Insurance HELP

[Lucy-S]

Hoping someone can shed some light or share any experience they've personally had!

Claimed on my insurance back in January for my horses interspinous ligament injury. Was put on the equinosis gait analysis and deemed nothing else to worry about as we think she just slipped and fell whilst she was struggling to settle in to her new home.(was sent to a referral for this).
As time went on she had check ups by my local vet and she thought there was a suspensory issue which didn’t match up to what my physio thought and my trainer. (They thought it was a training issue). To squish this I brought in another local vet who also had a equinosis machine to pop her on it and give his verdict. Horse was sound, push on with training and build her up. (In theory should of bought up any issues as it’s so sensitive then we would of investigated any lameness etc)

In recent months she started showing some frequent bucking behaviour, i addresses saddle fit and I have unluckily had 2 badly fitted saddles by 2 different qualified people, 3rd saddle fitter hired and we are working on it, currently not riding. Vet came out last Friday for yearly vacs and we started talking and it was decided that she was to come back into the clinic for re X-ray of her back and possible injections if required as her back is still spasming. She has 6 weekly regular physio and this hasn’t been seriously brought to my Attention only about the muscle atrophy and I’m a bit annoyed.

Anyway, vet is questioning other things going on in the hind end. Obviously back in early summer I didn’t scan the suspensorys as I was made to feel like it wasn’t an issue. Now I’m panicking because if it comes back on our lameness work up on Monday that it is suspensorys where do I stand?!

My insurance renews on Monday (confirmed over the phone), now I’m reading the paper work and small print and it’s telling me I need to tell them about anything that’s happened even if it didn’t come to anything. I’m obviously going to have to phone them tomorrow and tell them that actually in the summer X Y Z happened, am I going to be now screwed if it does come back as Suspensorys?! Obviously I want to be be honest with the insurance company I’m not stupid as it could effect any claim in the future but I guess my question is will they pay out if it’s now confirmed?

I am very new to all of this, she’s been my first horse and this whole experience has been far from enjoyable at times so please be nice!

 

[bouncing_ball]

Ask all the vets who’ve seen her for a veterinary history record.

Insurance will ask for it, if you claim so knowing what’s on it helps you decide what’s likely to be covered / excluded.

 

[Lucy-S]

Ask all the vets who’ve seen her for a veterinary history record.

Insurance will ask for it, if you claim so knowing what’s on it helps you decide what’s likely to be covered / excluded.

its a renewal so i know what they are excluding from now on but when I was in the phone they never mentioned about if she had seen a vet other than what’s on her claim if that makes sense

 

[bouncing_ball]

its a renewal so i know what they are excluding from now on but when I was in the phone they never mentioned about if she had seen a vet other than what’s on her claim if that makes sense

But if you make a future claim they’ll ask for all vet records and not pay anything mentioned on the claim that was 12 months or more.

 

[FestiveFuzz]

You’re meant to declare any veterinary involvement whether you intend to claim on your insurance or not. If you haven’t done so I would imagine if something does come to light re: suspensories they’ll likely backdate the claim to when the symptoms first appeared so instead of having the full 12mths to claim for any treatment, they’ll count the 12mths from whenever the vet first noted a potential suspensory issue.

 

[FestiveFuzz]

its a renewal so i know what they are excluding from now on but when I was in the phone they never mentioned about if she had seen a vet other than what’s on her claim if that makes sense

Also, just to note it is your responsibility to keep them up to date with any vet treatment, them not asking about any additional vet treatment doesn’t mean they won’t refer to her full veterinary history when it comes to considering future claims.

 

[Lucy-S]

Also, just to note it is your responsibility to keep them up to date with any vet treatment, them not asking about any additional vet treatment doesn’t mean they won’t refer to her full veterinary history when it comes to considering future claims.

Yeah this completely makes sense and my naivety didn’t realise!! I just hope I haven’t screwed myself over and hopefully they will just back date. I’ll have to pull the records tomorrow and see where I am. Thanks for these responses I appreciate it. Horses, a hugeee learning curve!!

 

[bouncing_ball]

In general it’s worth getting vets to email your vet history to you regularly as insurance ask for it as part of every claim. I’ve found history sometimes doesn’t say what I expect. For better or worse.

 

[FestiveFuzz]

Yeah this completely makes sense and my naivety didn’t realise!! I just hope I haven’t screwed myself over and hopefully they will just back date. I’ll have to pull the records tomorrow and see where I am. Thanks for these responses I appreciate it. Horses, a hugeee learning curve!!

Honestly try not to worry too much. I had a huge claim for my youngster this summer and realised when requesting his vet history that he’d had a couple of minor treatments whilst on youngstock livery that I’d totally forgotten to declare. Admittedly neither could even be vaguely attributed to the issue we were claiming for, but there was a nail-biting moment where I feared the whole policy would be null and void due to my forgetfulness ??‍ Thankfully it was all fine and the claim was processed without issue, but it does mean I’m ultra careful now, even if it seems insignificant.

 

[Lucy-S]

Honestly try not to worry too much. I had a huge claim for my youngster this summer and realised when requesting his vet history that he’d had a couple of minor treatments whilst on youngstock livery that I’d totally forgotten to declare. Admittedly neither could even be vaguely attributed to the issue we were claiming for, but there was a nail-biting moment where I feared the whole policy would be null and void due to my forgetfulness ??‍ Thankfully it was all fine and the claim was processed without issue, but it does mean I’m ultra careful now, even if it seems insignificant.

Thank you, that has given me some reassurance!
I just worry that if i start reinvestigating (which obviously I want to do) that I fear they will try and connect suspensorys and back together (due to suspensorys probably being mentioned as a question on her record) and the back claim hasn’t got much time left of it! Do you know if you start investigating and a couple things pop up, will they split the issues so I can claim in each thing even though they were found under the same investigation if that makes sense?
Financially this could cripple me and I’m on the brink of a mental breakdown it feels!! I just want her to be happy and to able to ride and enjoy her. I got her 5 stage vetted figuring I was doing the right thing and here I am!! I mean she could be fine and it just be her back that’s still sore and need injecting to help her along but I’m such a worrier I can’t help myself!!

 

[teddypops]

Thank you, that has given me some reassurance!
I just worry that if i start reinvestigating (which obviously I want to do) that I fear they will try and connect suspensorys and back together (due to suspensorys probably being mentioned as a question on her record) and the back claim hasn’t got much time left of it! Do you know if you start investigating and a couple things pop up, will they split the issues so I can claim in each thing even though they were found under the same investigation if that makes sense?
Financially this could cripple me and I’m on the brink of a mental breakdown it feels!! I just want her to be happy and to able to ride and enjoy her. I got her 5 stage vetted figuring I was doing the right thing and here I am!! I mean she could be fine and it just be her back that’s still sore and need injecting to help her along but I’m such a worrier I can’t help myself!!

Ask your vet. My vet is very good at determining what is and what isn’t related in order to deal with claims. If they are unrelated, you can have several claims at the same time.

 

[FestiveFuzz]

Thank you, that has given me some reassurance!
I just worry that if i start reinvestigating (which obviously I want to do) that I fear they will try and connect suspensorys and back together (due to suspensorys probably being mentioned as a question on her record) and the back claim hasn’t got much time left of it! Do you know if you start investigating and a couple things pop up, will they split the issues so I can claim in each thing even though they were found under the same investigation if that makes sense?
Financially this could cripple me and I’m on the brink of a mental breakdown it feels!! I just want her to be happy and to able to ride and enjoy her. I got her 5 stage vetted figuring I was doing the right thing and here I am!! I mean she could be fine and it just be her back that’s still sore and need injecting to help her along but I’m such a worrier I can’t help myself!!

I can totally relate, I’m a natural worrier and when it comes to my horses I feel it ten-fold. Your vet will be best to guide you as to whether you’re likely to be able to split claims but if one issue is likely to be considered a contributing factor you might struggle. For example my youngster fractured his sesamoid in his hind leg which has compromised the suspensory branch, upon renewal he’s had both hind legs excluded as well as any SI issues as they deem these as higher risk areas due to the likely compensatory nature of his injury.

That said, I once had one do their DDFT and then SDFT in the same leg and the insurers at the time were willing to have them both as separate claims as the specialist wrote a rather compelling letter as to why they weren’t interlinked. We sadly ended up losing her before commencing treatment but did get a letter accepting the second claim which very much surprised our regular vet so it is sometimes possible to claim for two separate but similar issues.

 

[Ossy2]

If the “symptoms” started less than a year ago (18 months in some policies so do check small print) renewal time or not there isn’t anything to exclude yet, but when you do make a claim the claim form will ask when the symptoms were first noted so any claim will be back dated to then, so you might only have till March 2022 as a claim period. So I’d get the ball moving ASAP with vet and insurance if you want the legs scanning ect.
Otherwise you’ll need the vets to agree the issues earlier in year and now are not related.

 

[greenbean10]

Thank you, that has given me some reassurance!
I just worry that if i start reinvestigating (which obviously I want to do) that I fear they will try and connect suspensorys and back together (due to suspensorys probably being mentioned as a question on her record) and the back claim hasn’t got much time left of it! Do you know if you start investigating and a couple things pop up, will they split the issues so I can claim in each thing even though they were found under the same investigation if that makes sense?
Financially this could cripple me and I’m on the brink of a mental breakdown it feels!! I just want her to be happy and to able to ride and enjoy her. I got her 5 stage vetted figuring I was doing the right thing and here I am!! I mean she could be fine and it just be her back that’s still sore and need injecting to help her along but I’m such a worrier I can’t help myself!!

My insurance company have split all of my claims - in fact I have 5 claims running currently. I was worried they were going to try to link it altogether (as who is unlucky enough to have 5 separate issues in the same 6 weeks?) but they haven't.

I actually think this will come down to your vet and how they relay the situation to your insurance company. If the bucking behaviour has only just started, and the suspensory query in January was deemed a non-issue then I would think you will be ok?

 

[Lucy-S]

I can totally relate, I’m a natural worrier and when it comes to my horses I feel it ten-fold. Your vet will be best to guide you as to whether you’re likely to be able to split claims but if one issue is likely to be considered a contributing factor you might struggle. For example my youngster fractured his sesamoid in his hind leg which has compromised the suspensory branch, upon renewal he’s had both hind legs excluded as well as any SI issues as they deem these as higher risk areas due to the likely compensatory nature of his injury.

That said, I once had one do their DDFT and then SDFT in the same leg and the insurers at the time were willing to have them both as separate claims as the specialist wrote a rather compelling letter as to why they weren’t interlinked. We sadly ended up losing her before commencing treatment but did get a letter accepting the second claim which very much surprised our regular vet so it is sometimes possible to claim for two separate but similar issues.

It’s just so frustrating that we pay all this money for insurance and then they very easily rule things out at their discretion!! I just feel frustrated that im in this position and wish I’d followed my heart at time and if nothing can back Atleast I could of told the insurance company and hope they didn’t rule it off but now I could be in a position that if I do make it a separate claim they may back date till when it was briefly mentioned but nothing was done I was referred but then the referral vet was certain that there was just her back and chances were that was it, so I followed his advice and now I’m here!! Urgh! Today we go for back X-rays again with possible steroid injections so I’ve got lots of questions to ask them!

I’m glad you had some success with your claims and sorry to hear you lost her

 

[Lucy-S]

If the “symptoms” started less than a year ago (18 months in some policies so do check small print) renewal time or not there isn’t anything to exclude yet, but when you do make a claim the claim form will ask when the symptoms were first noted so any claim will be back dated to then, so you might only have till March 2022 as a claim period. So I’d get the ball moving ASAP with vet and insurance if you want the legs scanning ect.
Otherwise you’ll need the vets to agree the issues earlier in year and now are not related.

Thank you for your advice, i do wonder if at the time it wasn’t an issues but now potentially could be. It’s so tough! Hopefully my vets are supportive and can help me with wording etc!