Insurance - don't get caught out!

My own recent problem getting a claim paid:

Having previously had a horse with a claim that was not paid (scintigraphy, insurance co would not pay because I had forgotten to ask the vet doing the scan to send a letter to insurance co first, stating the quote and the reason why they wanted to do)...so I paid that expensive bill out of pocket and learned to always let the insurance company have a heads up.

New horse, new problem. I have this horse on loan, he came to be very overweight before I got him, due to being out of work for some 18 months. No biggie, diet and exercise and the weight should come off. It did, and then started piling on again?! So spoke to my vet, told her that work and diet we'd done seems to be not working any longer, could there be a metabolic issue? She agreed that he probably could do with some bloods to check.

So I rang the insurance company, they said just keep them posted.

First a ordinary blood panel, including glucose and thyroid, looking specifically for EMS. Thyroid normal, glucouse elevated, at the top end of the normal range. Thought it might be a plan to do glucose and insulin comparison type test. Talked to insurance company, downloaded claim forms.

Did the bloods and all came back normal. Sent all data off to nutritionist who felt horse was not being overfed, but just a very very good doer (extraordinarily so), and feed him less. Gave me some tips and some advice and we've had some success since then. However, insurance company balking now because they first say that they want a specific date of "injury or illness" which there isn't one - he was fat and not losing weight. How do you give that a specific date. Then they wrote to me warning me that if this was a pre-existing condition they'd not pay anyway. So I wrote an email to them to say that he wasn't ever diagnised with anything previously, and due to the complications in getting the weight down (as a preventative measure to avoid IR/laminits) and being unsuccesful, the vet felt it a good idea to run bloods to ensure there was no underlying reasons for the lack of weight loss.

They refused to pay for diagnostic blood work based on the fact that there was no specific injury or illness. Hmph. Okay, one person on here told me that I was being unreasonable in my claim. But I'm not so sure really that it was unreasonable to get bloods done and ask them to pay for it. It's hardly like getting jabs done.
 
Wagtail said:
Things have noticably become more difficult in the past few years. Yes, I agree, sometimes there is no point in being insured.

But, we can learn from the second case, at least. Don't talk to your insurer until all the arrangements have been made and it is definitely going ahead (you can always cancel). Don't give them any inkling that something may be wrong until you know for sure. It's a shame it has to be like this, but unfortunately, honest and considerate customers are the ones who are being penalised.
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It unfortunatly doesnt matter if you tell them or not - they will req a full history from the vet practice and will be able to link the condition and determine the start date - if the client is trying to claim 12 months after the START DATE not when you started the expensive treatment then as far as Im aware it wont be paid.....
 
I gave up insuring my horses after my insurance compay were really slow to pay out, I now pay £20 into a savings account for both of them, I have been doing this for my first horse for nearly 5 years and the other one for 3 years, I have no idea what that adds up to but I hope it's enough to cover any vets bills etc. but if I don't use it .... it's still mine :)

I am also a BHS member and covered by their policy 3rd party (I think thats correct):)
 
LadyB said:
It unfortunatly doesnt matter if you tell them or not - they will req a full history from the vet practice and will be able to link the condition and determine the start date - if the client is trying to claim 12 months after the START DATE not when you started the expensive treatment then as far as Im aware it wont be paid.....
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I agree with that. However, in the second example I have given only 4 months had gone by (but it crossed over the renewal date of the policy) and they decided to exclude anything to do with the horse bucking going into canter just because they knew about it. If my sister had not phoned them to start with, she would not have had that ridiculous exclusion and the whole thing would have been paid for. I mean they could argue that any condition (even sore ears!) could be a reason for his bucking going into canter. It is the most ridiculous exclusion I have ever heard of. Needless to say, she cancelld the policy as there was absolutely no point in being insured. Now though, if she wants insurance she has to disclose this exclusion and therefore, evn though she has never claimed, ever, she cannot get any worthwhile insurance.
 
Yes I had insurance non-payout . We bought a mare and had her for 3 months when she came down with colic. to cut a very long story short 13 different vets from 2 different practices examined and treated this mare but she kept going slowly downhill and in the end me and husband decided to take her to the hunt as she was obviously deteriorating and in pain. We thought it was grass sickness but non of the vets offered a diagnosis. she wasnt insured. Then ,6 months later my other mare coliced,she was insured and went off to hospital EGS was diagnosed and she was PTS,2 weeks later my 2 year old came down with acute EGS and was PTS. Insurance refused payout due to the fact that we'd had a case 6 months before,but we that case was never diagnosed by a vet,and i was just too honest on the form. to make it worse they said that if the horses had been in next door neoghbours field they would have paid out as they would have been on different premises.
 
As someone else said a lot of problems arise because people really don't understand the policies also insurance companies employees often make honest mistakes, so if you think its wrong question it with someone else at the company

When looking for a renewal I spoke to 2 well known companies, both said that they only pay for diagnostics IF a cause is found. So if you send your horse for tests and they can't find a reason then they don't pay (simple) From the companies point of view this is to stop people who think there is a problem when in actual fact there isn't. ie horse keeps bucking/rearing/hopping how many times do we hear that someone experienced gets a new horse and suddenly it no longer bucks/rears etc
Insurance companies know that if the owner calls the vet for the above, vet is going to let them have all these tests often waste of 'our' money.

I think your 2nd case is just a mistake or misunderstanding. Because the renewal comes through and excludes BOTH conditions you or new employee thinks that they are not covered any more, however if you query it with the underwriters as long as you are within the 12 months they have to cover it under the OLD POLICY not the new one. If it was going to go over the 12 months you can ask for an extension if there are circumstances to warrant it, ie new problem making it impossible to diagnose old one.

Not all insurance automatically covers disposal costs or euthanasia costs, they are often separate (you have to tick the right boxes)
 
soulfull said:
So if you send your horse for tests and they can't find a reason then they don't pay (simple) From the companies point of view this is to stop people who think there is a problem when in actual fact there isn't.
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The trouble with that is there is only one loser - the horse. How many people would therefore NOT investigate a problem, in case the insurance doesn’t pay out on diagnostics?

I’m finding it hard to justify my vet fees insurance (I’ve claimed once in the 11years I’ve had it and the vets involved were the ones causing the trouble, not Scottish Equestrian, who I insure with), but apparently the bulk of any insurance quote is third party liability and in this day and age I don’t think any of us can afford to be without that!
 
I must say that NFU has been fab - i have been with them nearly five years.

My first horse was a TB (ex racehorse and pointer who retired at 11) - he had three claims in a year before finally been PTS. The claims were for investigation & treatment for Navicular, KS and a operation after his knee became infected - total paid was around £16,000.

About 6 months after this my new horse had to go for investigations on his back after he was bucking & generally being naughty - they found he had sprained his supraspinous ligament - tests, danilon & a 6 week stint at the physio yard (all paid for by them) came to about £2,500.

Fair enough my premium and excess have increased, but thats all i can expect, and exclusion obviously on back related problems on my new one. £19k of paid out vs approx £3,000 of premium.

They were slow at paying out, but hey-ho - i was so pleased that they paid. I do recommend you having a thorough understanding of your policy and any exclusions that apply.
 
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