Horse Insurance dragging their feet! HELP PLEASE

Joined
25 May 2010
Messages
3
Hi everyone!

I was hoping that you could offer all your knowledge as i am absolutelty fed up. I have a very knowlegable friend that has given me some advice but i would like to consider the extent of the law before going in all guns blazing.

My horse was insured with horseinsurance.co.uk, she was only covered for public liability, death and disposal as she had a major op in 2009 and i decided that i would not put her through the anaesthesia again if something was to happen. When taking out my policy my insurance were told all of the facts regarding her injuries and didnt/havnt disputed them.

Sadly, in june 2014 I had to make the heart breaking decision to have her put to sleep after owning her for 10 years due to a horrendous bout of laminitis that onset very quickly and absoulutelty crippled her. she could hardly walk and by the time the vet had arrived i knew what her advice was going to be anyway. We followed the advice and the vet assured me that even if we were to give her £20,000 there is nothing that they could do. We dealt with the whole situation and got the papers to make a claim against the insurance and paid the vet bill off in full until we got the claim through.

The insurance revceived the claim papers in June 2014 and yet we are still constantly having to get onto them now!! They are just totally dragging their feet!

In July the insurances response was that they had requested more information from the vets as they had made a slight contradiction between the notes and the way she had filled in the form. Us chasing this went on for THREE WHOLE MONTHS! My vets have been very coherent and have a whole log of the dates they have sent the replies and yet the insurance were saying that they hadnt recieved them as in this time my mum was on the phone to both vets and the insurance tryibng to co-ordinate the safe delivery of the email!!

At long last my mum managed to co ordinate it and had to get ba member of staffs personal email and get it sent to that. they confirmed that they had recieved it after my mother demanded to speak to the same person and got them to check their email whilst she was on the phone. But guess what!?!?! A week later they were telling us that they hadnt recieved the email! Anyway my mum yet again sorted their mess.

It went to the assessors which again said that they wanted more information and it is just carrying on like this. They have all of the information that they need and yet they are still dragging their feet. At the point my mum coordinated all of the emails she put in a verbal complaint upon the phone but i have no faith at all that this will have been recorded.
This has now dragged on for 8 months and i absolutely fed up of having to be on the phone to them.

I am looking at going to the financial obudsmand but it says on thier website that you should first use the compaines own complaints procedure... we did log a complaint but it was verbally, do we now have to go and log a written complaint??
And if so i want to be able to word it properly stating any laws that they are in breach of, i read somewhere that they must pay out promptly by law, is this correct?
Am i able to just go straight to the ombudsman??

Any advice will be greatly appreciated.

P.S. I know i have broken the number one horsey insurance rule by insuring with e and l haha but i had no idea it was them until we had to start being on the phone all of the time!
 

webble

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8 August 2012
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Border of Cheshire/Wirral/ N Wales
Sorry to hear about your horse. To offer you hope I had the same issue with them in that they took a long time to pay but they did twice!! They are/ were in the process of changing systems which hasn't helped.

I put my claim in in Aug 2014 and they paid in Dec 2014 and that was with leahurst taking 3 weeks to send the paperwork so yours does sound long winded but the paperwork issue could be making it longer. It doesn't mean they wont pay they just have to make sure everything is in order and if there were contradictions a delay is understandable. Do you have the dates from the vets of when everything was sent? I only ask as I was shocked at how long leahurst took

eta I think you are local to me just to let you know for future both Wrexham vets and leahurst logged my bills with their accounts as insurance pending so I didn't have to pay up front. I think that also gave the vets the nudge to get things done!
 
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Merlin11

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Sorry to hear of your troubles. They should treat a verbal complaint as a formal complaint but it may be worth putting in writing as well. At least then you have a formal record as well. I had my horse PTS in the summer due to laminitis. The insurer had to agree to it before they would pay out and it had to meet the BEVA definition. They paid out but it took a few months. I am with petplan.
 

ester

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did you speak to the insurers before PTS, are they suggesting that it did not meet the BEVA definition? Though presumably vet does.
 

chestnut cob

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Put the claim in writing. Make it as brief and succinct as possible - tell them precisely what your complaint is (no emotive language etc), supporting facts, and what you expect them to do about it. Then tell them that if you don't receive a decision in your favour/ the reimbursement within 14 days, you will complaint to the relevant governing authorities. Send it recorded/ special/ signed for delivery. You can also send it by email and they have to treat it the same was as a letter.
If they have turned down the claim, they need to tell you why. since your vet's advice was PTS, they shouldn't be able to refuse to pay.

Hope you get it sorted.
 

Emma_H

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4 December 2012
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395
Threaten the ombudsman and watchdog, I had same issue with your insurer which is actually E&L and the threat worked........eventually. It wasn't pts was colic claim with major delay tactics.

As it goes, I also had issues with Petplan on pts claim, they paid eventually after discussions with vet.

Good luck, don't give up xx
 

Pinkvboots

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25 August 2010
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10,959
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Hertfordshire
I am insured with the same company and I too did not realise it was E and L either until it was too late and they are known for being slow, they took 3 months to pay out for one claim which was fairly straight forward, I have another claim running with them at the moment and it first started in May 2014 and they have still not paid a penny and keep going back to my vet asking for more information, they will try any old reason to not pay out and after this claim is finished I will be looking elsewhere.
 

Goldenstar

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28 March 2011
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My friend has been down this path , you have to exhaust the complaints procedure with the company before the ombudsman will assess the case .
I think you will need to make a formal complaint in writing .
My friend got her money in the end but it took years something like two or three
 

unbalanced

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30 January 2011
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1,142
Hi. My heart is breaking for you because if I had had to deal with this when I lost my girl I don't know what I would have done.
My boyfriend is a claims adjuster and says you need to make a written complaint (keep a copy) then leave it 4-6 weeks. They are hopeless and the only thing they will notice is the threat from a regulator. Then contact the financial ombudsman. It's important you have made the complaint first as they can't get involved otherwise. Mostly insurance companies roll over for the ombudsman so this should sort it out for you.
Just keep correspondence in writing and keep copies and proof of postage from now on.
 
Joined
25 May 2010
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Thanks everyone so far. I am with Leahurst also and had the full backing from the vets and nikki at the practice. They were absolutely fabulous and dealt with absolutely everything for me as I was absolutely devastated!
At the time of putting brodie to sleep I didn't care if she ticked the boxes and BEEVA guidelines etc I could as she was in excruciating pain and that we really had no other option. By the time the vet had come and examined her and given me time to try and say goodbye with lots of kisses etc it was gone half 11 pm on a Saturday night. They arnt open on a Sunday and so there is no way of approving a putting to sleep and she was on agony. Their argument isn't with that either as when deciding whether to submit a claim I had a long conversation with the vet and she assured me there was nothing that could be done. The BEEVA guidelines outline what circumstances it is appropriate for immediate euthanasia and the vet put this in her notes that it was not suitable to keep brodie going etc.
I just think they show no compassion at all, I lost my baby who I had owned for 10 years and now 8 months later the case to try and get what is rightfully ours is still going on. They can drag their feet because as of in the morning I will be on the phone for a full copy of their complaints procedure and I will be on to Leahurst for signed copies of any correspondence that has between the vets and any third party regarding brodie because this is ridiculas!!
 

Goldenstar

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28 March 2011
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Getting upset and emotional over this is not going to help .
You need to be calm if the horse was PTS in line with guidelines I think you will in time get your money.
Companies like this have no emotion IMO they feet drag and make things difficult for you in the hope it's all too much for you and you give up and go away .
So just calmly follow their complaints procedure and if you don't get the judgment you want go to the ombudsman .
I forget if if it was two or three years it took my friend to go through the whole process but she won in the end .
 

shergar

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19 August 2012
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426
If the insurance company fails to send you a final answer in 8 wks or one you are not happy with ,you can ask the FINANCIAL OMBUDSMAN to investigate on your behalf .
Financial Ombudsman consumer help line are open Monday -Friday 8am _8pm 0800 023 4567.

May be a call from the Ombudsman will make them take notice.
 

Elbie

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22 August 2010
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Colchester
There are rules in place as to how quickly they have to respond to complaints. The definition of a complaint is quite vague so they should have dealt with your verbal complaint appropriately, clarified that you wanted to formally complain and then went through the appropriate channels. Insurance bodies are coming down quite heavy on Consumer Acts and Conduct Risk, how complaints are dealt with and what companies can/can't do.

For your claim to still be outstanding is completely unacceptable. Even if you sent in your claim on a scrap of paper and nothing else I don't see how it would take this long (I say as someone who works in equine claims).

Send them a recorded letter stating that you are formally complaining and expect resolution within 8 weeks. If you aren't happy then you can forward to the FOS
 
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