Disputing Insurance Decision

[Marv99]

A bit of a plea for help to you all!

Last summer my horse went lame. After much diagnosis my vet came to the conclusion that it was arthritis in his fetlock joint due to poor confirmation and treated him with cartrofen injections (sp!). I toook out the insurance policy on the 13th June and my horse went lame towards the end of July. However my insurance company have claimed that it was an existing condition and have refused to pay out.

At the time I had a lot on my plate as I was getting married and we had a severe illness in the family. Although I tried to dispute the insurance I gave in when they stoutly refused to consider my claim the condition was not pre existing.

Anyway my horse has now gone lame again. The vet thinks it may be the same problem and has treated him agin with another cartrofen injection. I am now faced with more bills however my vet believes since I am still within the twelve months from when he first went lame I should dispute the matter with the insurance and claim for the cartrofen and the previous treatments.

So big thanks for getting this far but what I want to know is how to I go about challenging the insurance company again! Any ideas/experiences would be gratefully received.

 

[soloequestrian]

Ask Consumer Direct - look them up online for the number, they're very helpful.

 

[cptrayes]

Was your horse vetted on purchase? If not, I'm afraid it doesn't sound like you have much chance to be honest. Arthritis doesn't usually come on in 6 weeks, it's a gradual degeneration before it causes lameness and your insurance company is probably right that it was a pre-existing condition. The fact that you didn't know didn't make it not there when you insured him.

Your vet did you no favours if he told the insurance company that it was due to poor confirmation. If they have that information, forget it, you won't have a snowball in hell's chance of a payout, because the poor conformation predisposing arthritic changes WAS a pre-existing condition.

I'm sorry about his problems, I hope you can get through them and have him back sound again.

 

[charlie_brown1]

We put our cob out on loan at the start of December 2009, and took insurance out on him and he had a bit of a slip on the mud at Xmas. The loan lady said she had never heard a horse squeel like he did. So got vet out and ended up being spavin, had the xrays, injections etc and the insurance have just paid out! The vets said that it was possisbly an old injury that may have caused it. Poor old soul. I made a claim and they paid out.
Mandy

 

[ducktails]

what insurance company are you with?

 

[Donkeymad]

I'm sorry but I have to agree with cptrayes. Arthtritis does not come on in several weeks, and if it was indeed caused by bad conformation, then it is very definately a pre-existing condition.

If you do wish to try to over turn the decsion, a eltter from your vet stating WHY it is not a pre-exisitng condition, would be the way to go. Afraid I don't think you have much chance.