Insurance Exclusions - Advice? Also re-valuing after injury

Doublethyme

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Background - mare is subject to a current claim for vets fees for an injury to her annular ligament and her Superficial Digital Flexor Tendon on a hind leg in the pastern area.

I had my insurance renewal through today and they have excluded :

"All losses arising directly or indirectly from accidents, injury or disease to both hindleg superficial or deep flexor tendons including the suspensory ligaments"

Now I know they have to put exclusions on and was expecting this and can accept the superficial flexor tendon, but is it normal for them to exclude the deep flexor tendons and the suspensorys as well in these cases? Seems harsh, as she has had no problems with these tendons and ligaments!

Also no mention of the annular ligament so does that mean I am covered for this ligament in future or will they just exclude that anyway without mentioning it even on the good leg!

sigh - I am prepared to put up and shut up, but just wanted to know if this was usual or worth a bit of an argument over. I will speak to my vet next week as Mins is back for her next check up and scan.

The actual injury was never a "strain" type in the first place, but an impact injury, so it all seems a tad OTT to exclude basically all the ligaments and tendons in her back legs!!

I am not complaining about the insurance company themselves, as they have paid up without complaint and I understand they need to put exclusions on. Just scary is all that she won't be covered for so much in the future
frown.gif


Also, I am thinking that I obviously need to re-evaluate her "market value" that she is insured for - its not worth me paying money to an insurance company for something they are highly unlikely to pay out for.

The mare has been insured for £3,500 (probably too little before her injury). She is a 13 year old 16hh Danish (Voltaire lines) Warmblood x TB (AES registered), schooled to Novice dressage level (although only competed unaffiliated), jumps 3ft, but hasn't actually done much with me jumping wise, done unaffiliated showing with good results. Fantastically safe, lovely hack, ridden by children and novices. Now all academic because she has injured her ligament which will at best leave her able to do lightish work (am hoping hacking and low level dressage, but possibly less).

What amount would you insure her for? I suppose as a market value (not that she will ever be for sale), she would make someone a fantastically safe, comfortable, quality hack or potentially a quality brood mare, but getting on for that. A nominal £1,000? I am assuming I have to put something on the insurance policy, as the market value/death cover is not an optional part of the policy.
 

JLD

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it's worth checking with them and asking for an explanation, the worst they can say is no, I recently changed companies after having 'neck back and all soft tissue associated with' excluded, which didnt really leave much left insured, didnt get it lifted but at least now pay much less for what is effectively colick surgery insurance. I did however get some exclusions modified a little.
 

ladyt25

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Have they excluded both legs? i would have expected an exclusion for the affected leg but not both and yes I would have expected a ligament and tendon exclusion (not just the specific ligament/tendon effected) as all supporting structures around the area. Basically it will depend on the extent of the damage though. For example if say in 12mths time your vet can carry out scans/tests etc and confirm there is no reason they can see why there should be further problems then you may get the exclusion removed/amended. All depends on individual circumstances really.

As for value, that really is entirely up to you, just remember you will only get the sum insured or market value (whichever is the lesser) should the worse happen so be realistic. If your horse can still be used as a safe hack/ lower level RC horse after all this then the value may be higher than £1000 but that's up to you. Remember some (well most) will have a minimum sum insured allowed for a horse in order to provide the full vets fees cover (for example min sum insured £500). Check your policy, you don't want to be paying for say £5000 vets fees when, due to the sum insured of your horse you actually may only be restricted to say £1000 vets bills!
 

tikino

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insurance companies can be a bit of a nightmare when it comes to exclusions. my horse had a but case of mud rash that went into lymphangitis the insurance company decieded to exclude me for all skin conditions. i had to get my vet to write a report to the insurance company to ask why all skin condition were excluded result she is excluded for skin conditions on hind legs. so speak to your vet about getting a letter to themas no reason to exclude both legs.
 
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