I hate insurance companies! Big day tomorrow

Kokopelli

Kokopelli

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Andy has his xrays tomorrow to see if he has KS. Very long wait as mum has been on holiday so we have no transport and tomorrow is the first day we can do.

We've made the very tough decision that if he has it and needs surgery we will not put him through it and have him pts. My vet and the other vets at the practice completely agree with this decision.

We rung insurance company up on friday to inform them about xrays and they said they will not pay out if we have him pts but will pay up to £5000 for the surgery! I'm so baffled. Not only will they be paying less if we have him pts but no vet in their right mind will operate on my lovely boy in the condition he is in.

At the end of the day his welfare is my top priority and if it is bad and we need him pts the insurance company can go screw themselves. Yes I won't be able to buy another horse but at the end of the day Andy owes me nothing and I'm not leaving him in pain for my own selfish reasons.

Is there anyway I can argue this? If maybe my vet spoke to insurance company would they reconsider?


I know atm this is all hypothetical as we don't know anything until tomorrow. But it's also got me worried if it's not KS then what the hell is wrong with him? :( Keep your fingers crossed for him, I just want him to be happy and pain free which seems to be a lot more difficult than I ever thought.
 
I would speak to your vets for advice. It could be that the insurance is giving a standard answer to ensure you aren't just having him PTS to obtain the money. Not for one moment suggesting this is your situation but trying to read it for the view of the agent who doesn't know your history and horse. Good luck for tomorrow, you must be feeling under enormous stress and worry right now.
 
Can't see how they can refuse to pay for the diagnosis. But can see how they would refuse to pay out for his destruction (if that's what you're questioning), as he probably doesnt meet BVA guidelines for destruction.
 
I think your vet may be able to say to the insurers that pts is the only option due to horse's temperament...or something along those lines.

Hope tomorrow goes ok. x
 
Insurance will only pay for PTS after all other avenues of treatment have been exhausted :(. If your vet cannot argue that he is in terrible pain and cannot live for another minute without causing serious welfare concerns then it is unlikely they would be swayed on this.

Hope you get some good news tomorrow x
 
Never really saw it from that point of view, will speak to vet tomorrow once we know what's definitely going on. Just so I don't get jumped on by other users we're definitely not just trying to get money. He's a 14yo who doesn't do box rest (had to be sedated when he hurt his leg) and has various other medical issues which wouldn't cope with the strain of surgery.

I honestly would love to not go down the pts option. Really need to stop getting so worried over what ifs, it might not even be KS.

Will ring insurance compamy again tomorrow as I may have got wrong end of stick, I read it as wouldn't pay for diagnostics either.
 
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Unfortunately, because it would be your decision and not necessity to have the horse PTS and it therefore wouldn't comply with BEVA guidelines, the insurance company are correct. I know it maybe seem harsh and horrible but the rule is there so people just don't have horses PTS in situations where they know the horse is no longer going to be able to be ridden etc and they think they can just have it PTS and get the insurance money for another.

If you had loss of use then you would be covered for the scenario you have stated.

The only way you would be able to make a claim under the death section of the policy is IF the vet stated it did comply with BEVA guidelines but I can't see how they would do this.

I hope for you it doesn't come to this and that the cause of his behaviour is down to something else, and something treatable.

At the end of the day, you should forget about the insurance and do what is right for the horse, which I am sure you would do anyway.
 
Kokopelli said:
Never really saw it from that point of view, will speak to vet tomorrow once we know what's definitely going on. Just so I don't get jumped on by other users we're definitely not just trying to get money. He's a 14yo who doesn't do box rest (had to be sedated when he hurt his leg) and has various other medical issues which wouldn't cope with the strain of surgery.

I honestly would love to not go down the pts option. Really need to stop getting so worried over what ifs, it might not even be KS.

Will ring insurance compamy again tomorrow as I may have got wrong end of stick, I read it as wouldn't pay for diagnostics either.
Click to expand...

Really really hope you didn't think my post was intimating you would do that..I was trying to think why the insurance company would refuse. Was not suggesting that you would put your horse down purely from a financial perspective.

I would strongly suggest you talk to your vet before the insurance company though. If you vet agrees that, in the event of KS it would be better for your horse to be PTS, I think you need to be clear why he/she is making that recommendation. good luck for tomorrow.
 
I'm really sorry to hear this, and fingers crossed for you that it's not KS, but I'm so glad to hear your opinion that you don't care if the insurance won't pay out, you will still not put him through the trauma of surgery. It makes me mad when I see people who let their horses go on suffering because their insurers say they won't pay out.

I really can't express how much I admire your attitude.

Best of luck. Xxx
 
If the worse comes to the worse, get the vet to write a statement stating that it is in the best interest of the horse to have him PTS. They have no choice but to pay you out. In the section that says the cause get them to put 'Act of God.'

I have had many issues with insurance companies and have learnt with animals to admit negligence if you want them to pay for third party.
With pay out for PTS you do need the vets to help.
 
Been in similar situation 2 u. Long story short Horse broke her leg (in stable??!) was fixable with pins/plates &/or long-term box rest & would have 2 b cross-tied poss up to a year. As she had ongoing breathing problems & may have been PTS b4 the summer anyway I decided not 2 put her thro the trauma of op & box rest so had her PTS- with the blessing of my own vet, ortho vet specialist at vet school & the head guy in charge if my mares treatment.
Went 2 insurers- yes they'd pay for op, 3 months in vet school care, all drugs, bandages etc etc etc but NO they would not pay for PTS & disposal as not an emergency situation.
They said if I waited another 48hrs with her cross-tied in vet school the insurers own vets would assess the situation/possibly examine her & if they agreed PTS was best option then they would pay out. I was horrified at extending her pain discomfort etc & went ahead with PTS

Once it was over I tried to argue my case with insurers who agreed it was daft 2 agree to pay 5k for op etc but not the 210 that it took for drugs & disposal. They would not negotiate at all & I just gave up cos wasn't worth the hassle over that small amount of money.
So basically if horse doesn't meet BEVA guidelines & u go ahead anyway u will not receive anything.
Ps sorry u r in the situation I remember very clearly how distressing it is
 
Fight them.

I had problems last year with nfu not paying out when my warmblood was put to sleep.
I fought them for 6 months.
Eventually they paid up in full.

It was so stressful and upsetting, but i would not let them get away with it.

I quoted the animal wwelfare act.

Which outlines basic animal needs.
The five welfare needs
This means pet owners are now legally obliged to care for their pet properly - which most owners already do - by providing these five basic needs:


•somewhere suitable to live

•a proper diet, including fresh water

•the ability to express normal behaviour

•for any need to be housed with, or apart from, other animals

•protection from, and treatment of, illness and injury.



By having my horse put down i would have been sticking to these quidelines.
So by nfu saying they would not pay out as my horse did not "neede" putting down then they would be forcing me to not obide by them.

Look it up, im sure it helped.

http://www.rspca.org.uk/in-action/changingthelaw/whatwechanged/animalwelfareact
 
I was recently in the same situation. A multitude of previous injuries, surgery and cancer over previous years, then within 8 weeks ( when it snowed), a bad COPD attack, the treatment of which brought on laminitis. Whilst on the box rest recovering from this, she tore a tendon for 3" needing a minimum of 5 months box rest to sort with no guarantee of soundness after. So in short, I couldn't retire to a nice paddock because of the Lammi, I couldn't turn out because of the tendon and I couldn't keep her in because of the COPD. No options left.

The insurance refused to help with the disposal. Another instance of being willing to pay for expensive vet treatment, but the ultimate kindness, sorry but no.


OP? Best wishes for today. Thinking of you....
 
Same as Jannette I'm afraid.

It was 6 yrs ago now, but my insurance company would have paid for x rays and ongoing treatment for navicular which would have run into the thousands, but wouldn't pay the few hundred pounds for disposal when I decided to call it a day. (He was in his early 20's so you'd think they'd see sense there)

Hopefully your vet can help and write a recommendation letter as kissing spines is much more difficult to get a positive outcome with.

Wishing you lots of luck. I think you are being very brave and kind thinking of Andy before yourself xx
 
If it's bad news and you need to consider PTS, can you not speak to the insurers (or better yet, get your vet to write or speak to their independent vet) and ask if there is a possibility of an economic settlement?

If there are risks with the surgery etc and your vet feels it would be better to PTS than go through with the surgery the insurance company may make you an offer (possibly the sum insured) if it is going to cost less than the surgery. However, this may only work if after the surgery your horse could still potentially have to be PTS.

If your vet is going to ask them to reconsider I would avoid stating things like "not a good candidate for box rest" as some policies do not pay for behavioural problems and therefore they would look at the need to PTS due to a 'behavioural' issue.

Hopefully all goes well for you and you don't need this advice
 
OP, I dearly hope it isn't kissing spines so good luck with the diagnosis. If it is KS, there are other alternative treatments other than surgery:

http://www.scienceofmotion.com/videos/kissing_spine.html

Only you can decide if this is a route you would like to take or if it would be right for your horse. Maybe the insurance company would pay up for this type of rehabilitation? Good luck.
 
It's a horrible time, but hopefully you will be a bit clearer after today. It's difficult not to think what if/worst case scenario - it might be bad news, but there might be some other options available as well. Fingers crossed for you today xx

I've been there with a KS horse although thankfully mine was a moderate case and is improving after treatment. There are more treatment options for KS horses so it isn't as bad as it used to be, although those options may not be available or right for your boy, I realise that.

Insurance co might be a bit tricky but def agree that you should get your vet on side and see what you can negotiate with them. Makes no sense to cover vet costs if PTS is the right option (and cheaper from their perspective).

Best of luck x
 
Kokopelli said:
At the end of the day his welfare is my top priority and if it is bad and we need him pts the insurance company can go screw themselves. Yes I won't be able to buy another horse but at the end of the day Andy owes me nothing and I'm not leaving him in pain for my own selfish reasons.
Click to expand...

IIRC you already have another which I have seen advertised for fairly big money, £8k I think it was, that would buy you a fairly nice replacement.
 
hope everything goes ok



my insurance didnt pay out as although my vet's agreed it was kinder to pts..that was it....it was MY decision to take her out of pain and to stop fighting....so they didnt pay up as such...but did send me acheque for something else (cant remember what now)

this was petplan and they were fantastic.
 
Thanks for the advice and support everyone, on route to vets now so will keep you all updated. Interesting to see a lot of people in similar situations with the insurance. Thank fully I did get it wrong and today will be covered.

Marmalade, sadly Louie isn't mine if he was he wouldn't be for sale as he is lovely. I'm not making any money out of his sale I've got him for the fun of having a horse as when we got him Andy was still out on loan.
 
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