Daft KBIS exclusion - is it possible to argue & get reinstated

[BeckyD]

Just had my renewal through for Bill's insurance, and it's gone up by £14 a month (12%). Not too bad I thought, until I saw the exclusion on there. I made a claim for his right check ligament, which was warm and puffy for a few days, ultrasound scan showed no problems, but as I've had a bit of bad luck with injuries in the past, vet recommended that I treat it as a full-on check ligament injury just to be on safe side. I have claimed all of £100 from KBIS as despite my initial panic, it turned out to be minor and only required 2 vet visits (plus a further one when I was panicking that he'd worsened it but his legs were just puffy from being in - yes I'm a worrier).

My lovely shiny new KBIS exclusion? Both front legs.

Hmmm. He is insured for his full purchase price, and for full loss of use, so moving insurers isn't easy as I'll need to get a full 5-stage vetting (which I have no reason to think he would fail, but you never know). There's no sign now of any check ligament problems.

Am I likely to have any joy arguing the toss with them? I can't phone them until Friday as I'm at work at the moment. I could understand them excluding check ligaments on both legs, but not such a massive exclusion!

 

[SpottedCat]

I had no joy arguing for a more sensible exclusion with them when they wanted to exclude my horse's entire digestive system after gastric ulcers. They were unmoving on the issue, despite the fact that their exclusion covered his teeth, which had nothing to do with the ulcers.

I switched to AmTrust - they underwrite themselves so their exclusions are far more sensible. They only excluded gastric ulcers (fair enough) and then when said horse had a kick to the head (which caused non-permanent damage to a tooth - so KBIS would not have paid out on a claim!), they were perfectly happy to accept a vets letter saying it would not cause any more issues and should not be excluded.

 

[ecrozier]

You can get exclusions lifted - when I bought roo his vetting flagged up his feet. The vet was not a native English speaker, and made a tiny mistake, what he said and meant at the time was that as roo had never been shod or really trimmed his feet were a bit messy, he had minor thrush, but all would clear up with correct shoeing. Saddle he wrote 'Corrective' not correct!! So SEIB panicked and excluded all 4 feet! I complained and they said that I needed to get vet and farrier to write to them and send pictures, and I did, and exclusion was lifted

 

[SpottedCat]

You can get exclusions lifted

Not, in my experience, with KBIS in recent years, no matter what your vet is prepared to write

 

[galaxy]

Friend couldn't get KBIS to lift OTT exclusions either. They were very rude to her!

I hear people complain about NFU all the time on here, but one of their main selling points to me is that they don't do blanket exclusions.

 

[philamena]

No experience of KBIS but have experience of AmTrust Equine. On the whole they've been very friendly to deal with, but in terms of exclusions: they excluded both of my mare's front feet from the word go because when I had her vetted she hoof tested slightly positive, which vet thought was because her feet were long and she'd been forging a lot as a result. A week later after reshoeing she was fine, so vet retested and was completely happy and signed off the addendum to the vetting... but when I questioned the exclusion (after all, if we'd just done the vetting a week later she'd have sailed through with them none the wiser) they still insisted on excluding for 6 months then retesting and re-xraying to get them reinstated. So although the exclusion is only temporary and makes a kind of sense from their point of view, it's going to cost me to get it lifted.

They also asked for a rather eyepopping quantity of x rays for the Loss of Use cover - my vet said she's never seen so many requested for loss of use - so if you are planning on moving it is worth getting the full low down on exactly how many x rays they'll want rather than just the 'x rays of all four feet and hocks' line...

 

[SpottedCat]

Philamena - if it's not a rude question, how much is your horse insured for and are you on their competition horse policy (which you did used to have to ring up for rather than get a quote online).

I only ask because my horse is insured for LoU and when I switched to them no vetting/x-rays were requested, and I've only ever heard of x-rays being required for LoU insurance with a seriously expensive horse.....

Their competition horse policy is slightly different from the normal ones in that you can't 'mix and match' bits of it - so you have to have the LoU cover and if you don't want that then you need to be on one of their different policies.

 

[humblepie]

I had an exclusion amended to just the joint which was affected with KBIS. It was an injury/knock and like you then resulted I think in both forelegs being totally excluded. That was about 2 years ago. On this year's renewal I wrote a covering letter with a question on an exclusion and didn't get a response, let alone a "no".

 

[star]

i got KBIS to lift an exclusion. when i got my youngster 4yrs back they put an exclusion for anything related to imbalance in his feet due to a comment the vet made on the vetting. i waited for the farrier to sort his feet out then got him to write a letter explaining no current probs with feet and all should be fine now and they lifted it with no quibbles.

 

[star]

...

 

[BeckyD]

Not, in my experience, with KBIS in recent years, no matter what your vet is prepared to write

Darn. Looks like I'll be leaving KBIS. What a shame; they've been really good up until this problem. It's too large a problem to just ignore though - anything can happen where horses are concerned and I fail to see why this exclusion has been applied. I agree that check liagemnt injuries do seem to happen on both legs with worrying frequency, but to exclude everything else on those two legs as well?!

I liked KBIS as they have the highest limit for vets fees (£7,500) and as someone whose vets bill hit £10k+ for bilateral PSD (with an NFU vets' fee limit of £5k) that extra £2,500 was a big incentive.

 

[BeckyD]

Philamena - if it's not a rude question, how much is your horse insured for and are you on their competition horse policy (which you did used to have to ring up for rather than get a quote online).

I only ask because my horse is insured for LoU and when I switched to them no vetting/x-rays were requested, and I've only ever heard of x-rays being required for LoU insurance with a seriously expensive horse.....

Their competition horse policy is slightly different from the normal ones in that you can't 'mix and match' bits of it - so you have to have the LoU cover and if you don't want that then you need to be on one of their different policies.

If I have no joy on Friday with KBIS I'll try Amtrust. I do want LoU and my horse isn't seriously expensive (on the scale of things - expensive to me tho) so maybe the competition horse policy would be the one for me. if they don't want X-rays etc so much the better (I know how much that can all add up to).

 

[philamena]

Philamena - if it's not a rude question, how much is your horse insured for and are you on their competition horse policy (which you did used to have to ring up for rather than get a quote online).

I only ask because my horse is insured for LoU and when I switched to them no vetting/x-rays were requested, and I've only ever heard of x-rays being required for LoU insurance with a seriously expensive horse.....

Their competition horse policy is slightly different from the normal ones in that you can't 'mix and match' bits of it - so you have to have the LoU cover and if you don't want that then you need to be on one of their different policies.

Not rude at all. She's insured for 10k which I think is their scary threshhold where lots of stuff kicks in costs wise. I did have to ring up for the quote and the policy worked out cheaper partly because they helpfully don't lump intermediate eventing in with the pre novice eventing, ie you don't pay for intermediate level risk if you're only at pre novice at the mo. So that was helpful, but I'm pretty sure that if i were shopping for insurance now I'd insure her for less.

 

[fabscd]

Give it ago before just jumping if you are otherwise happy with the service. Normally you can get exclusions lifted with the provision of a vets report. I am with KBIS, and actually found them quite reasonable with their exclusions. The excluded the specific bits that were affected, rather than petplan who, because i had told them i *might* be claiming sometime in the future because i was having some investigations done into my horses movement, excluded the spine and all musculature associated with it! Due to this and my premium having gone up by nearly 40% over the last 2 years without any explanation other than 'prices have gone up' (and yes, that is word for word what was said) I jumped ship to KBIS!

 

[Holidays_are_coming]

When I decided to leave NFU, I got quotes and sent full vet historys to SEIB and KBIS, she has had a few minor things ie, allergic reaction to something, and a minor blunt trauma to her tendon and a few Major Sarcoid, and a major hoof injury.

SEIB excluded her sarcoid and the hoof and that was it, KBIS wanted to exclude her front legs, all skin condtions, as well as sarcoids and the hoof. Well I went with SEIB and they have been fab with her ulcers, the renewal exclued her whole digestive system so I called them and they changed it to just Ulcers. Most companys wont need a new vetting Just Bills vet history since he has been with u.

 

[Alibear]

Philamena - if it's not a rude question, how much is your horse insured for and are you on their competition horse policy (which you did used to have to ring up for rather than get a quote online).

I only ask because my horse is insured for LoU and when I switched to them no vetting/x-rays were requested, and I've only ever heard of x-rays being required for LoU insurance with a seriously expensive horse.....

Their competition horse policy is slightly different from the normal ones in that you can't 'mix and match' bits of it - so you have to have the LoU cover and if you don't want that then you need to be on one of their different policies.

Sc Macnamara was on Amtrust's competition horse policy and they didn't even look at any x-rays when they paid out for his LOU due to navicular.They just took my vets written report and were happy with that. He was insured for 5K.

 

[ecrozier]

We also got an exclusion on J'a hindleg lifted - he had a mystery lameness for about a month when he was 6, probably a tweaked muscle or similar but never reoccurred or caused any more problems. Initially they excluded that whole leg but managed to get that exclusion lifted completely. That's with seib though.

 

[Nats]

I moved to KBIS in December and the policy has a bilateral front exclusion for SDFT, DDFT, check and suspensory ligaments as my horse is currently being rehabbed after a torn check ligament. At the time, they said they were less concerned about check ligaments than tendons and that I could probably have the exclusion modified with a vet's letter once the injury had healed. Of course that could just have been to get my business

 

[NR99]

Not, in my experience, with KBIS in recent years, no matter what your vet is prepared to write

My experience too, whilst they were very nice about they said their hands were tied by the underwriters. Horse had one a bump (tiny) on foreleg on purchase having had an injury as a baby and vet stated would cause no issue, they asked me to get it xrayed which I did, they cam back clear showing surface only but they still excluded that leg.

 

[NR99]

When I decided to leave NFU, I got quotes and sent full vet historys to SEIB and KBIS, she has had a few minor things ie, allergic reaction to something, and a minor blunt trauma to her tendon and a few Major Sarcoid, and a major hoof injury.

SEIB excluded her sarcoid and the hoof and that was it, KBIS wanted to exclude her front legs, all skin condtions, as well as sarcoids and the hoof. Well I went with SEIB and they have been fab with her ulcers, the renewal exclued her whole digestive system so I called them and they changed it to just Ulcers. Most companys wont need a new vetting Just Bills vet history since he has been with u.

I also switched all horses to SEIB following a recommendation from a HHO friend and they have been brilliant with Cruises SDFT injury. Can't fault them!

 

[gunnergundog]

KBIS in my experience were the master of the exclusion clause. I only ever succeeded in getting one lifted....after paying for a 5 stage vetting.....one horse ended up with two pages of A4 exclusions! Ridiculous!

Not sure if they still cover eventers but the one insurance company that I would recommend is Bloodstock & General in Newmarket; we had quite a few TBs insured with them but they also covered my eventers and were IMO very pragmatic about things.

 

[LadyRascasse]

I have successfully argued an exclusion with Petplan (lameness - yes a full blanket exclusion on lameness) but I had to provide a vet report which specified his problem and why it won't affect tendons in the future etc

 

[Rollin]

Years ago NFU tried to exclude all claims for hind limbs after my unbroken filly ran into some wire whilst being loose schooled for 5 stage vetting. As the vet was present she was treated immediately and only suffered minor cuts. Actually the NFU broker agreed with me and this exclusion was lifted.

However, now I live in France I insure with Carriage House who are brilliant. I have only made two claims in 15 years and they have never given me any hassle.

 

[kaiserchief]

It's well worth writing to them and asking for them to only exclude the injured leg then next year writing again if there's been no recurrence to ask for a full removal of the exclusion. They may ask for a letter from your vet to say that in their professional opinion the other leg isn't at risk.

I have always found KBIS to be excellent to deal with. When I bought my pony he was very poor and had severe mud fever which needed to be treated by a vet but under my care it has not recurred so when mud fever was listed as an exclusion on his insurance renewal I phoned and queried it and they agreed to remove it immediately.

Give them a call - the worst that will happen is they'll keep the exclusion on there for a year and if there's no recurrence reconsider removing it.

 

[Worried1]

I successfully got KBIS to lift an exclusion and have stayed with them ever since.

Diva was vetted in our absence, despite it being a very wet day and the only hard place to lunge was on a slope the vet asked for her to be lunged.

She took a couple of short strides, in line with conditions and the slope.

The vet was not at all concerned and passed her.

We bought her and were horrified when the insurance came through and found BOTH front legs excluded for ANYTHING except injury with an external wound.

We argued and they asked for x-rays, these were sent but discredited as too old, we agreed to re-xray at our cost. My vet was explicit in asking what views were required.

So her shoes were removed, x-rays done and sent off along with vet report giving clean bill of health!

KBIS came back and said they wanted alternative views, I went ballistic and did my vet! Lots of phonecalls and emails went on and I threatened to take them to the FSA and claim full costs.

In the death they sent their own vet to re-vet her at their cost... Funnily enough she passed no problem!

Since then they have been very good and paid promptly!

 

[Lill]

I have just changed from KBIS. They kept re-adding an exclusion for any problems arising "directly or indirectly from a foot abscess". Which i argued with them about, as the abscess was caused by standing on a NAIL. So wasn't just random or anything. They then added another random vague one so have cancelled them and trying Petplan now, albeit with a different horse!

 

[popsdosh]

I successfully got KBIS to lift an exclusion and have stayed with them ever since.

Diva was vetted in our absence, despite it being a very wet day and the only hard place to lunge was on a slope the vet asked for her to be lunged.

She took a couple of short strides, in line with conditions and the slope.

The vet was not at all concerned and passed her.

We bought her and were horrified when the insurance came through and found BOTH front legs excluded for ANYTHING except injury with an external wound.

We argued and they asked for x-rays, these were sent but discredited as too old, we agreed to re-xray at our cost. My vet was explicit in asking what views were required.

So her shoes were removed, x-rays done and sent off along with vet report giving clean bill of health!

KBIS came back and said they wanted alternative views, I went ballistic and did my vet! Lots of phonecalls and emails went on and I threatened to take them to the FSA and claim full costs.

In the death they sent their own vet to re-vet her at their cost... Funnily enough she passed no problem!

Since then they have been very good and paid promptly!

On this one I would blame the original vet more than the insurance company because if they were not bothered by it why did they mention it.
Just be aware as it can easily pass you by but most insurers are writing a general exclusion into their policies along the lines of.
They will not pay on any condition that has occurred before including problems you may not have claimed for.It is very common also when you make a claim for them to ask for the horses complete veterinary history before they will pay.
I never insure any of my horses anymore but I always found it was a lot easier to keep exclusions to a minimum by actually talking to them when a claim was made that may lead to an exclusion .For example I had a mare that had colic and the NFU agreed that as long as there was no recurrence before renewal they would not exclude colic on the policy.Sometimes it pays to be proactive about these things

 

[Wilbur_Force]

I am now having a complete flap because I've recently changed to KBIS from NFU despite being with them for 6 years. Huge increase in premium but perhaps from reading this thread, the reason why KBIS are so reasonable cost wise is because they exclude everything! Oh dear

 

[star]

I've been with KBIS for 12yrs and wouldn't change. I have got them to lift unreasonable exclusions and the others that have been placed have been understandable. insuring animals against vets fees is approaching being a loss leader for the insurance companies. so far in 12yrs and 3 different horses I've claimed about 10k. I reckon I've paid out about 3k in premiums. I guess this cant apply to everyone or they would be out of business but with advances in vet medicine premiums are only like to go up further and the only way to keep them slightly in check is to place exclusions.

my youngster had an exclusion placed for anything related to mediolateral foot imbalance after his vetting - rather broad but fair enough as foot imbalance can cause lameness. after a year of corrective trimming and then perfect feet I got farrier to write a letter saying feet now perfect and they lifted it no probs. however, he also had a sarcoid when i got him so is now excluded for those and has since had OCD in his stifles and they have just excluded his stifles so I really haven't found them unreasonable.

 

[whiteclover]

Im with KBIS and am not happy that theyve put an exclusion on my insurance policy as well. I wont be renewing with them.