Insurance, is this right?

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superted1989

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Just to give a little background...................
I lost my fab sec D last summer, he was elderly and had been retired for nearly 2 years, and I miss him dreadfully. As I have a spinal condition and arthiritis, I've worked out that the ridden side just doesn't bother me anymore but I love all of the care side. I took on a loan, from a friend, of an aged mare in November last year but. owing to outside circumstances, she suddenly has to have back (still friends, long story attached!). So, my thinking is to look for something that is 'paddock sound' but would enjoy being turned out to show standard everyday and generally pampered and fussed!
To the point.................
I was chatting about this to one of my horsey friends who mentioned a friend of a friend has a horse with navicular syndrome (or something like that) where no treament will keep him sound enough to ride. The owner can't afford to keep 2 horses (this one is about 10) and is looking at PTS as she wants something to ride and compete. Straight away, I said, get me her number to find out a bit more as he sounded like something that could come and live with me! Anyway, as it's a friend of a friend, she tried to get the number but was told that the woman would have to PTS or the insurance wouldn't pay out. Is this right? I remember, a few years ago, a lady on our yard having a real battle to be allowed to have her horse PTS, he had an injury, was on 4 bute a day and had spent the best part of 2 years on box rest, the vet had said there was no chance of recovery. Her insurance company wanted him off bute for 4 days, then reassessed by the vet before agreeing to pay out if the vet still said no chance (she didn't follow them, had him PTS without their permission and didn't claim).
So, if a horse can live a perfectly happy life, without pain but not 'in work', do most insurance companies pay out these days? Seems morally wrong in terms of taking a life, but, practically, right as you pay premiums to protect your investment.
Just to add, I don't know if the aforementioned horse is insured or not, or even if the owner would rehome, but it could explain why there are so few 'paddock ornaments' available!
 
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It doesn't seem right at all, the insurance company should take the word of a reputable vet, but there you go...

I wouldn't have thought you'd have any trouble finding a field ornament to pamper. Have you advertised?
 
To get an insurance payout on death your vet has to declare to the insurance company that it met BEVA guidelines which basically means that the horse is suffering and there was no choice.

Is the horse actually paddock sound? It may well not be without painkillers or something which (in a way) would meet the above guidelines.... If it was paddock sound I don't think it would....

If you are in the south have a look on nfed for a companion, they are out there (I know of an 22 yr old 12.2hh, pm if suitable)
 
Most insurers pay out for Loss of Use but that doesn't mean that the horses has to be PTS, simply it is unable to perform the tasks required. I think, though, that this will depend on what the person has declared that they want cover for on their policy. For example, if you state that you showjump and the horse then has an injury that means it can't jump you would be covered. However, if you declare you only hack and the horse is still capable of being ridden then you wouldn't be as the insurer sees the horse as fit for purpose.

Maybe someone else can confirm this - but that is my understanding.
 
Superted, if you can't help this horse then I'm sure Equine Market Watch would have a new friend for you.
 
They would only pay out for loss of use if you were insured for LOU - not many are as it bumps premiums through the roof
 
I imagine the woman has insured the horse for loss of horse and wants the insurance money. If horse is in too much pain to cope with living in the field day to day then she have it PTS on the grounds of it being a welfare case. If she doesn't have it PTS, she won't get the insurance money. Simple as that.
 
carolineb said:
I imagine the woman has insured the horse for loss of horse and wants the insurance money. If horse is in too much pain to cope with living in the field day to day then she have it PTS on the grounds of it being a welfare case. If she doesn't have it PTS, she won't get the insurance money. Simple as that.
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Sorry that is not my understanding of LOU - you get a pay out if the horse is no longer fit for purpose ie competing as in this case. The horse is then hot branded and can have a long happy life eating grass and does not have to be PTS
 
I said she would have had the horse insured for loss of HORSE as opposed to LOU which basically means she will get a pay out ONLY if the horse is PTS. A horse that is insured for LOU will be paid out on if it can no longer do the job it was meant for i.e. top class eventer can't event anymore but can still happy hack.

She has obviously NOT insured for LOU only for Loss of Horse so will not get an insurance payout unless the horse is PTS on humane grounds.
 
Reference, LOU - this is the petplan equine explanation:-

What happens to the horse after a Permanent Loss of Use claim is paid?Most insurance companies give the owner the choice of keeping the horse or having it humanely destroyed. If the horse is destroyed the insurer will require proof of destruction from your vet.

If the horse is not destroyed most insurance companies will need it to be freeze marked with the letter "L" in a circle. Some insurance companies will pay for this and others will deduct the cost from the amount they pay you.

If she is not insured for LOU and wants the insurers to pay out the only way they will do this is if the horse has to be destroyed on advice from the vet i.e. loss of horse (eg death) due to injury or illness.
 
carolineb said:
I said she would have had the horse insured for loss of HORSE as opposed to LOU which basically means she will get a pay out ONLY if the horse is PTS. A horse that is insured for LOU will be paid out on if it can no longer do the job it was meant for i.e. top class eventer can't event anymore but can still happy hack.

She has obviously NOT insured for LOU only for Loss of Horse so will not get an insurance payout unless the horse is PTS on humane grounds.
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Apologies - miss read, that wil serve me right for trying to HHO and work at the same time !!
 
She could claim under LOU if the horse wasn't suitable for the purpose it was insured for. However, if the horse is elderly then it is highly unlikely she would be able to have this cover. Plus, to claim LOU you do not have to have the horse down, it basically gives you the option say if you couldn't afford to keep a lame horse you can have it PTS and claim under LOU whereas you couldn't under the death section as you can only claim under the death section IF the horse has to be PTS under BVA guidelines - ie it is not humane to keep it alive!

A horse with navicular that is paddock sound would not fit the criteria for being PTS under BEVA guidelines so she could not claim.

Therefore i am not sure what the horses owner is on about. She can still claim LOU (if she has that cover) but does not have to have the horse PTS but she cannot claim under the death benefit as this horse would not fit the criteria.
 
Thanks for all of the replies.
Like i said, working through friends of friends, I don't really know a lot about the horse's circumstances, if he's insured or if the owner would want to rehome! I may have got a bit confused over 'loss of use', I've never had that on a policy as the premium seems to increase dramatically!
Somewhere, out there, is an equine friend who would like a job as being my pampered pet, would have been great to be local to save the (expensive) ferry fare!
 
It could be that the owner has decided that she doesn't want to take the risk of passing the horse on due to his condition (which I can understand tbh) but is telling people that he has to be PTS for insurance reasons to avoid the judgemental types ;) that exist on yards...
 
Our mare didn't meet BEVA guidlelines with a blown tendon (for the 4th time), on 3 bute a day.

Vet/Insurance said to meet BEVA they have to be in that much pain it is unfair to keep them (view on pain was max bute /stables 24/7)
 
Ladylina83 said:
Sorry that is not my understanding of LOU - you get a pay out if the horse is no longer fit for purpose ie competing as in this case. The horse is then hot branded and can have a long happy life eating grass and does not have to be PTS
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Not strictly true. Some years ago when I had LOU on an expensive dressage horse the policy stated that they would pay out 40% if LOU confirmed but horse not PTS and 100% if horse were to be PTS.

BEVA guidelines are that it is necessary to PTS on humane grounds (eg. broken leg, some colics, etc). If the horse can be kept comfortable then it is not BEVA.
 
To have LOU is optional on most policies. I don't have it on my grey mares as she is white, so would have to have the freezemark such thst it left a bald patch rather than white hair. I used to loan a white grey pony who had one of these & she had dreadful time in the summer with the bald area getting burnt (despite copious amounts of cream) & weeping, then the flies would go for it & it would swell up. Despite the advent of fly rugs, I wouldn't do that to my girl. That's my reason, this horses owner could have her own.
 
Pampered Ponies said:
Most insurers pay out for Loss of Use but that doesn't mean that the horses has to be PTS, simply it is unable to perform the tasks required. I think, though, that this will depend on what the person has declared that they want cover for on their policy. For example, if you state that you showjump and the horse then has an injury that means it can't jump you would be covered. However, if you declare you only hack and the horse is still capable of being ridden then you wouldn't be as the insurer sees the horse as fit for purpose.

Maybe someone else can confirm this - but that is my understanding.
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You're right!! Loss of Use is normally an optional add on which may not have been purchased.

It comes into play when if you had say insured the horse to be a Grade A SJ and it became unsound and only able to hack, you would (essentially) have grounds to claim as they are no longer fit for the purpose you purchased them for.

OP- be a little careful and make sure you have it in writing who takes care of the vets bill when they come in (which unfortunately, they will)
 
superted1989 said:
Thanks for all of the replies.
Like i said, working through friends of friends, I don't really know a lot about the horse's circumstances, if he's insured or if the owner would want to rehome! I may have got a bit confused over 'loss of use', I've never had that on a policy as the premium seems to increase dramatically!
Somewhere, out there, is an equine friend who would like a job as being my pampered pet, would have been great to be local to save the (expensive) ferry fare!
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I would try any local rescue centres etc as they are full to the brim of companion only types as they tend to be tricky to rehome
 
eggs said:
Not strictly true. Some years ago when I had LOU on an expensive dressage horse the policy stated that they would pay out 40% if LOU confirmed but horse not PTS and 100% if horse were to be PTS.

BEVA guidelines are that it is necessary to PTS on humane grounds (eg. broken leg, some colics, etc). If the horse can be kept comfortable then it is not BEVA.
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The settlement varies per company - usually you will be paid a maximum or 100% of the sum insured/market value (whichever is the lesser) if the horse is essentially of no use at all (ie can only be a field ornament at best). The decision would be up to you whether you had the horse PTS. However, some insurers (I don't agree with this) say if you keep the horse, even just as a pet essentially, then that is a 'use'. I do not agree with this at all and, if this had been the case then you should have disputed it.

Often with a mare they may argue you can breed for her and then that is still a use, which I guess can be true so you would have to state you never intend to breed/she isn't suitable for breeding from etc.

When an insurer agrees to settle on a 100% LOU basis this means that essentially that horse will become their property and hence often, if you do want to keep the horse as a pet they may request you pay a salvage figure which is normall about £250/£500 or something (ie that will be knocked off your settlement).

In cases where a horse maybe was used for jumping/competitive work and was no longer able to due to injury etc but could be used for light hacking or something then an insurer would only pay a % of the sum insured (a maximum % being around 60%-75% with most companies).

Aaand, I am done! :-)
 
Most companies use the opinion of a vet to determine whether the horse is LOU.

The company I worked for would send every claim to a vet and it would be his opinion to say whether the claim was valid, and if so, what settlement should be made. He was also consulted regarding any claims where the horse needed to be or was put to sleep and the BEVA criteria wasn't met. Vets are used as an uninterested party - they get paid no matter what their opinion!

I find it hard to believe a company would say you must put your horse down, due to the BEVA guidelines. But maybe they're saying she doesn't have LOU cover and therefore she would only get a payout if the horse was PTS, and then only if criteria was met. But then I suppose it depends on the policy she has.
 
Just to let you know, I went to see the horse. He, and his owner, are lovely but there was a bit more to the story than I was led to believe (happens with horsey hearsay, as I'm sure everybody is aware!).
He's only young, very bright and full of himself, and his owner was devasted. However, I felt he was just too much horse for me and it wouldn't be fair to take him on, not be able to cope and end up back at square one. His owner never once mentioned insurance, just wanted him to have a chance at life.
Anyway, he was reassessed since then, by the vets and, it appears, the original prognosis was way off the mark. He's been on field rest for a month and the injury (broken navicular bone) is healing and he's sound. They have given him a very good chance of coming sound enough to be a pleasure (not heavy competition) horse. All very good news for both horse and owner.
 
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