Insurance/ Flexion Test issues

[Masmo]

Hi, I wonder if anyone could help offer me any advice. I purchased my horse in May and he passed a 5* vetting. It was mentioned he was 1/10 lame in flexion tests but vet said this was expected in a 15 year old horse.

I took out an insurance policy at time of getting him and didn't realise at the time that it only covered external injuries. Last week I upped his insurance policy to include internal injuries etc and asked on the telephone when he was covered from and I was advised it was from immediate effect.

A few days after this I noticed he was a bit stiff and thinking I was covered called the vet out to investigate, he did a lot of work including blocking rear suspensories etc. We then booked the vet to come out the following tues (tomorrow) for X-rays and scans.

This morning I received a letter from my insurers stating that firstly they did not have a copy of his vetting certificate (which I had posted when I got the horse but they apparently didn't receive) and that also he would only be covered for external injuries for fourteen days or until vetting cert was received whichever was the latter.

I e-mailed them straight away with a copy of the cert and voiced my concerns that I was told he was covered straight away and it now appeared they were saying he wasn't.

The reply from them is that as he tested positive on flexion test 1/10 that they were excluding any condition arising around his rear hocks etc.

I feel really pushed into a corner as they told me he was covered and mentioned nothing about the vetting cert not having been received etc on the phone.

Can anyone offer me any advise or am I just going to have to shell out?

 

[Elbie]

I'm guessing that when they said you were covered straight away they are meaning the cover is added from that date but it would be subject to the terms and conditions of the policy, i.e. illness/internal injuries are not covered for the first 14 days. Without knowin what was said its hard to comment but you could write a letter of complaint and ask them to review. They will then listen to the call and be able to say whether you were ill advisd by the call agent.

It is most likely that if they did receive the vet cert when the policy started they still would have placed the exclusion. Depending on when the vet cert is dated, they may remove the exclusion if the vet can confirm your horse has not had any issues with the hind limbs since the vetting. I can understand your frustration but unfortunately they generally don't notice this information is missing until the event of a claim.

Even if they do remove the exclusion, personally I think they still woudn't cover as it falls within the first 14 days of internal cover being added. I would ask them to listen to the call so they can determine whether you were mis-advised

 

[kittyb]

Masmo, which insurer are you with? A lot of them will try it on but will remove the exclusion if pushed in the right way

It does sound a bit like you were ill advised, did you use a broker or did you buy direct? If you used a broker then you could have a case to push them to pay