Insurance exclusions gone mad?

[MochaDun]

I've just had my renewal paperwork through for my insurance. On the policy it now says "Excluding all losses arising directly or indirectly from rain scald". Seriously?! Can this be right or is that not utter madness? Considering the winter we've had and name me a horse that hasn't had mud fever this year so will he be excluded from that next year?! He was treated once for rain scald about 6 years ago - some prescribed shampoo and that was it. Was very mild and easily sorted in less than a week.

Have others had similar exclusions applied?

 

[Polos Mum]

Perhaps call them and see if a call from your vet will reassure them that it's not a recurrent condition.

Insurance co/s will try it on with anything these days to get out of paying - but some of them will apply common sense with some nudging !

 

[Holly Hocks]

After 12 months, they will normally remove the exclusion if there haven't been any further recurrences and a letter from your vet. However they will leave degenerative conditions on there for obvious reasons.

 

[Caol Ila]

They are ridiculous. In 2008, my horse had an altercation with another horse over the fence and as a result, got her left leg entangled in the fence and a cut to her left hock. The joint was not damaged (she had x-rays to prove it) but because of the proximity of the wound to the joint, the vets were very aggressive and proactive about wound care, as an infection there would have been bad news. This of course created a mahoosive vet bill, which my insurance dutifully paid up. The horse recovered 100% within a month.

However, that hock is now excluded. When I renewed insurance the following year, I had the following conversation.

Me: So if my horse were to be unlucky and get kicked on that hock by another horse, an incident clearly unrelated to getting tangled in a fence in 2008, the insurance would not cover resulting vet bills.

Insurance rep: That's correct.

Me: That's insane.

 

[ladyt25]

Me: So if my horse were to be unlucky and get kicked on that hock by another horse, an incident clearly unrelated to getting tangled in a fence in 2008, the insurance would not cover resulting vet bills.

Insurance rep: That's correct.

Me: That's insane.

The advice you were given there is incorrect. The exclusion would apply to any further issues with that leg that were related to the previous injury. A new kick injury would not have been related even if it was to be a kick to the hock in the exact same place as the previous injury. It's completely unrelated!

As for the OPs query. I would certainly ring them up and query the exclusion if this is to do with something your horse had 6 years ago? i can understanding them excluding it if it was something your horse was prone to and got every year for example but not for a one off occurrence many years ago. However, as for the comment re horses having had mudfever this year - none of our 5 have and 3 of them are out 24/7. Mudfever isn't actually directly to do with mud or wet conditions.

 

[Pearlsasinger]

That is why we no longer insure!

 

[Daytona]

My horse had signs of old ringworm healing up when I bought him, he from Germany and I'm told alot pick it up on the journey over here

Anyway vet noted it on vets cert and insurance excluded it

I mean really..??? Who or why would you claim for ringworm anyway..?

It's rediculas if you ask me

 

[Goldenstar]

That is why we no longer insure!

I am with you , it's just not worth the fuss I am happier paddling my own canoe and desisions are between me and the horse.

 

[christine48]

That is why we no longer insure!

Same here, the money gets put into a account each month.
Having said that, NFU have been great in the past. One horse did a tendon and had stem cells, no exclusion. Another had a fractured mandible which was wired for a few months , no exclusion. The other incident was when she got a hind leg caught in a gate which needed stitching and x rays ( massive trauma to the tibia) , again no exclusion on the policy.

 

[Toby_Zaphod]

You don’t have to necessarily live with exclusions on you insurance policy!

I like many others I switched from NFU to KBIS because of the ridiculous increase of premiums. I filed in clinical details & also sent a copy of the vetting my horse had when he was bought 4 years ago. As a result I received a quote etc however there were 4 exclusions on the insurance.

1. Losses arising directly or indirectly from wound to right hind hock & capped hock
2. Ditto…… from wolf teeth
3. Ditto…… corneal oedema
4. Ditto……fibrous swelling of extensor tendon right hind cannon

I telephoned KBIS & followed up with a letter regarding the above telling them that (1) the wound was minor, the hock had slight fluid on it at time but was not capped & was now totally recovered. Regarding (2) he had had his wolf teeth removed 3 years ago so that exclusion was redundant. Regarding (4) I had no recall of him ever having this injury & I produced a full clinical printout from my vet where there was no mention of this on it. Regarding (3) I accepted that he had a minor eye injury from when he was young & this did not affect his sight but I understood they may wish to have this as an exclusion.

As a result I received a new policy of insurance & all exclusions except the eye had been removed.

If anyone has exclusions on their policy & the horse is now recovered, is fit & healthy & has no lasting effect then contact your insurance company & they will ask you to sign a health declaration & the exclusions will probably be removed. They will only remove exclusions if you take steps to have the removed.

As a result of this the one rear leg of my horse, which was basically excluded from cover, is now fully covered...... worth doing I think?

 

[Sam@Crosby]

Like the other post states - give the insurance company as much information as possible and ask them to reconsider - underwriters are people so will relate when you give them information about a condition that is not likely to reoccur. x

 

[dalidaydream]

That is why we no longer insure!

I am with you , it's just not worth the fuss I am happier paddling my own canoe and desisions are between me and the horse.

Ditto. I'm much happier now I can have a discussion with my vet about my pony's treatment without having to worry about every tiny thing on his medical record being excluded. I made the decision after several very long phone calls to my insurance company made me realise that I'd basically wasted the premiums for the previous 3 years because there was nothing that they would've paid out for (excluding colic surgery which I wouldn't consider anyway).

 

[scheherazade]

I have recently bought a horse which had a few old mud fever scabs on his legs which were mentioned in the vetting - I have an exclusion for mud fever!!!!!!

I'm not even sure that I would even call the vet for mud fever and would probably just treat it myself, but seriously?!?!?!

 

[Toby_Zaphod]

I think that quite a lot of the time the employees at the insurance company who read the vettings or claims for injury/illness don't have any real veterinary knowledge so have been told that if a person is wanting cover for their horse & there is any mention of a previous injury or illness then put an exclusion on it.

Then if the client contacts the insurer at a later date regarding the exclusions & produces evidence that there is no lasting damage & the exclusion should be removed then that will be passed onto someone with far more knowledge than the 'normal' employee so a judgement can be made.

There is no point just moaning that your horse has got various exclusions on him. This shouldn't happen if you don't follow it up & speak to the insurer with a view to getting them removed. Contrary to popular belief insurers do not want to squirm out of their responsibilities regarding settling insurance claims (unless they're E&L ). They have to be in full possession of the facts & if you as a client don't speak to them about issues then how can they be expected to offer you the cover you want.

 

[fidleyspromise]

...Considering the winter we've had and name me a horse that hasn't had mud fever this year...

Neither of mine have and most horses (if not all) have not had mud fever this year.
They are all out 24/7.

This is why I no longer insure and instead put money aside each month.

 

[Cinnamontoast]

Mine was diagnosed with an arthritic hock, had the x rays etc. The insurance renewal excludes ALL arthritic conditions. I phoned and complained and was told tough. The condition may or may not be injury related but to exclude all other arthritis?! Mental, an arthritic shoulder, say, would not be related to his hock!

I'm also excluded for mudfever, which is crazy as I'd never need to claim for it, just treat or at the max, get antibiotics (it was very severe before I learned how to manage it).

 

[mynutmeg]

It's a bit mad sometimes - my mare had a severe choke last summer and basically didn't drink for 24 hours. She had 2 small bags of fluid from our local vet. Because of this she became dehydrated and the last straw for us getting her up to the dick vets was some mild colic symptoms. She had her abdo ultrasounded at the dick vets and was fine, didn't actually recieve any treatment for colic, only the choke and subsequent pneumonia. they have excluded her for colic (although they are happy to review in a year if no further issues) but haven't excluded her lungs at all Obviously they've excluded choke but that's to be expected when they paid out over £2500 and I can't moan too much as they paid all the stabling cost etc so I literally had my excess and that was it - definately had more from them than I've paid in premiums and why despite exclusions etc I would never not insure, I simply don't have £2000 + sitting around for that sort of emergency

 

[Kenzo]

My insurance excluded both hind legs, stifles, pelvis, spine, back and any associated muscles to those surrounding areas, from being diagnosed with bone spavin 6 months before, they made dam sure that we couldn't investigate further issues and would only treat one condition at a time (even if one was a result of another) and that Id have give it a year to treat the hocks, when my renewal came up they slapped on those exclusions on.
When I questioned that practically 60% of my horse is now excluded and what if he was injured from a field accident for example, would they pay out, i was told no at first then well we'd have to consider it even if when I pointed out that it's an unrelated injury!
Go forth and multiply SEIB, you're a joke!

 

[stencilface]

I had a minor tantrum at my insurers after they excluded his second back leg for having tenosynovitis - a whole leg! They have reduced it to being specific to those injuries and anything else related to them which is a relief. Currently horse is on box rest for another unidentified lameness, I'm loathe to call the vets early now, and box rest is what they would recommend anyway. Fingers crossed I think he's sounder, and will be trotting up this weekend

 

[Fransurrey]

Another one who doesn't insure after silly exclusions. I had a claim of about £350 in 2008. My only claim in 13 years of ownership. It was for LGL. Two syringes of bute, x-rays only because I demanded them and that was it. No claims since. Last year I ended up arguing with the insurance broker about them continuing to exclude laminitis, EMS, Cushings AND insulin resistance, all because of this one mild attack 4 years earlier. I had him tested for Cushings (negative) and a vet gave her report on his general health. Still no lifting of exclusions (with existing insurer OR Petplan, who were the alternative, due to veteran policy), so I had another argument with the broker, who told me I was being irresponsible by cancelling the premium, then joined the BHS with Gold Membership. I burnt the renewal premium for therapy. Felt good.

 

[dalidaydream]

I think that quite a lot of the time the employees at the insurance company who read the vettings or claims for injury/illness don't have any real veterinary knowledge so have been told that if a person is wanting cover for their horse & there is any mention of a previous injury or illness then put an exclusion on it.

Then if the client contacts the insurer at a later date regarding the exclusions & produces evidence that there is no lasting damage & the exclusion should be removed then that will be passed onto someone with far more knowledge than the 'normal' employee so a judgement can be made.

There is no point just moaning that your horse has got various exclusions on him. This shouldn't happen if you don't follow it up & speak to the insurer with a view to getting them removed. Contrary to popular belief insurers do not want to squirm out of their responsibilities regarding settling insurance claims (unless they're E&L ). They have to be in full possession of the facts & if you as a client don't speak to them about issues then how can they be expected to offer you the cover you want.

I was insured with PetPlan. I spoke to them at great length (I was phoned back by "someone with more knowledge", ie senior manager). I was told quite clearly that it didn't matter whether the exclusion was on the policy or not because every time you make a claim the horse's medical history would be checked and anything that could in any way be associated with the claim in the last 3 years would exclude the claim. They then went on to ask if I would like to pay the premium there and then over the phone and still couldn't believe it when I told them I wouldn't be re-insuring because they had already told me there was very little they would pay out for. All they really cared about was getting the premium.

Oh and just to add, I'd had my vet out to do a full work up as I'd been told the insurance company would then lift the exclusions. They lifted one and added several more. So I was also out of pocket for the vet visit and report and I was no better off with the insurance. It was when I pointed out that if I hadn't gone to this effort they wouldn't know about the other things (a sore back from over-exurberance after being cooped up because of snow - back and pelvis excluded!) she pointed out that it was better to know at the point of paying the premium than getting to claiming and then finding out, which I suppose was a good point.

 

[MochaDun]

There is no point just moaning that your horse has got various exclusions on him. This shouldn't happen if you don't follow it up & speak to the insurer with a view to getting them removed. Contrary to popular belief insurers do not want to squirm out of their responsibilities regarding settling insurance claims (unless they're E&L ). They have to be in full possession of the facts & if you as a client don't speak to them about issues then how can they be expected to offer you the cover you want.

Good advice TZ, I did ring mine and the rain scald exclusion came off as not suffered from that since the one small case years ago. But sadly as he's had treatment this winter for mud fever and mites, any losses relating to those two things are now on but at least I know if he stays clear of those they will get lifted further down the line.