Insurance issues & exclusions

[pottamus]

Just had my renewal through from NFU and noted that they no longer exclude specifics where a claim has been made, but have a general all round exclusion on pre-existing/previously had conditions, regardless of whether you have claimed or not.
Now I wondered what your thoughts are on this and how you guys will manage or cater for this if you have a horse with an existing condition that is likely to rear up again at some point...for example...laminitis, COPD, back problems, arthritis, skin conditions you name it...there are loads that could be affected!
Are you setting some money aside to cover the fees if you need to make a further claim?
I always thought that you could insure for anything if you were prepared to pay for it and I am happy to do this, but has anyone in this situation ever been able to pay an extra amount to insure for the existing condition regardless or is it a complete no go?
It is a scary and worrying thing for me as I have a horse with a condition that I will try my utmost to prevent coming back...but nothing is ever guarenteed and even I dont kid myself to think I can control my horses health 100% of the time for the rest of his life...so I am interested in your thoughts really.

 

[Birker2020]

Apologies for the long reply but I feel I have just got to say I am extremely impressed with NFU having been a client of theirs for over 9 years now. They have paid out on the death of 3 of my horses without a quibble, and countless injuries/accidents in the meantime (non of which have been my fault I might add!). Nov 08-Nov09 brought about a £3.2k claim for bone spavin which I thought would increase my premium so much that I would have to reduce my horses value (having him revetted to up his value 2 years ago as he was under valued). However it turned out that not only was my premium cheaper per month but that I had been given a £120 bonus discount due to the fact that NFU have no share holders so any profits that they make get passed on to their customers. They doubled their bonus this year to celebrate their 100 year anniversary. It came out at £2.00 cheaper per month than last years premium.

The only thing I would say against them is that in 2002 I had a claim for a small bony spur on my horses coffin joint which necessitated an intraarticular injection of steroid/HA once as he was 2/10ths lame. When renewal came around they excluded all three bones (coffin, navicular and presumably the short pastern bone) in all four feet. I hit the roof and told my vet what they'd said and the vet rang them, argued that it was a ridiculous exclusion for the other three feet and they took the exclusion off.

You are right in what you say about you can insure for anything. Having dealings with underwriters in the past as part of my job working for AIG it is my understanding that, in basic terms, the underwriter assesses the risk against a scale, working out the chance of the injury occuring against it not, and then comes up with a percentage ratio, this in turn is worked out against a premium amount.

My biggest tip would be to minimise the amount of things you tell the insurance company. I am worried as my horse is extremely colicky. I think he could have gastric ulcers or some other long standing condition. At the moment when he gets colic he gets spasmodic colic which is easily treatable, although the vet has had to come out in a small number of occassions when it will not go away, so the insurance company will not doubt exclude that condition, should the day ever come when he requires colic surgery, unless my vet could somehow come up with an explanation regarding the fact that all horses get colic from time to time, etc, etc.

I think the crux of the matter is establishing what is a one off and what is a recurring problem and how the underwriter and claim handlers relate to that point. I do think its difficult to say this, that and the other is excluded when in some cases it is not so black and white.

Do you get my point? Sorry, I am not explaining myself very well. xx

 

[SpottedCat]

[ QUOTE ]
Just had my renewal through from NFU and noted that they no longer exclude specifics where a claim has been made, but have a general all round exclusion on pre-existing/previously had conditions, regardless of whether you have claimed or not.


[/ QUOTE ]

All insurance companies have always done this, you just haven't read the small print!

You have to inform your insurance company of any 'non-standard' vets visit regardless of whether it leads to a claim or not otherwise your insurance is invalid and they are quite within their rights to refuse to pay another claim, whether or not it is related to the thing you did not tell them about. It is why if the cost of the treatment goes over the excess you may as well claim - the condition will be excluded anyway after a year/whatever your claim limit is, and you have to tell them. They are within their rights to ask to see your horse's full vet history from your vet and to refuse to pay a claim if you won't provide it, so it is worth telling them about everything.

It always amazes me how few people realise that this is how horse insurance works and therefore how many get stung when it comes to claiming further down the line.

 

[SpottedCat]

[ QUOTE ]


My biggest tip would be to minimise the amount of things you tell the insurance company. I am worried as my horse is extremely colicky. I think he could have gastric ulcers or some other long standing condition. At the moment when he gets colic he gets spasmodic colic which is easily treatable, although the vet has had to come out in a small number of occassions when it will not go away, so the insurance company will not doubt exclude that condition, should the day ever come when he requires colic surgery, unless my vet could somehow come up with an explanation regarding the fact that all horses get colic from time to time, etc, etc.



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That's not really how it works though - my horse was diagnosed with ulcers, god knows how long he had them for before hand, but the insurance claim ran from the date of diagnosis.

If you really suspect your horse may have ulcers then really you should get him scoped and diagnosed, the damage to the stomach and gut can get beyond the point of repair and this is a relatively easily treatable condition