Insurance Exclusions Advice

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justafluke

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Evening everyone.

Could anyone help advice whether it is worth challenging this or looking elsewhere?

I use Equestrian Insurance Solutions (Equestrian Direct before they went bust). Have been with them 5 yrs. Premium for this yrs ins just received, same ballpark as usual. However, I now have several exclusions. My horse is rising 16 now, 3/4bred and i have claimed twice. Both claims were in last 18months and were successful. First claim was front leg lameness/pedal bone pain (initially near-fore then both) caused by farrier/NB shoes not suiting this horses foot confirmation, insurance paid out 900pounds, now have a new farrier and she has been sound 12+months. Second claim was Jan2010- acute mastitus flared up first time ever and lead to a long infection. Insurance paid 400 pounds.

The exclusions on the renewal now state 1) near-fore leg lameness 2) no cover on mastitus 3) any lameness attributed to balance issues.

I have been told the 3rd exclusion can be removed with a letter from farrier confirming horse is in balance but the other exclusions stand.

Does anyone think this is excessive or should I be happy with the amount I have had paid out and shut up?! 480 pounds a year to insure a horse is a lot when it wont cover anything that has ever happened before! Is it usual for a one strike then exclude policy, I do know people that have claimed 3 times for the same problem with this company before the leg was excluded?

Considered not insuring and putting the money away instead but don't like the idea of not being covered! Now horse is getting to the veteran stage I'm not sure I'll get the level of cover elsewhere. Horse has been in great health until these two issues but being a typical TB type I'd like cover for silly accidents and surgery! I'm sure you guys here will have some good ideas!

If anyone has experienced success finding a way round this sort of problem then I would be grateful for the help.

Thanks!
 
Get a quote from pet plan as they cover for full injury and illness till the horse is 25 if insured with them before they are 20. They will make exclusions (tell them the conditons claimed for but not the exclusions on your renewal) but then ask them how to have these removed. eg my horse had a tendon injury claim, a sidebone claim and a mudfever claim. She has an exclusion for all tendons and ligaments in left fore limb but this can be limited to the actual injured tendon if a vet examines and says sound and has been in full work for last 12 months. Sidebone won't go away although doesn't cause a prob so not sure if that could be lifted and the mud fever can be lifted if no mud fever for 12 months. So def worth asking!
 
Your exclusions are applicable 12 months after the start of the condition- this will have happened to your friends policies too, they were probably able to claim 3 times within the 12 months. If you can clarify (via your vets) what the LF lameness was from (ie what area it was) then I'm sure that they can narrow the exclusion. I'm sure the mastitis exclusion will be reviewable after 12 months clear too. If there was no bone/joint involvement exclusions can usually be reviewed/narrowed after 12 months clear.

I suspect that if you write a letter asking them what you will have to produce to get the excusions removed or reconsidered in 12 months they will send you a concise reply with all this information. All companies place exclusions for claims that have been made so another company will probably place the same or harsher exclusions. :)
 
to be honest would kind of expect those sort of exclutions maybe slightly more spacific with thye forelimb lameness. But if your horse has another lamness in the same leg as long as your vet can insist and prove it has nothing to do with the original lamenss they will often payout. and as said if the condition cauess no propblem in 12 months they will remove the exclution.
Out of intrest was it with EIS that you claimed with? how were they at paying out? I still have two claims with equine first so slow paying out!!! had to stay with EIS as too many excultions!!!
 
Thanks all for your comments. That makes sense for the exclusions to apply for 12months I suppose! I will certainly look at getting the forelimb exclusion narrowed down as no real reason the tendons/joints should be excluded too. Will get insurers to clarify before I renew and chase them to remove at the 12 month point.

LL-- in answer to your query -- EIS have actually been great, this recent claim for mastitus was settled in 6 weeks, no questions (and I think most of the time taken was my vets sorting their paperwork!) My first claim for forelimb lameness was done 2weeks before Equestrian Direct went bust, was a bit of a nightmare so took 16weeks for a payout but once EIS were up and running it was fine. I was a bit skeptical at first about staying with them and did think about going back to petplan or another big insurer but have been happy enough with the service to stay. I hope yours get sorted soon!

Thanks all!
 
i wouldn't go with petplan, my lad had lameness that had successfully been blocked to his feet, but when my renewal came through they excluded lameness, i argued with then then they excluded feet and pedal bones (including lamintus) the following year they excluded his tendons (this horse has never had any issues with any of his tendons or ligaments) as well as about 3 other thing so i cancelled it.
 
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