arthritis is it doesn't just affect on bone/pair of limbs, eventually it will affect all. So if they have paid out once for it they are likely to exclude all arthritic conditions.

How old is your horse? Did you not consider claiming for LOU? You wouldn't have got future arthritic bouts paid for but the value of the horse would have gone towards the long term care...
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They have to still pay out for any further treatment for 12 months after first noticing though (hope I've got that right) so if he needed further treatment for arthritis in that time they would have to pay out - guess thats when they would only do it on the limbs affected in the original claim...damn and blast!

He is a young 17 - I thought I did have loss of use - perhaps I'll get that just in case.

Thanks for your advice
 
LouLou3 said:
They have to still pay out for any further treatment for 12 months after first noticing though (hope I've got that right) so if he needed further treatment for arthritis in that time they would have to pay out - guess thats when they would only do it on the limbs affected in the original claim...damn and blast!

He is a young 17 - I thought I did have loss of use - perhaps I'll get that just in case.

Thanks for your advice
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I'm with you on that one... I would dispute the only limbs affected thing as with their exclusion have already half admitted it is whole body issue.
 
Archie has a supernumery tooth which requires remedial dentistry. One tooth in his whole mouth, an extra one at that. Just had my exclusion notice, to advise they are excluding anything to do with his teeth, gums, swallowing ... bet they don't reduce my premiums though.

I questioned with my vet what looked like it could be a sarcoid, back in 2006, when I got him. It has disappeared, never proving a problem and medication or treatment never sought. When his full history was requested about his teeth recently my vet printed off history and it mentioned 'possible sarcoid, 2006'. He has since undergone a thorough going over by my vet and he categorically says Archie has no sarcoids, is at low risk, etc. And still I have had an exclusion notice for sarcoids and all other skin conditions. Am so mad ... he doesn't have sarcoids but because I was stupid enough to draw attention to something which might have been I am now paying the price. Hopefully the vet is right and he will never develop them.

I do have my vets letter but doubt whether anyone would want to insure me now one insurance company have said they won't (even though I am peeved). It is their stance and they are not budging.
 
ossy said:
I'm with you on that one... I would dispute the only limbs affected thing as with their exclusion have already half admitted it is whole body issue.
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Thanks ossy - thats what I thought agree with you through they will probably find a way around it. I phoned them and put them on the spot by asking them if he had other arthritic claims within the 12 months will they pay - they said in theory yes but obviously couldn't say for definite...
 
Archiesmummy said:
Archie has a supernumery tooth which requires remedial dentistry. One tooth in his whole mouth, an extra one at that. Just had my exclusion notice, to advise they are excluding anything to do with his teeth, gums, swallowing ... bet they don't reduce my premiums though.

I questioned with my vet what looked like it could be a sarcoid, back in 2006, when I got him. It has disappeared, never proving a problem and medication or treatment never sought. When his full history was requested about his teeth recently my vet printed off history and it mentioned 'possible sarcoid, 2006'. He has since undergone a thorough going over by my vet and he categorically says Archie has no sarcoids, is at low risk, etc. And still I have had an exclusion notice for sarcoids and all other skin conditions. Am so mad ... he doesn't have sarcoids but because I was stupid enough to draw attention to something which might have been I am now paying the price. Hopefully the vet is right and he will never develop them.

I do have my vets letter but doubt whether anyone would want to insure me now one insurance company have said they won't (even though I am peeved). It is their stance and they are not budging.
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Ah ditto - my boy was lame for ages before they finally diagnosed arthritis - they kept finding abcesses in one foot which now they say is because he was weight bearing through bad foot balance but at the time we assumed that was the root cause of his lameness - as that was on the notes they have excluded that BUT they want to know which foot so they are only going to exclude abccesses in that one foot! Anyway - it was on the vet notes and to be fair to them they have paid out for all treatment even when we did just think it was abcesses so I don't mind - just seems bizarre to ask me which foot for the abcesses but not the arthritis.
 
LouLou3 said:
They have to still pay out for any further treatment for 12 months after first noticing though (hope I've got that right) so if he needed further treatment for arthritis in that time they would have to pay out - guess thats when they would only do it on the limbs affected in the original claim...damn and blast!

He is a young 17 - I thought I did have loss of use - perhaps I'll get that just in case.

Thanks for your advice
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Can't get loss of use - he is now too old
 
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