Has anyone claimed for ulcers and a soundness problem at basically the same time?

[Tash88]

My horse has had a few issues for about 6 weeks - general unhappy demeanor and reluctance to go forward with some right hand lameness behind when not going forward properly, also clearly uncomfortable when I do the girth up. After some dithering on my part and trying different things I had him scoped which revealed Grade 3 ulcers and treatment was started. A week later I had a lameness work up which has revealed stifle problems (3/10 on left and 4/10 on right after flexions) and he has been referred to hospital for x rays and probably arthroscopy as the vet thinks he has OCD.

The dithering was because the symptoms were inconsistent and there was no acute onset of the lameness, also quite frankly I was scared of what I might find.

I have submitted two separate insurance claims but I am worried that the underwriters will see the two as linked, and the ulcers could have been caused by the lameness, but it would be difficult to prove that. They could have also been caused by the fact he isn't good on grass (it clearly doesn't agree with him so he has no grass now and lucerne hay) or a hundred other things, but the ulcery behaviour definitely came on before the lameness.

I need to have two separate claims really as both are expensive courses of treatment and I want to do the very best for my horse. He had a five stage vetting before I bought him just over a year ago and passed that, and has no exclusions.

Does anyone have any experience with this kind of thing? My vet has looked at the claim forms and is satisfied that both will be processed as separate incidents.

Many thanks x

 

[HeyMich]

I had 2 claims within a few months last year, one for ulcers (similar symptoms to yours and also scoped positive) and one for a field injury, so not directly linked. It meant that I had max claim allowance for both issues, but unfortunately had to pay the excess on both claims. I'd just take your vet's advice and claim accordingly.

Good luck, hope your horse recovers well.

 

[Tash88]

Thank you for the quick reply - it doesn't help that the same horse also had a field injury a couple of months ago but it was a front leg that was injured with no ongoing issues, and I think they have paid out for that now.

I don't mind about paying the excess (a total of £400 isn't much compared to what the vets fees would be) but I just want the £5k for each incident. I don't care about exclusions either, I am expecting those, just want to do all I can for him right now.

 

[teddypops]

Does your vet think they are related?

 

[Tash88]

Does your vet think they are related?

No, she hasn't said that and she is fully supportive of me raising this as two incidents.

 

[teddypops]

No, she hasn't said that and she is fully supportive of me raising this as two incidents.

You should be ok then. I have 2 separate claims going on at the moment, one for lameness and one because my pony fell over a few times. Vet happy they are not related and ins co agreed.

 

[be positive]

I think I would proceed with caution, your vet may see them as not being linked because he is working for you, the ins co vets may see things differently, if you have had the vet involved in the grass issue and he is convincing enough that his intolerance to grass is the cause of the ulcers then you may be fine but if there is no history of trying to sort that issue I suspect they may say the two are linked, and they may well be as he is bilaterally lame so it could have been going on for some time , so they may try putting the two claims together.

I would want it clarified before agreeing to surgery if money is an issue, I would also want a good idea of the prognosis.

 

[Tash88]

I did mention the grass issue to my vet when she came to do the scope, but I didn't put that on the claim form (she may have done though, I haven't seen her side of it yet).

Money is a bit of an issue but it will not stop me getting it sorted if that makes sense, I agree with having a clearer idea of the prognosis as well; my horse is having x rays done at the hospital the day before the surgery is booked for and the surgeon is going to call me with the results (I can't be there as have work meetings I can't get out of) so if the prognosis isn't good or there is a less invasive treatment recommended I may not go ahead with the surgery.

The vet said that my horse's two issues could be linked but there is no way of proving it as neither have come on overnight, particularly the ulcers as they are grade 3, and it is probably my management and the fact the horse hasn't been pushed that have stopped them becoming much of a problem if that makes sense. But the main thing is that they are being dealt with now and hopefully the insurance will help me to do that, after all I am paying £74 a month.

 

[ihatework]

One I had insured with KBIS wouldn’t let me make 2 separate claims, they were wrapped up as one

 

[be positive]

I don't think the insurance company need to prove they are linked, it will be more for your vet to prove they are not, which is going to prove hard as neither came on overnight and it is highly likely they will link them, you may pay £74 per month but are not likely to ever cover the potential £10k in costs so I would be preparing to pay whatever the difference is once the £5k limit is reached, if the stifles are sorted and the management is right the ulcers should resolve fairly quickly so may not run up too high a bill.

 

[Bellaboo18]

I've got my fingers crossed for you but to be honest from reading your OP they definitely sound linked. Like bp says, it'll be for your vet to prove they aren't linked. Good luck.

 

[maya2008]

I did. Lameness ongoing, then injury giving box rest. Colic within 24 hours, with ulcers on investigation. So ongoing lameness claim, injury claim, colic/ulcer claim...! All paid out - NFU.

 

[Tash88]

Thank you for the replies yesterday evening. I haven't heard from them yet but I am expecting them to link them, but it depends on what my vet said really.

I do have a way of paying if I can't get two incidents, so my horse will not go without but it is a shame that insurance could potentially prevent people from having the best treatment for their horses in situations like this.

 

[emfen1305]

I claimed for ulcers, hock arthritis (inc bone scan) and PSD (diagnosis and surgery) at the same time under 3 different claims - ulcers and hocks came at the within the same claim period and the PSD claim was started a month before the end of the other two so still within the same period but had already maxed insurance out. This was with NFU.

 

[fusspot]

I had this problem.My boy was showing signs of Ulcers and was booked in for a scope.On morning I was taking him to the vets he had a large swelling along his jawline.Absoloutely no signs of anything before and eating etc fine-I thought he may have been stung! Whilst at vets after scoping they had a good look in his mouth and x rayed and he had a tooth root infection.After 5 days of antibiotics etc at home the swelling didn’t subside and he was in vets for 2 weeks on IV antibiotics but within 48 hours of IV being stopped the infection re appeared.He ended up having tooth removed.
I put in the first claim for the Ulcers and a separate one for the tooth so should have been covered for £5000 each thing-the Insurance put them together as said the tooth problem had caused the Ulcers even though the tooth problem had only just appeared that morning.Vets wrote in saying there was absolutely no connection but they wouldn’t take it and ended up costing me because they would only pay out £5000 for whole lot.Hope you are luckier than me.x

 

[Tash88]

Thank you Emfen and Fusspot - more interesting stories.

My horse had an accident at the beginning of June and had to have nearly a week of box rest; he has made a full recovery thankfully (front leg so not connected to the stifles) but I have £4k left on the insurance for that one so my vet might make the connection between that and the ulcers which would be plausible given what happened and the timescales. I would be fine with that and then having the stifles under a separate claim, if I can't have all three under separate incidents which is the ideal.

I am with KBIS if that makes any difference. NFU seem to be good from your stories!

Tash x

 

[emfen1305]

My advice would be to try and get ulcers on a separate claim if possible or onto the front leg injury as I maxed out 5K after 4 scopes and 3 rounds of treatment - they are very expensive, it all depends on your vet and the insurance company!

 

[fusspot]

Thank you Emfen and Fusspot - more interesting stories.

My horse had an accident at the beginning of June and had to have nearly a week of box rest; he has made a full recovery thankfully (front leg so not connected to the stifles) but I have £4k left on the insurance for that one so my vet might make the connection between that and the ulcers which would be plausible given what happened and the timescales. I would be fine with that and then having the stifles under a separate claim, if I can't have all three under separate incidents which is the ideal.

I am with KBIS if that makes any difference. NFU seem to be good from your stories!

Tash x

I was with KBIS at the time-had 3 insured for over 10 years with them.They then tripled my policies so I moved them all to NFU-within 2 months of moving my sons first pony went down with Laminitis -she had cushings but shown absolutely no symptoms.We lost her New Years Day morning and NFU were brilliant-paid out everything for her inc her value-didn’t expect anything apart from vets bill and disposal even though she had only been insured for 3 months with them in the end.

 

[Tash88]

Sorry to hear about your son's pony. Sounds like NFU were brilliant and I've heard about KBIS massively increasing premiums after claims (surely the exclusions are enough?!) from a few people now so I may well swap to another insurer afterwards, although won't be able to do that until October 2020 as this October I will still be in the middle of these claims.

I think NFU is a bit of a hassle for some people because you have to go into the office and speak to them rather than doing it online, but they have an office not too far from me and I'm sure it will be worth it!

 

[fusspot]

Sorry to hear about your son's pony. Sounds like NFU were brilliant and I've heard about KBIS massively increasing premiums after claims (surely the exclusions are enough?!) from a few people now so I may well swap to another insurer afterwards, although won't be able to do that until October 2020 as this October I will still be in the middle of these claims.

I think NFU is a bit of a hassle for some people because you have to go into the office and speak to them rather than doing it online, but they have an office not too far from me and I'm sure it will be worth it!

I did all mine over the phone-cheaper and got more included.x

 

[emfen1305]

I did mine over the phone too but I heard they were scaling back their equine offering in certain parts of the country as they are no longer as competitive!