I'm not usually a ranter but...insurance exclusions!!

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My claim for sacroiliac treatment has gone through to insurers and as usual vets have sent clinical history through. I just received a letter from insurers saying that I had not informed them of the following so to minimise issues with future claims they were placing exclusions on the following:

-liver disorders - fair enough, I forgot to tell them but also have no intention of ever claiming on it so no problem with that.

- mouth and oral disorders (based on vet note saying 'routine rasp, small ulceration'. This was caused by sharp tooth, routine rasp and all was good again)

- stifles (based on vet report saying 'stifle effusions bilaterally'. These were assessed by scinitigraphy and x Ray as part of sacroiliac injury assessment and were fine, no injury)

- tendon and ligament disorders (based on vet report stating 'pain on palpating over rh suspensory'. No lameness or injury was found on workup, another note on tendons and suspensory said no injury found, swelling completely resolved, this was after a small swelling when he got caught in a fence)

- right forelimb, based upon the above

- back/spine and associated soft tissue (I accept he now has a sacroiliac injury which is what the claim is for but the bone scan showed his spine is fine, no idea what this is for)

- both hindlimbs (based on vets preliminary thoughts prior to sacroiliac and PSSM diagnosis)

I feel like I'm being punished for getting my horses teeth done and checking on swellings!! There is very little of the poor horse left to cover (just his belly I think!) I wouldn't put him through any big surgeries like for colic so my insurers have just lost a customer and I will just set up a bank account for vets bills instead. It's a complete joke.
 
I'd phone the insurance, although they're a bit reluctant to remove exclusions. You might see if the vet would write to them too. You can lift exclusions after two years, I think, if no further issue has arisen, depends on the issue, of course.
 
Can I ask who you are insured with? Just looking into mine at the moment and wish to avoid this scenario!

And given all the exclusions they have put on your policy, I too would be cancelling!
 
I think I could currently only claim for his feet and his tummy! The funny part is that even if you include is pssm, liver and sacroiliac his is still a ridiculously healthy horse and has never been anything but full of the joys of life! My insurance company begins with a p and another p. I'm a little annoyed that they act like I'm trying to hide something. I didn't mention these things as they were all resolved in days with no 'injury', just little things. (Apart from liver, admit that one but only because I never intend to claim for it).
 
I think most policies would be the same if something was revealed to them: a mate's ex decided to phone her insurance and list every tiny thing the horse had ever had done leg swelling, unknown swelling, absolutely everything, what a loser. :(
 
KBIS? The masters of the exclusion clause in my experience! If not, others are catching up! :)

Don't get me wrong, KBIS have always paid up quickly and without quibble in my experience, by my god, you pay for that with the exclusions that they impose.
 
Show to your vet and get them to write a letter to the insurance for the items which are irrelevant... Has worked for me in the past
 
Exclusion clauses can indeed be lifted by appropriate veterinary intervention. However, in my experience the insurance companies usually insist that it is the vet that diagnosed the initial lameness that then certifies that it is no longer an issue. Depending on the nature of the exclusion and what may be required to mitigate it, this can sometimes prove to be problematic for some vets and their egos, if alternative medication/therapy has been required or the intervention of other professionals with whom they have 'history' ! :)

Nothing is ever black and white unfortunately and sometimes 'we' end up paying the price, in the form of higher premiums/exclusion clauses !
 
I'll definitely be speaking to them and my vet. It wouldn't be so annoying but for most of those vet reports they state that no injury was found and no pathology to indicate injury. I do feel like I'm being punished for being a concerned owner and calling my vet because I would rather make sure it isn't anything sinister. Ho hum, I guess I have to remember they are a business not a charity doing it out of the goodness of their hearts and that if they can exclude anything without a fight then they will.

In the time I have had him I've paid them over 3 grand and will get £1500 back and the rest of the pony written off!
 
Bloomin nightmare! A few years ago boyo had some ongoing intermittent short-lasting low grade lameness which resulted in vet consult. Hoof testers showed nothing, no heat, no swelling so I was advised that nerve blocking was next step. So off we went to horsepital for a couple of days of blocking and ultrasounds which came back clear - a week later the abscess broke! £1300 bill paid out by insurers (ScEq) and WHOLE LEG excluded on renewal. Since he was otherwise fit and healthy I challenged it and they were very happy to lift the exclusion on receiving letter from vet. Similarly he's had 2 minor colics each resolved thankfully with a single analgesic plus buscopan (and one needed a biosponge) and now colic in general is excluded. I queried this since was concerned that a surgery was also excluded (for the sake of 2 £150 bills not claimed) and again have been advised that if the vet can confirm he has had no reoccurrence within 12 months then they are happy to reinsure. So I'm happy with the service (and they're very good when you DO claim) but just slightly frustrated that they don't actively advise of how and when exclusions MAY be lifted. Ask the questions OP ;-)
 
I recently cancelled my insurance with AF, a number of reasons but one of them was for exclusions, my horse tore his right eyelid in the field which was straight forward stitch and then healed with no issues, so they decided to exclude both eyes!
 
I should think you have a case for getting some of those removed. I've had exclusions lifted in the past for a couple of horses. Ask your vet if they are willing to write a letter stating all of the above were part of the diagnosis of X problem and aren't causing an issue now. Send that to insurer and go from there.
 
Its crazy. My mare had a thickened hindleg due to lymphangitis and on vetting it was reported that it was purely cosmetic and not a problem - so the insurance slapped an exclusion on all the tendons and ligaments of BOTH hind legs. She then developed epilepsy which I made a reasonable sized claim on for examination and 6 months of treatment so obviously that went on the list too, but towards the end of her life some 16 years later it was removed but the hind legs stayed on!!!
 
Maybe they were irritated that you haven't been informing them of these visits as they happen (which probably in your small print it requires you to do), the next time you have a call out maybe call the insurance co - they can make a note that it was a non issue and won't get a fright when they get a history print out with lots of visits they didn't know about.

Most policies required you to tell them about every call out other than vaccinations.
 
I've had the same problem with teeth and mouth exclusions. I use the vets to do my horses teeth, always have and they are very good. Unfortunately for me they are very thorough and write records on everything. The first vet I'd had out to do his teeth put on his dental records that he had a slight wave mouth. I had no idea until I claimed for something else and they got his vet records. They excluded everything to do with his mouth and teeth - which would mean any infection or kick to the mouth/jaw fracture etc I wouldn't be covered. I had a very tense and lengthy conversation with the insurers who would not back down. My point being that they were penalising me for using my vet as a dentist. I spoke to my vet who said he didn't have a wave mouth, the original vet had been a bit overzealous in the description but that vet didn't work for them anymore and he wasn't allowed to go against her word. I eventually changed insurers and even though the new ones have seen his vet records and know the history they are happy with not putting it as an exclusion.
 
When I got my horse he had a sunburnt nose and overgrown hooves, noted on the vetting, so they excluded all skin and hoof conditions! I had the vet back 6 months later to confirm the sunburn was gone (in the middle of winter!) and have them lifted, but always thought someone else might not notice or query and then find they were not covered for something totally unrelated. It is this kind of behaviour that led to me stopping insurance and now relying on BHS gold and a savings account.
 
I looked into insurance when I first got current horse. They wanted to exclude huge amounts, including both back legs, for an annual premium that was more than he was worth at the time! I decided against insuring, but have a fund for emergencies instead.
 
I got rid of insurance years ago, now have PL only and a blank credit card in the safe ready for any need that may arise due to the red tape based on 'not insuring that leg any more' and '....left cheek bone not insured'.....

:p
 
I got huffy with my insurer last year after they put that he had COPD and excluded anything whatever to do with his breathing. He had a stinking deep lung infection which took about 3 months to clear. The result of the scope said that the bacteria "may have been triggered by mild COPD but is more likely an unrelated infection". The horse had never suffered from or been treated for cough (and my previous vet had written to verify this), once the infection cleared he hasn't coughed since - 12 months - but try as we might both the vet and I have been unable to budge them from that decision. I tried again when it came up for renewal saying that there had been no further treatment but no joy. He was treated for bad mud fever a couple of years ago and that's now an exclusion, which I'm not quibbling, but they were quite adamant that they needed to be notified if it recurred.....even though I wouldn't have been able to claim. He's not had it again so it's not an issue but surely if they're not going to pay it's not their business?! Any more exclusions and I'll be off!
 
You can get lots of exclusions lifted, I used to work at one of the big companies so I can help with anyone that wants to challenge exclusions.

Vets cover themselves in their comments and you should questions comments on your invoices so that when histories are sent through you know what your getting!

Anyone who would like help please PM
 
I too have set up a savings account - 4 years ago now and so far *touch wood* haven't had to dip into it. I made the decision I would only use it for things I would have claimed on so little things I've just paid for. It's currently up to about £3k.

Mine both had several exclusions - One for melanoma and both front legs which I understand as had claimed for both, but these are also the two things most likely to cause problems so doesn't make a policy worth it for me. What really annoyed me was when he had new growths inside his sheath. Vet wasn't certain if they were melanoma - relatively manageable - or a squaemous cell carcinoma - potentially life threatening - so he had to have a biopsy. I spoke to the insurance company to explain why the biopsy was essential and they told me they would only pay up IF it was the carcinoma so I was stuck between a rock and a hard place. I had to have to biopsy to find out but I didn't know if I could have it paid for until after the results came back. It was melanoma, so I had to pay the £400.

The final straw was the other one having both front legs and feet excluded because I claimed for a splint. He was 15 and lame for quite a long time with it, so vet was convinced it was something more serious, hence lots of xrays and expense but it was just a splint and once it formed (it took about 5 months, probably as he was older) has never been a problem. Just after this they both hit 16 the policy changed to a veteran so excluded anything except emergency colic surgery and accidental external injury AND the price rocketed so I packed it in.
 
I'm going through a similar thing - had my boy x-rayed as part of his vetting as the vet wasnt sure if he felt something in the stifle area, turned out to be completely clear and this is all on the vetting report - but stupid insurers have put it on as an exclusion! My vet even emailed them to explain the vetting report, to say that what he felt was proven to be nothing by the x-rays and there is no medical reason to exclude anything to do with his stifles, but they just choose to ignore my emails every time I send it. I've rang them countless times, forwarded the email onto various different people in the business and still nothing.

They did the same with his flu jab as well! Excluded him from flu just because (he was a yearling when I bought him) he hadnt had his jab at the stud. Again vet gave him jab days after he passed the vetting and emailed insurers, sure enough they wont take that off either.

Its a painful process and I'm starting to think the savings account is a good idea...however he did injure himself in spectacular fashion last year and they were brilliant, paid my vets direct and I havent paid a penny - so I'm reluctant to go because he is a baby they can do so many weird and wonderful things to themselves!

Just so annoying that as a careful owner, getting things like x-rays and vettings done actually puts you in a worse position than if you hadnt bothered - even when they pass the vetting and come back with clear x-rays!
 
I gave up with them, I actually ask the woman on the phone if there were any bits of my horse they wanted to insure. They even excluded his bum because he had a mild skin infection due to pin worm. There was in the end no point of paying all that money out for nothing. I just have savings and a credit card, plus a good relationship with my vet and hope that covers it!
 
Well I called my insurers and spent most of the conversation grinding my teeth in frustration whilst being terribly nice and grown up about it. The stifles they won't even review because the vet wrote that effusions were found, even though they x rayed as fine. The other conditions bar liver they said they woul review if I had a full investigation and vet report done for each item (so all 4 legs, spine and soft tissue and mouth) and then another report in 12 months showing there has not been a reoccurrence. With tendons and ligaments they said that with the above they wouldn't lift it but if after all the above and 12 months clear they would narrow it down to one specific tendon...even though he has never had a tendon injury!! Heaven knows how much it would cost to get vets reports on everything.

I very politely told the nice lady where the company could put the policy. BHS and a bank account it is.
 
After my dog was hit by a car (she was ok but dislocated her hip) i wanted to get all my animals some cover. Mare - can't be covered because shes a brood (even though she isn't pregnant, as soon as she is all insurance would be invalid) dog, had the dislocated hip so can't cover him, cat is not kept indoors so wouldn't cover him. The only one they would cover was my 6yo gelding who im looking after for a friend, and they have cover already (aka the likelihood of the company having to pay out was zero cause he already had cover)
 
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