Insurance payouts...

Nudibranch

Nudibranch

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Right, Ill try and keep it short. Any suggestions what to say to an insurance company who are refusing to pay most of a (valid) claim...? It is the company generally seen as one of the best on here, beginning with a P, lets just say. Basically had the vet out when horse collapsed in September, he came out three times in all to do bloods, follow up checks, etc etc, but all resulting from the one condition. Horse was immediately retired with suspected narcolepsy. So I paid the excess and sent off the claim form - yesterday I get a very short letter back from the insurer stating they would pay out £45!!! All it said was that dates after the 10th September would not be paid. Now considering the initial call-out was on 10th, it seems they don't want to pay the following tests and treatment. WHAT???
I just do not understand their logic, this company supposedly pays out on conditions for life yet they will not pay out for a course of treatments after the first vet's visit! I will obviously be calling them first thing tomorrow morning but any advice on how to approach this with them would be appreciated...
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Sounds very odd to me.
Keep your cool on the phone with them tomorrow and find out exactly why they are claiming not to pay.
Then phone your vet and get him to speak to them.
Meanwhile it might be worth researching the governing bodies tonight, the industry will be regulated and if you have no luck on the phone tomorrow I would slip into the conversation about reporting them to their governing body. Make sure you get the names of the claims assessors involved
 
I cant understand why they wouldnt pay if it was a new illness, you should be able to claim for max of 1 year of usually 5k?

I didnt claim straight away on my horses injury it was only when they wanted her for scans and xrays etc i made my claim but they just took it from the date of the first vet visit of the date of the incident i think.
 
Yes, I phoned them the same day the vet came and they just said, no problem, just fill in the claim form and send it in when the treatment is finished. Am really annoyed, and it's not even a massive claim, a couple of hundred quid so I can't see why they're trying to shirk their responsibility.
 
I work within the insurance industry and have unfortunately had to claim for 9k worth of vets bills followed by humane destruction of my 5year old this year inc loss of use. All of which were with your insuring company. They will only withold payment where one of the policy terms has been broken and even then will be pretty reasonable, it sounds as though your letter may be a mistake or that there is more information needed. If you dont get any luck and want to pm me please feel free.
 
There will be a reason and a phone call should establish what this is. Have you read your policy wording? You may find that certain aspects are not covered. They will only pay out under the terms of the policy. Without knowing what they are it is difficult to advise you further.
 
Nah it's not E&L... beginning with "P" remember! My vet won't accept E&L claims, you have to pay up front if you use them.

Have gone through policy wording with a fine toothed comb and can't see anything that would exempt a payout for this, which is a fairly simple case. I used to work for an insurance company so I know what they're like, but this seems extreme.
 
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It isn t E and L by any chance?

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Nope, she said it "begins with a 'P'" !

We are also with this 'P' - they tried it on with us when Murph went for hydrotherapy, despite them claiming to pay up to £1000 for alternative treatments. Murphs hydro came to exactly £1000. Insurance refused, we laughed at them, told them that we knew they were just trying it on, and then they caved & payed out. At the end of the day, the dont WANT to be paying out, so they will occasionally try it on, but just ignore them and tell them they've got no right to refuse!

Good luck anyway. Oh, and i hope horsey is ok now.
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Ah-ha... spoke to the insurance company and they are blaming the vet for only sending part of the bill. Vet are blaming the company, saying they did send it all and the insurer musn't have processed it properly. Personally I'm with the vet, since I also enclosed all the invoices. Anyway I will receive a new claim form for the outstanding amount and hopefully this time they will pay it!
 
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