Horse unrideable and insurance dilemma

J

Jenniferdella1

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This is also under KISSING SPINES in veterinary.

My horse is a TB, 7 yr old mare, ex-racer. Had problems which worsened after a few weeks of having her. I bought her in November, 2008. Insured her from the day before she was delivered. I thought her problems due to my lack of experience and her being a TB. She has been dx with Kissing Spines, the latest is that the vet feels she carries too many uncertainties for the spine surgery though he is willing to do it......he is a vet surgeon after all...it is the 12 weeks post op intensive rehab that I have to pay for that'll kill me financially and the fact that this is a horse I would never wish to ride myself again after my confidence being knocked out of me (not her fault, she was in pain).

My insurance company which could be called No Flippin' Use!! have said they'll pay for her surgery up to 5K and for any other unrelated claim but will not pay out for euthanisation (insured for at 2.5K) or loss of use (£750) for which my policy says I am covered for!? I'm incredulous and what the heck do I do now?

I cannot give my mare away, I couldn't bare the thought of her being drugged and sold on, she's way too TB to be a companion, I've tried putting her with another couple of mares and she's very dominant, she needs to live in in the winter anyway and she cannot be ridden as the vet said she's too dangerous to carry a rider and her KS's and bone spurs are right under where the saddle sits!..............and he even said that even if she had KS surgery there's no guarantee at all that she'll ever be rideable.

I'm now in a real dilemma as I am sure she's in pain anyway........rider or not. The vet tried to but said it was impossible to get her to even canter on a lunge line (that was without a saddle or anything on her at all). He spoke to 'that' insurance company and their vet specialist said they wouldn't pay for a euthanasia claim even though my vet is fully supportive of that decision. I cannot give her away as I'm scared she'd end up as live export. What can I do? Apart from being even more out of pocket by paying for her to be pts myself.........what the heck was the point of my insurance?

In the meantime after much discussion, tears and heartache she will be euthanised next week.

I will be taking this to the ombudsman but if anyone has has a similar experience and can give me some advice I'd be very grateful.
 
OMG that's awful - really sorry to hear about your horse.
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However, your insurance company seem to be contradicting themselves a bit - are you absolutely certain that is the course of action they intend to proceed with? If it is then you need to try and get it sorted out before you have your girl PTS.
 
So why did the insurance company say no to paying out for euthanasia? Are they saying that you have to have the surgery? Sounds ar$e about face to me as that would cost more for the surgery than euthanasia and the LOU
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Is cr*p and hurts, I know. Hugs to you hunny.
 
How awful! Have you spoken to several different people at your insurance company or just one? Prob pointing out the obvious but have you spoken to the highest up person in the company you can get hold of on the phone?
 
My only suggestion is to talk to your vet and see if he will talk to the insurance company.

If the vet says the only/best option is PTS/LOU then the company may accept that.
 
how awful for you
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i just don't understand how your insurance can refuse to pay out for PTS when the vet is clearly recommending this is the best option. i'd try and talk to most senior person possible at your insurance company and i'd also take your insurance details to citizens advice and ask them to have a look for you or maybe ring the BHS advice line. i think you need to have a legal specialist look at this....
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I can understand why your insurance company won't pay out for euthanasia. Insurance companies will only agree to a mortality payout if there are no other options (e.g. surgery), and welfare would otherwise be compromised. If a horse can be maintained as pasture sound then a mortality claim cannot be made. There are detailed notes on the criteria for mortality insurance claims on the British Equine Veterinary Association website.

However your horse sounds like she could be a candidate for a LOU claim, and I am suprised that your insurance company have completely ruled this out. The fact that your horse has been given a poor prognosis for returning to her previous/intended level of work is in your favour although the insurance company may insist that you go ahead with the surgery and rehab before they accept that this is the case, but with your vet's support you may be able to get them to reconsider.

I think you have made the right decision for your mare. It is a horrible situation to be put in, and it makes it even worse when the insurers don't seem to want to act in your horses best interests.
 
Thanks for the feedback everyone. This forum has been such a source of wisdom, comfort and advice since I've had problems with my mare.

I will be calling the insurance co again tomorrow morning. I couldn't bear to think of my mare going through surgery then rehab (even if I could afford it, ins co said they'll not cover all of that) and then be landed still with the poss of an unrideable horse who may have to face being pts anyway.

Apparently this is not so rare as I thought and one of my friends is a lawyer so said she'd write on my behalf if they will not reconsider. I'm still incredulous, just when I'm emotionally upset about the fate of my lovely mare and then to be dumped by the insurers. They seem to think that if surgery is poss then I should go ahead. Seems crazy to me.
 
I've spoken with insurer's so did my lawyer friend. They say I'm not covered for LOU but the wording of my policy suggests I am.

My main issue is around them not supporting my vet's view that the fairest option for my mare would be euthanasia. They've basically asked me if I can put her in a field if the surgery removes her pain but as the vet has said he's not 100% that's the whole reason behind her pain I don't think I can condone surgery.

I've appealed and instigated an investigation by the Ombudsman as my policy contains 2 statements re euthanasia.

A) is humane destruction whereby euthanasia should be immediate and can be done by a vet without their (the insurer's) consent (as in sudden illness or broken leg etc...) and

B) which states that the horse can be euthanised with their prior written consent upon the advice of a vet when the euthanasia doesn't have to take place immediately or where there is no urgency.

I was convinced my mare came under rule B).

I do understand there are plenty of chancers out there but I'm terribly disappointed by their decision.

I was advised to get another vet's opinion and then that will be another lot of vets fees for which I'm not sure I'm now covered. They have agreed for their 'other' vet specialist to call my own vet to see if he (the insurer's vet) agrees with the other claims vet!
 
Thanks to everyone who has kindly given their advice and shared their experiences.

My lovely mare was put to sleep this morning.

Many avenues were explored regarding her being a companion (she was too TB'y and bossy) and the blood bank (she was not suitable). She has been getting worse and its obvious from just watching her in the field that her back is becoming more and more of a problem. Vet said she was too dangerous to ride and given the poor prognosis re post op kissing spines surgery we felt it was the kindest way.

At least she's at peace now. I'm in bits.
 
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