insurance and exclusions

[Deltofe2493]

Hey

I am currently processing a claim with Insurance Emporium company for mare's stifle (meniscus to be exact).

A few days ago they asked for my horse's history (they should have had this when I signed up with them) and passport/vacc records (have sent over), and they have placed an exclusion for stifle and meniscus on my policy from 2025.

She's currently excluded for Kissing Spine, PSL in both hinds, Pedal Bones of both hinds, hock arthritis in both hinds and gastric ulcers and all related conditions to these. All her previous problems have been in her left leg, and never had a stifle problem, but I am wondering (and quite scared) if they're going to try to relate this to a pre-existing injury.

Is it normal to have put the exclusion on without approving/denying the claim?

Any experiences welcome!

 

[poiuytrewq]

I’d say probably so, I counted it almost as a good sign as I figured it meant they had agreed to pay the claim and I’m my case they always then did.
They also removed an exclusion once that I thought had been unfair. If you don’t agree it’s worth ageing, however in your case I’d say pretty normal. You’ve claimed alerting the fact there is a stifle issue so they have excluded from 2025. They will continue to pay this claim for the year though (in my experience)
So my horses back was claimed for in June and they excluded his back from the following year but did continue to pay out on that open claim until the June.

 

[Barton Bounty]

Im also with the Insurance Emporium , I haven’t had an exclusion imposed. I claimed in 2020 for a hospital stay for colic and then in 2023 when sadly I lost him. Paid out in full both times.

Im not sure if the exclusion is a new thing with them?

 

[ihatework]

This all sounds pretty routine for any insurance company. Once you have claimed for something an exclusion gets applied from the renewal date. It’s also routine to send in clinical history with each new claim.

 

[kathantoinette]

I’m with IE. I received the exclusion notification just before the settlement confirmation came through.

 

[poiuytrewq]

Im also with the Insurance Emporium , I haven’t had an exclusion imposed. I claimed in 2020 for a hospital stay for colic and then in 2023 when sadly I lost him. Paid out in full both times.

Im not sure if the exclusion is a new thing with them?

They have in theory always made exclusions. I was with them longer ago than that, however there was one claim I made that they weirdly didn’t exclude and I actually made a very similar claim a year or two later.
Generally any claim will result in an exclusion. It’s pretty standard.

 

[Barton Bounty]

They have in theory always made exclusions. I was with them longer ago than that, however there was one claim I made that they weirdly didn’t exclude and I actually made a very similar claim a year or two later.
Generally any claim will result in an exclusion. It’s pretty standard.

Yeah, mine was both the same, one was medical management and the other an operation. Bizarre

 

[Deltofe2493]

Thanks everyone that sounds slightly more reassuring.

I was concerned as where they've asked for her vacc record to call previous vets I'm nervous there may be something on there from before my ownership in 2021 and then try to use as an excuse not to pay.

Another fingers crossed sitch lol.

 

[Gamebird]

Thanks everyone that sounds slightly more reassuring.

I was concerned as where they've asked for her vacc record to call previous vets I'm nervous there may be something on there from before my ownership in 2021 and then try to use as an excuse not to pay.

Another fingers crossed sitch lol.

They can't obtain history from before your ownership as the vets would need consent of the previous owners to release it.

 

[Deltofe2493]

They can't obtain history from before your ownership as the vets would need consent of the previous owners to release it.

Their exact words 'We can then contact each veterinary practice on your behalf for substantiation of your horse’s medical history.'

So does that mean the vets will then contact previous owners prior to 2021 so IE can access the info?

 

[conniegirl]

no it just means they will contact all the vets you have had since the mare became yours

 

[PinkvSantaboots]

Hey

I am currently processing a claim with Insurance Emporium company for mare's stifle (meniscus to be exact).

A few days ago they asked for my horse's history (they should have had this when I signed up with them) and passport/vacc records (have sent over), and they have placed an exclusion for stifle and meniscus on my policy from 2025.

She's currently excluded for Kissing Spine, PSL in both hinds, Pedal Bones of both hinds, hock arthritis in both hinds and gastric ulcers and all related conditions to these. All her previous problems have been in her left leg, and never had a stifle problem, but I am wondering (and quite scared) if they're going to try to relate this to a pre-existing injury.

Is it normal to have put the exclusion on without approving/denying the claim?

Any experiences welcome!

Yes it's normal for them to add the exclusion without agreeing to pay out on the claim.

 

[Deltofe2493]

Yes it's normal for them to add the exclusion without agreeing to pay out on the claim.

 

[Deltofe2493]

no it just means they will contact all the vets you have had since the mare became yours

I have just had an email saying they will be contacting my most recent vets.

I'm confused as to why though as I have already sent the history over to them and my current vet sent their history directly. What more information could they possibly need?!

 

[PinkvSantaboots]

I have just had an email saying they will be contacting my most recent vets.

I'm confused as to why though as I have already sent the history over to them and my current vet sent their history directly. What more information could they possibly need?!

They tend to do it with ever claim you make.

 

[hmm]

I have just had an email saying they will be contacting my most recent vets.

I'm confused as to why though as I have already sent the history over to them and my current vet sent their history directly. What more information could they possibly need?!

I had this, don’t panic!
My boy had a flu + tet booster from a practice I don’t usually use, because when he was due, I wasn’t well so my friend sorted it while hers were getting done.
They then just asked that vet for a copy of his history (which was non existent tbh!).
He had vaccinations done by other vets previously but they weren’t interested in those.

 

[Deltofe2493]

I had this, don’t panic!
My boy had a flu + tet booster from a practice I don’t usually use, because when he was due, I wasn’t well so my friend sorted it while hers were getting done.
They then just asked that vet for a copy of his history (which was non existent tbh!).
He had vaccinations done by other vets previously but they weren’t interested in those.

So strange as they already had their history though lol. Maybe they thought it had been tampered with or something so wanted it directly from them?

I can imagine IE are finding it hard to believe that mare has managed to come up with yet another injury

Keeping all of my fingers and toes crossed and hoping this is just procedure!

 

[Landcruiser]

Every single claim, new or continuation, will require the VET to send the up to date history, along with the vet's up to date sign off. It's absolutely standard practice.

 

[Annagain]

I think they're trying to guard against using one vet for jabs and another for treatment so they're checking that the vet who is treating your horse now is the same one who vaccinated her and they'll look into discrepancies. Wig's passport is full of them as his first jab with me was due the day after he came to me. I spotted this when I checked his passport when I went to see him so I asked the vet who was vetting him to vaccinate him if he passed. Then last year, him needing jabs cocincided with my dental vet's (she's a qualified vet but all she does is teeth) visit so she did him and this year it was a trip to my normal vet. It could well be another local practice next year as my one man band vet is considering retirement!

 

[Deltofe2493]

Every day is a school day!

It is a tricky one as my local vet who has done her jabs / treated her for a few cuts also came out for the lameness exam. However they were completely useless (blocked the wrong leg and sent me incorrect history which I needed to register with new vet).

Hopefully they have everything they need now and will be settled shortly!

 

[WestCoast]

My insurance insisted on me sending a record of every vet visit this year just to renew. And then tried to exclude all reproductive and endocrine problems because she’s on regumate. I challenged and they changed it to all hormonal reproductive problems which I accepted. She’s 16 next year and I suspect she’ll go into catastrophe cover only.