Insurance: pre-existing conditions clause

[tasel]

The insurance company is NFU Mutual. Previously, it used to be the case that they just had exclusions, such as "hock of near hind leg", etc. However, according to the company, they now have a pre-existing conditions clause, meaning that even if you claimed for the right hindleg before and your horse suffers another injury in this region that did not relate to the previous condition, you are still covered.

Has anyone had experience with this? Are they really that ethical about it?

 

[tasel]

Really??? No one has a clue?

 

[ladyt25]

Do you mean you are not still covered? I think you'll find most (if not all) insurers will exclude pre-existing conditions it's a general exclusion. ie they're not going to cover treatment for say arthritis is the horse already suffered with it prior to inception of a policy/ renewal date of the policy.

However, this should not mean if the horse suffers an injury to say a leg or part of the body that the whole area would then be excluded for further injuries/ailments that were NOT related to the previous injury.

 

[welshied]

Yeah we have this problem our horse has arthritis in one of his hind legs so that whole leg isn't covered for any injury that he may get in it! You wonder why you bother insuring them at all

 

[tasel]

No... that's what confuses me. Basically, they say they have a new policy that even if a particular leg, for example, was claimed for before, if the new condition had nothing whatsoever to do with th previous one (let's say previous one was arthritis, now it's an injury), then you are covered for the new incident. Vet has to state that new incident had nothing to do with the previous one.

That's why they don't state anything anymore on the exclusion list... just that it depends whether the new condition has anything to do with the other pre-existing injuries that were already known to the insurer.

 

[chestnut cob]

Usually they say they won't insure that particular area of the body for anything relating to the condition or attributable to it.

Mine had soft palate surgery a couple of years ago and his says "excludes anything directly or indirectly attributable to soft palate displacement". The other has shivers so I have "anything directly or indirectly attributable to shivers".

I would query it and get your vet to help you out if they're being tricky about exclusions.

 

[hoggedmane]

when I had my TB vetted he had some bramble scratches on his rear fetlock. The vet noted these on the form and the insurers excluded any injuries to the fetlock because of this. Blatantly ridiculous.

 

[ladyt25]

Anything not relating to a previous/existing condition should be covered. So, if your horse say has arthritis in a leg, arthritis would or should be excluded BUT if the horse was then kicked by another horse or I don't know, cut the same leg open on fencing or something then that should be treated as a separate incident as would not be connected to the existing arthritis.

It isn't really a 'new' policy it's how it should have worked in the first place - common sense and proper underwriting really!!!

 

[tasel]

[ QUOTE ]
Anything not relating to a previous/existing condition should be covered. So, if your horse say has arthritis in a leg, arthritis would or should be excluded BUT if the horse was then kicked by another horse or I don't know, cut the same leg open on fencing or something then that should be treated as a separate incident as would not be connected to the existing arthritis.

It isn't really a 'new' policy it's how it should have worked in the first place - common sense and proper underwriting really!!!

[/ QUOTE ]

That's it LadyT - that's what they told me and it DOES make sense. I was surprised they didn't have anything listed under exclusions, so I asked... and they basically said what you say above.