Insurance exclusions- fighting them?

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Celticecho

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My horse came in from the field last night with a very nasty cut through his coronet band and done onto the hoof wall. It was very deep and impossible to make sure it was fully clean so I called the vet right away. Vet came out and treated. Back out this morning to redress and he will be back again on Monday. It’s going to be a lengthy process as when his hoof grows down it will need a cast to support it.
With my insurance I have an exclusion on his front feet. Absolutely nothing related. As a 5 year old he had concussive laminitis but easily treated. 4 years ago he went lame again due to a foot issue caused by confirmation. Bit of a long one but solved completely by having him barefoot. He has been sound and competing at a decent level ever since.
So called the insurance company today to report the injury to his coronet band and they said that it is very unlikely that they will pay out. Surely a trauma injury should not be effected by an exclusion! Has anyone had any success with fighting an insurance company in these circumstances? If so, how? My vet has said that he will write a letter to support this being absolutely nothing to do with previous issues. I am pretty terrified as this is going to be an expensive one and although I will still do everything for my horse, this situation is what I pay insurance for surely!
 
Good luck. Normally you should have tried to have the exclusion removed before there was a problem, or at a more specific exclusion.

Cob here had an exclusion to hind leg as he had a cut on it when insurance taken out. Was successfully removed a year later, by a letter from Vet saying it had never been a problem.
 
What is the exclusion for, the specific wording? If it is for lameness in relation to the front legs, then you ought to be able to say that this claim is to treat an injury, not to treat lameness.

Who are you insured with? You can pretty much give up if it is anything to do with E&L or its many guises.

Sorry about your rubbish start to the new year.
 
The exact wording of the exclusion is ‘ all loses arising directly or indirectly from or attributable to the front feet.’

Really should have tried to get the exclusion lifted before but hindsight is a wonderful thing!
I am insured with equicover. For all previous claims they have been fantastic so hopefully we can get this one resolved.
 
I would imagine the initial injury could be attributable to to coronary band not the feet, but subsequent treatment to the feet wold be excluded.

I agree to let the vet write a letter to the insurance company. The injury is a totally different thing, not pertaining to the previous issue. I have heard of people successfully going to the insurance ombudsman if the insurance company is unreasonable, but it would be nicer if the vet could get this injury paid.
 
Celticecho said:
The exact wording of the exclusion is ‘ all loses arising directly or indirectly from or attributable to the front feet.’

Really should have tried to get the exclusion lifted before but hindsight is a wonderful thing!
I am insured with equicover. For all previous claims they have been fantastic so hopefully we can get this one resolved.
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I would try to argue that the injury did not arise directly or indirectly from the front feet and is not attributable to the front feet. I think on that wording you might succeed in an appeal. Although treatment to the front foot is required, it is not in any way as a result of the front feet, other than that they happen to be on the end of a leg which has been injured.
 
I think you will struggle to get the claim paid.
On the bright side one of my horses survived a horrific injury to his coronet and foot on a hind foot he was plastered on the third day after the injury when we where sure the internal structures of the foot where not infected .
He was confined in crate we built about the size of the space they have in a lorry to prevent damaging the cast as they where expensive and I needed each cast to last as long as possible .
He had four casts the healing that happened while the casts where on was extraordinary I really thought we would have to put him to sleep as it seemed impossible that his hoof could heal and now just over a year on you would not know it had ever happened .
 
once you renew your insurance it means you have accepted their exclusions !the time to fight them is at renewal,but remember ultimately if you dont accept what they are offering they will just not insure you. you will have an uphill fight.
 
Was nearly 10 years ago but new horse (at time) was found to have a cracked tooth when the dentist came out. The insurance refused to pay out as they said he could have had it when I'd bought him a few months earlier. Vet wrote a letter for me and the company agreed to pay half (it cost £1500).
 
Thank you all for being very helpful. I understand them not paying out of any issues with the hoof itself but definitely going to try to fight them not paying out for the coronet band where the main site of the injury actually is.
Poor horse is bored out of his mind already and this is only his second day of what is likely to be a very long box rest! I changed the dressing today and the wound looks very clean so fingers crossed it will all be ok.
 
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