claiming on insurance?

[Jericho]

hypothetical question..

My horse is covered for vets fee with E&L insurance which states that cover for treatment is for an injury or illness that has happened or started during the period of insurance. So what happens if a diagnosis is something like navicular or bone spavin or another long term problem which has only manifested recently?

Does anyone have experiences of claiming for vet fees on an existing condition which is more than likely to have started before the insurance wasnt taken out? I guess a likely scenario is buying a horse, getting it insured and then 6months later finding out that it has problems which havent necessarily caused a problem or wasnt picked up in a vetting e.g. twisted pelvis or bone spavin (or maybe the horse was on bute)

 

[cellie]

I have insurance with e and l and have managed to claim successfully for spavin/ tendon actually you name it we have claimed it.The spavin could have been manifesting for years and until the horse breaks down with lameness you wouldnt know.I didnt have vetting and still claimed.If you had vetting it proves and vet you didnt know.Have I interpreted your question properly.?

 

[ladyt25]

Hmm, the first problem you may encounter is who you're insured with! They have been know for stating the condition was 'pre-existing' even if you bought the horse, it passed a vetting and it wasnt till months down the line you realised there was a problem.

If you have been insured for a few years then there should not be a problem to be honest. The same should apply if a newer purchase even if the symptoms occurred within the first few months of cover. Providing they didn't occur within the first 14 days of the inception of cover you really shouldn't have a problem.

 

[aimee8282]

They would need to prove that you knew of the lameness and did not tell them (non-disclosure)....ie clinical history from a vet showing lameness for 3-4 years. If clinical is clear and the lameness has just started, even though spavin is a long standing problem that has probably been there for a while, you should be ok. Although E&L aren't the best sorry to say!

 

[Spook]

Ask your vet to help with the claim. One of our liveries has sucessfully claimed on 2 horses for navicular, on both occasions the vet assisted her with the claim.

 

[Spook]

Just to add she was claiming for loss of use.

 

[barney1]

Hi, I have been having an ongoing nightmare with my insurance company, even with the help of my vet they are still refusing to settle my claim. I changed my insurance company in September only due to the fact that this company quoted a better price on not including my tack, as I always take it home, it was considerably cheaper to put it on the house insurance.

In October my horse was lame due to a piece of chip bone in his fetlock, while he was on box rest recovering from key-hole surgery he went hopping lame in the stable, back to the vets for investigative key-hole surgery and they found a cyst. My insurance company are refusing to settle this claim on the grounds that it was an underlying condition before inception of the policy, the sac surrounding the cyst had actually split, causing the acute lameness, this happened in December. My vet and the surgeon from Newmarket both stated that the cyst could have been there for months in a dormant state and that I would have had no way of knowing that it was there. They kept referring me back to my previous insurances, who quite rightly feel that enough time had elapsed from inception of my policy to actually be covered.

This is now in the hands of the Financial Ombudsman, so I am hoping for a good outcome. Equestrian Direct have been of no help whatsoever in trying to resolve this problem, all they want to do is quote the policy conditions.