Frustrated with Insurance Company

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NR99

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Have a 7yo TB who had to have a lameness work up recently as has been very naughty when ridden in the school, he can be a so and so on the XC but when it started in the school I knew something wasn't right, various investigations have followed, called vets as after one violent outburst he was clearly lower on one side of his pelvis than the other, as he walked back from the school it became less obvious. They had him in for a lameness workup and tests managed to show lameness in all four legs either on straight or circle as well as her suspecting pain higher up in the pelvic/sacriolac region. She wrote a full report requesting authorisation of a bone scan from the insurers. As I have exclusions which the vet is aware of, on relating to lack of topline on purchase, one relating to a slight roll over of the fetlock joint on near hind and one to a slight muscle lost on near shoulder (about fist sized vet says probably had since baby) they are refusing to pay for the scan unless a diagnosis is given as they say some of the things in her report may apply to the exclusions, vet says she can not diagnose without the bone scan. I can't afford a bone scan at the moment and TBH that is why I have paid £900 in insurance since we bought him in August 08.

Where do I go from here, I feel like I am in catch 22 no bone scan no diagnosis and no diagnosis no authorisation for the scan.

Sorry I know you all can't really help, just wanted to rant to people who will understand as they are looking at me like I am a bit weird in the office.

Thanks for getting this far, afternoon cake for anyone that did x
 
Very tricky, I can see your POV and the Insurers POV to be fair.
In your situation, and assuming you trust your vet, I would ask them for the probabilities based on their experience of the bone scan showing up a pre-existing/excluded condition and then decide whether to risk having to pay for the bone scan yourself.
 
KBIS - previous horses insured with E & L and I know they are a Vets nightmare but they have always paid out on mine (even if I have needed to argue my case first). Unfortunately as this is my first time with KBIS I don't know much about them.
 
Sounds similar to something I have been through, who is your vet?

What exactly has the vet done so far by way of blocks/x-rays etc etc
 
I went through a similar sitituation with my young TB. I took the gamble and had the scan done as my vet was so convinced that it would show the problem up however it didn't show what they thought it would. The vet at the RVC told me that only about 50% of scans carried out actually show up the problem. I dont think I would bother having one carried out again. They eventually found the problem by doing extensive nerve blocks and found he had PSD in both hinds. I'm still locked in battle with SEIB over my horse. Long story but get some advice on your policy and double check every little detail time and time again with your insurer.
tongue.gif
Good Luck
 
Not a terrific amount yet. I called them out because of the pelvic misalignment and because I said before that I don't think it is just misbehavious because he gives off all the signs of a horse happy in his work obedient etc and then bam there is an explosion. He had a nasty moment on the Sat, I called them out on the Monday and by then he had developed a curb on near side hock. I have also changed farrier as I was concerned that his shoes were too small and not giving enough heel support. That farrier concurred and said he had pain in the heel and lands on his heel (near fore), so I told the vet when I sent him the next day for lameness workup etc they still nerve blocked that foot and said it got better but not totally and it threw the lameness to the other foot. they did the various elements of a lameness work up, ie hard,soft, striaght circle and concluded he was lame on a circle or in a straight line on each leg so needed a scan as did not no where to start. I still feel his main problem is Pelvic/SI related as despite improving his overall topline we have not been able to significantly improve a weak rump and he has a Hunters bump, although I think there may be other underlying issues in his legs, the Pelvic area is the one I think causes him the pain and therefore the sudden violent reaction.

I could go on and on but do not want to bore everyone.
 
Thanks for the advice, I will do it is just so frustrating that with such a comprehensive policy I am stilted before I have even started!

Good luck with your wrangling.

X
 
Feel free to pm me on this - I wont be bored if you do a long rambling essay as I too have had a nightmare with insureres on a multi-limb lameness!
 
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