Insurance paying out!

[ycbm]

Actually I've had the horse for 5 years so he certainly was not drugged! It did work he was fine for 6 months then got totally different symptoms to the ones in December. He was under GA as he was too dangerous to do under stabbing sedation and would have injured himself, my vet is the top othropedic surgeon in Scotland so knew exactly what he was doing. I will certainly not give up I will be fighting this all the way. Just for the money my horse was worth!!

OK, your posts are confusing me I'm afraid. So, did you take out a new policy on a horse you had already owned some time? In which case, everything I have said, except for buying him while drugged, still applies.

If the operation itself was not covered by insurance on the grounds that it was a pre existing condition, then there is simply no liability on the part of the insurance company for death during recovery from an operation that was not covered by its policy with you.. It was NOT a freak accident unrelated to the kissing spines. It was the kind of accident which is entirely predictable that it will happen to a small number of horses subjected to a GA. The horse was only subjected to the GA risk to operate on the kissing spines.
.

If you can prove that the lameness you called the vet for on the thirteenth day of your new policy was unrelated to the kissing spines, then you might be able to claim for the operation and the death. That might be an avenue to try but I suspect you are unlikely to succeed; kissing spines does not develop overnight and they will likely still say that he had it when you insured him, even if the lameness at thirteen days was unrelated.

But if you intend to try to claim for the death of the horse and not the costs of the operation, you don't have a snowball's chance in hell of winning that argument, and if your vets are telling you that you do, then they are wrong.

 

[ycbm]

Dupe

 

[ycbm]

PS. I've just seen that right back at the beginning you say that they agreed to pay for the operation. If this is the case, then that's your argument with them, and I don't understand why anyone is even discussing with you whether he had or had not been cured of the kissing spines at the precise moment that he died. That is irrelevant.

If the cost of the operation was not covered, then his death, sadly, is not covered.

How you prove that they told you that they would pay out for the operation, I don't know, but if that's the route you are going down, good luck. Just don't confuse the issue by including any argument about whether he had kissing spines when he died, it's not going to help.

 

[Tiddlypom]

I don't understand why anyone is even discussing with you whether he had or had not been cured of the kissing spines at the precise moment that he died. That is irrelevant.

Think this was me querying why the horse was operated for KS, when no KS were found post op. I thought maybe the vets had been mistaken in their initial diagnosis, but OP clarified things in post #25. Was just trying to get the whole picture clear, in order to offer best advice.

 

[ycbm]

Think this was me querying why the horse was operated for KS, when no KS were found post op. I thought maybe the vets had been mistaken in their initial diagnosis, but OP clarified things in post #25. Was just trying to get the whole picture clear, in order to offer best advice.

I think the OP suggested it had come from the vet? I wasn't meaning your posts or anyone's except the OP, but it is a very confusing story so I hope the OP will clarify, but maybe s/he is too upset, understandably.

 

[MagicMelon]

Doubt I'll get anywhere as they refused to tell me where to put in a complaint and put the phone down on me yesterday! He was insured for accidental death and death due to injury and illness.

What actually happened was when he woke up he panicked and when getting up didn't position his feet right and flipped over breaking his neck and killing him instantly so was a complete freak accident vet has confirmed that on time of death he was kissing spine free. He is willing to write a letter and so is my own vet too!

They WHAT?! I'd have been calling them straight back and demanding to speak to the manager/director of the firm to tell them their employee just refused to let you complain and then hung up, that's awful - what insurer is this OP?

I think the fact that your reported an issue at 13 days (ie. 1 day before the insurance cover technically kicked in) then even though it was months down the line before you got a proper diagnosis, they will link it back to this and thus considered pre-existing. I really don't think they'll cover the accidental death, even though it was a pure accident - it was related to the surgery, its one of the risks. Therefore, its not "accidental" in the way they're meaning it I don't think. So is it loss of horse that you're wanting them to pay out for? You say you've got £4k in vets bills but they would never cover that anyway as he wasn't covered for vet fees? I'm a bit confused as well, sorry OP as someone else has said that you did state the insurer paid for the operation so he must have been insured for vets fees...?

 

[Horselover2010]

They WHAT?! I'd have been calling them straight back and demanding to speak to the manager/director of the firm to tell them their employee just refused to let you complain and then hung up, that's awful - what insurer is this OP?

I think the fact that your reported an issue at 13 days (ie. 1 day before the insurance cover technically kicked in) then even though it was months down the line before you got a proper diagnosis, they will link it back to this and thus considered pre-existing. I really don't think they'll cover the accidental death, even though it was a pure accident - it was related to the surgery, its one of the risks. Therefore, its not "accidental" in the way they're meaning it I don't think. So is it loss of horse that you're wanting them to pay out for? You say you've got £4k in vets bills but they would never cover that anyway as he wasn't covered for vet fees? I'm a bit confused as well, sorry OP as someone else has said that you did state the insurer paid for the operation so he must have been insured for vets fees...?

No they said they would then backed out ! And seis

 

[Tiddlypom]

Did you get issued with a claim form and a claim number at any point? IME insurers send out a claim form as soon as you report an illness/injury, which is then completed by the owner and the treating vet. The insurers will examine this before they will confirm that they will accept a claim. Any verbal assurance of cover is qualified by the insurers being satisfied by the full claim details. A full vet history may be needed, too.

Yes, it's a lot of hassle, and goes to explain why many of us are wondering whether equine insurance is worth it.

What do you have in writing from the insurers?

 

[Horselover2010]

Did you get issued with a claim form and a claim number at any point? IME insurers send out a claim form as soon as you report an illness/injury, which is then completed by the owner and the treating vet. The insurers will examine this before they will confirm that they will accept a claim. Any verbal assurance of cover is qualified by the insurers being satisfied by the full claim details. A full vet history may be needed, too.

Yes, it's a lot of hassle, and goes to explain why many of us are wondering whether equine insurance is worth it.

What do you have in writing from the insurers?

Nothing in writing was all verbal I told them everything over the phone and it took them 2 weeks to actually send out the forms! I filled them out and sent away my horses full 5 year history along with it, no other vet visits other than injections. And it's took them 7 weeks to send back a letter rejecting my claim.

 

[be positive]

Nothing in writing was all verbal I told them everything over the phone and it took them 2 weeks to actually send out the forms! I filled them out and sent away my horses full 5 year history along with it, no other vet visits other than injections. And it's took them 7 weeks to send back a letter rejecting my claim.

The dates do not add up, you said the op was 3 weeks ago yet now say they have taken 7 weeks to reject your claim, you should therefore not have sent the horse in for surgery until you had confirmation that the costs would be met, this is standard for any non emergency procedure.
You posted a thread in August about buying him as he was on loan to you for 5 years, you knew he had KS at the time yet still seem to have bought him, if the insurance company know he was not yours until then, which they should as it is relevant to his insured value and a change in ownership which they should have been made aware of, as far as they are concerned you actually purchased him with a known problem.

http://www.horseandhound.co.uk/forums/showthread.php?706335-Help!&p=12994922#post12994922

I feel for you, you have lost your horse in tragic circumstances, you now owe a large amount of money, the vets involved have done nothing wrong but I think they are wrong suggesting you fight the insurance company as there are several reasons for them to reject any claim, you should have been advised to wait a while for the operation to ensure you were covered the horse could easily have waited another few weeks until the situation was clear, I think you need to speak to the vets, tell them where you stand and see if they will take a payment plan, they may drop some of the costs/ not add interest if you sort something out ASAP .

 

[Horselover2010]

The dates do not add up, you said the op was 3 weeks ago yet now say they have taken 7 weeks to reject your claim, you should therefore not have sent the horse in for surgery until you had confirmation that the costs would be met, this is standard for any non emergency procedure.
You posted a thread in August about buying him as he was on loan to you for 5 years, you knew he had KS at the time yet still seem to have bought him, if the insurance company know he was not yours until then, which they should as it is relevant to his insured value and a change in ownership which they should have been made aware of, as far as they are concerned you actually purchased him with a known problem.

http://www.horseandhound.co.uk/forums/showthread.php?706335-Help!&p=12994922#post12994922

I feel for you, you have lost your horse in tragic circumstances, you now owe a large amount of money, the vets involved have done nothing wrong but I think they are wrong suggesting you fight the insurance company as there are several reasons for them to reject any claim, you should have been advised to wait a while for the operation to ensure you were covered the horse could easily have waited another few weeks until the situation was clear, I think you need to speak to the vets, tell them where you stand and see if they will take a payment plan, they may drop some of the costs/ not add interest if you sort something out ASAP .

Actually the horse was proven mine so I did own him I only loaned up for 6 months as it was proven that he gave up ownership when he said he couldn't afford him anymore he was ours. I went for the operation as the only way he wasn't in pain was to be on 3 bute a day and I didn't want him to be in pain anymore. The I can work my ass off to pay for the surgery I just wanted him to be okay!