Insurance claim refused for cellulitis

[Best brown boy]

Hi, just wondering if anyone else has been refused an insurance claim for a second bout of cellulitis.

My boy had it for the 1st time in 2015, the first time he’d had it in the 6 years I’d had him and no previous history before this. It was due to the tiniest graze and resulted in his left hind ballooning rapidly. Pleased to say it cleared up well after a course of antibiotics and Bute, claim sent to insurance co. and vet bill settled without a problem. Since then he’s had no further issues until last week. This time it was in his front right and vet was called. Tiny scab just above coronet (query dermatitis), fat leg, hopping lame, temp 39.1. Treatment given as before and claim sent to insurance. Today I’m told they won’t payout as he’s had cellulitis before. I argued that cellulitis is an infection and the 1st time he had it was in left hind and this was right fore so surely not an ongoing or repeat condition. With a bill of £650+ on the horizon I have appealed their decision and my wonderful vet has said she will back me as she agrees that while he’s had it before, the originating cause was completely different.

Has anyone else been in this position with an insurance claim and if so what was the outcome?
thanks for reading ?

 

[poiuytrewq]

I would imagine that to be the case sorry!
After the first bout what exclusions were you given?

 

[teddypops]

It will be on your policy as an exclusion, but hopefully your vet will be able to get them to agree to covering it as it is on a different leg.

 

[Tiddlypom]

Treatment given as before and claim sent to insurance. Today I’m told they won’t payout as he’s had cellulitis before.

What exclusions, if any, do you have on your policy?

 

[Best brown boy]

I would imagine that to be the case sorry!
After the first bout what exclusions were you given?

Well that’s the thing, no exclusions at all!

 

[Best brown boy]

Well that’s the thing, no exclusions at all!

 

[Best brown boy]

It will be on your policy as an exclusion, but hopefully your vet will be able to get them to agree to covering it as it is on a different leg.

They didn’t put it on as an exclusion!

 

[teddypops]

They didn’t put it on as an exclusion!

That’s odd. They usually add everything on as an exclusion.

 

[OrangeAndLemon]

Mine had cellulitis a couple of years ago. He has it as an exclusion.

Exclusions can be removed when a horse has not had a reoccurance over a number of years but you have to ask for it to be removed.

I'm guessing you had it as an exclusion and haven't asked for it to be removed.

 

[Best brown boy]

Mine had cellulitis a couple of years ago. He has it as an exclusion.

Exclusions can be removed when a horse has not had a reoccurance over a number of years but you have to ask for it to be removed.

I'm guessing you had it as an exclusion and haven't asked for it to be removed.

 

[Best brown boy]

When he had it 6 years ago it was not put on as an exclusion and hasn’t been each year since then - my thinking is that if it’s not on his Policy how can they say they won’t pay?

 

[quizzie]

Some policies do not put on specific exclusions, but in the small print there will likely be a line excluding any previous conditions the horse may have suffered from, without them needing to be specified.

 

[Best brown boy]

Some policies do not put on specific exclusions, but in the small print there will likely be a line excluding any previous conditions the horse may have suffered from, without them needing to be specified.

Ok that’s probably what they’ve done then. Guess I’m just clutching at straws

 

[The Bouncing Bog Trotter]

My insurance for my old mare had no specific excisions but did say something along the lines of no claims would be allowed for anything previously claimed for or anything which has arisen as a result of, or could potentially be connected to a previous claim - or words to that effect. My vet informed me that this meant that I couldn't claim for another annular ligament repair on other leg.

 

[spotty_pony]

It will be excluded because it is the same condition you claimed for previously. Claims are usually open for one year and then they are closed - any treatment outside this year for the same problem is not covered.

 

[Red-1]

I'm surprised it wasn't listed as an exclusion. I had one with mud fever from a boot rub when eventing. Only, the day after the event, there was no skin sign, just a swollen leg. It had been a muddy event and I feared a pulled tendon as he was also lame, so he was scanned. Scan was clear, but it was days before the skin erupted. It neared up with a week, he was sound, happy days.

Next year they excluded any skin condition. At all

I cancelled the insurance.

 

[Lady Jane]

Hi, just wondering if anyone else has been refused an insurance claim for a second bout of cellulitis.

My boy had it for the 1st time in 2015, the first time he’d had it in the 6 years I’d had him and no previous history before this. It was due to the tiniest graze and resulted in his left hind ballooning rapidly. Pleased to say it cleared up well after a course of antibiotics and Bute, claim sent to insurance co. and vet bill settled without a problem. Since then he’s had no further issues until last week. This time it was in his front right and vet was called. Tiny scab just above coronet (query dermatitis), fat leg, hopping lame, temp 39.1. Treatment given as before and claim sent to insurance. Today I’m told they won’t payout as he’s had cellulitis before. I argued that cellulitis is an infection and the 1st time he had it was in left hind and this was right fore so surely not an ongoing or repeat condition. With a bill of £650+ on the horizon I have appealed their decision and my wonderful vet has said she will back me as she agrees that while he’s had it before, the originating cause was completely different.

Has anyone else been in this position with an insurance claim and if so what was the outcome?
thanks for reading ?

Who are you insured with? Have you read the small print?