Insurance refusing to pay for loss of horse (long)

J

jcneill

Member
Joined
27 March 2009
Messages
15
Visit site
I had my boy rescanned and xrayed last week as he is still very lame following surgery to remove some damaged cartledge from his fetlock. The result was not at all what I expected. I thought the vet would say turn him away for 12 months then see how he is. What she said was that basically the operation hasn't worked. He was given a 70 - 80% chance of full recovery, and he's just in the 20% it hasn't worked for. His prognosis is now dire. He'll never be ridden again and will have to spend the rest of his life on 2 bute a day. On top of this as he is resting the bad leg, this will lead to other problems. My vet has been very kind but honest and told me the best thing for him is to have him put to sleep. However she told me that he did not meet the BEVA guidlelines for euthenasia but she would argue my case with NFU. I have never heard of these guidelines before but didn't think it would be a problem.

I have decided that the injection is the way I want my boy to go. He's been sedated before so I this is the way I feel most comfortable with. I rang NFU and was very shocked when they said that they wouldn't even consider a claim unless it meet the strict BEVA guidelines, with no exceptions. I have to pay for the whole process myself. The vets visit to actually PTS and his removal and disposal. So on top of not even having the loss of horse payout which I thought I was covered for, its going to cost about £500. My vet says she will back my case and I should persue this, but I'm so distressed about loosing my boy I don't know if I have the energy. Has anyone else battled the insurance companies and won or am I wasting my time?

Thanks if you stuck with this
 
The same thing has happened to two friends of mine, one was a 4yo with DJD so aggressive that the vet said no option but to pts, NFU disagreed. Another was a horse who had completely severed his tendon, he was in a cast for 3 months and no improvement so pts - insurance company (not NFU) refused to pay out :(
 
Has the vet given any idea if the horse could possible recover to a degree where they would be field sound without bute or have you already been down that path? Are there any other options available to treat the problem?

If not then i would get your vet to write or discuss this case with the insurance company but I would not advise having the horse PTS before getting it agreed by the NFU (that is assuming the horse can be made comfortable in the short term on painkillers). The vet is really the one who can argue your case for you but the NFU may want a 2nd opinion from a vet they use before they decide. It is quite likely they ultimately agree with the vet and will agree to pay but the biggest mistake you can make is to have the horse PTS before getting consent from the insurer (my friend did this and they refused to pay out - I won't go in to details).

Unfortunately insurers do tend to be a bit like this as too many people don't maybe have vets fees cover or don't want to bother with treatment so just want to get rid of their horse and get their cash. Sad but true and this is why the insurance companies will always want the vet to confirm the horse does require euthanasia under BEVA guidelines.
 
To meet BEVA guidelines for euthanasia for humane reasons your horse needs to have pain which does NOT respond to normal dose painkillers OR be unlikely to survive the time left on your insurance claim. If your horse is currently comfortable on 2 bute a day I am puzzled as to why the vet is so keen to PTS.

If you intend to challenge this decision you will need a second opinion and to invite the insurance to let their vet examine the horse. If the insurance have paid out for surgery and treament I think it's unlikely to pay for loss of horse unless you pay for loss of use. Hope this makes sense!

I'm sorry to hear this - I have had to retire my beloved horse due to injury at 12, he is mooching around and had bute as and when. PTS has not been mentioned but it is always in my mind if he deteriorates.
 
Oh hunny. So sorry to hear this.

I fought the insurance company that shall not be named when my first horse's chronic rear suspensory ligament damage proved too much for her to cope with. She would have been put to sleep whether they would pay or not, it was the right decision for her, but when the insurance company said no, my vet sent qutie a stinging letter, pointing out all that we had done, the report from the AHT, the fact that there was no come back from the diagnosis: the horse could no longer stale properly, found turning hard (had to move long and slow), and that was before the ground got soft, which was going to hurt her even more. ETS: she was on max. dose Bute before she went.

The time of her being put to sleep is a little hazy now, but I do remember the insurance vet rang me the day before she was being put to sleep, to go through it all again.

The insurance did pay out in full in the end.

I hope it all goes as well as it can hunny.
 
Last edited:
I just wanted to say how sorry I am about you and you horse.... ((((((((((HUG)))))))))))

The worry of insurance is one more thing you dont need. I agree with the others invite the insurers to have a vet asses your horse too for a second opinion. Again so sorry and I regret that I am no further use to you :-(
 
I'm very sorry to hear about your horse.
I battled for 6 months with my insurance company and we eventually won but only after threatening to take legal action.

You basically need to get it in writing from your vet that the best option for the welfare of the horse is PTS. A second opinion from a different vet would also help your case.
 
Inviting the insurers to get a second opinion sounds sensible, I will contact them tomorrow.

Even though I wrote earlier he's on 2 bute a day, he still doesn't look what I would call comfortable. As many have said, it would be easier if they could talk. He will survive the next 12 months but he certainly isn't himself. I've discussed all possible options with the vet and the most realistic one for both of us (without sounding heartless) is to have him PTS.

Thanks for all the replies.
 
I am sorry to hear about your horse and the difficult situation you are in, but this demonstrates the exact reason I no longer insure my horses other than for 3rd party.

We had a lovely BSJA mare that was diagnosed with wobblers - the vet recommended pts as she was becoming a danger to herself and others around her, but as was not in 'pain' would not pay out. We had been paying monthly premiums on her for many years, with no claims...............

I now have a separate savings account for vets bills.

Good luck in whatever you decide.
 
I am very sorry to hear about what has happened to you (((((((hugs)))))). I don't have much knowledge on the insurance side, however my mare also had an operation to remove damaged cartilage from the fetlock joint. They gave her a course of injections (which the name of has completely eluded me!) which helped her to regenerate a secondary form of cartilage, she was on box rest for a longtime also. Has this been tried? If so then I am sorry and I hope everything turns out well for you.

All my wishes xxxxx
 
so sorry to read this insurance co's can be so cruel :(
not what you need at a time like this ,a friend of mine was in a similar possition and her vet fought her corner and won but as previously said she couldn't PTS until it had been sorted out

really feel for you hope you get it sorted out :(
 
Cuffey - thanks for the link.

OP my insurance company are saying the same about my horse at the minute. I'm going to ring the vet tomorrow morning. Starting to wonder why I bother with insurance companies :(
 
A friend who had a horse with navicular was in a similar situation and the insurance was refusing to pay stating that the horse was not bad enough to be destroyed as it was 'comfortable' on bute.

She then took it to another vet for a second opinion and this vet stated that the horse was going to get worse and where it asked to the reason for the lameness he put down 'Act of God' and they immediately paid out.

Insurance companies always try to get out of paying in most circumstances and if you have a claim coming from a third party (it was your fault) then admit negligence and they will pay. If you do not then they will not.
 
The horse I had before Sunny was in a similar position with advanced DJD + navicular syndrome. Worst in both front feet (only diagnosed very late in the day as he was bilaterally lame to what turned out to be a shocking degree) but also present in hinds. I knew he would struggle to get through another winter and he was losing weight and getting dangerously panicky if his buddy that looked after him in the field was absent for any reason. I talked it through with one of the best lameness vets in the UK and he agreed that pts was going to be the kindest option. My insurers then told me that his planned pts was outside what he was insured for. I was horrified but rules is rules. I mentioned it to my vet and he was horrified too. Bless him, for no charge whatsoever, he wrote and spoke to my insurers (what used to be Equestrian Direct) and they agreed to make a goodwill payment to me of 60% of the horse's insured value. I think this was a decent and honourable thing to do but god knows where "decent and honourable" comes into anything these days. Worth a try though. Good luck x
 
Another thing I meant to add was that if you call your local hunt then they will also euthanise your horse for you and remove the carcass. They will euthanise with a humane killer, which is the way I would far rather a horse went, a lot quicker although a bit messier.

They will take the horse for about £200 - they will take a horse that has been injected but will cost you more as they cannot be fed to hounds.
 
The BEVA guidelines are quite strict. I once heard it put this way: Ask yourself this question - if it was a prize winning stallion/filly belonging to a money no object racing owner could something be done to save the horse for breeding. If the answer is yes, then it's unlikely to be covered by BEVA guidelines. The trouble is if the guidelines were looser none of us would be able to afford the insurance anyway.
 
It does sound like insurance companies are harsh but sadly that is how the policies work. Horse insurance LOSES insurance companies money so they are not going to just pay out because you and you vet decide the best option would be to have the horse PTS as opposed to trying other avenues. This is often what happens when people only have their horses covered for Death and not vets fees - the treatment to possibly 'fix' the horse will be expensive and long with no guarantee of success so they elect to have the horse PTS rather than forking out and then they expect the insurance company just to pay out and ask no question. Well, sadly it does not happen like that. IF the horse can live comfortably but can no longer be ridden then that does not comply with BEVA guidelines for euthanasia.

I am certainly not saying this is the case in this instance but just pointing out it is not always black and white an a case of "insurance companies trying to get out of paying". If you had Loss of Use cover then that would cover you for exactly these circumstances where you choose to have the horse PTS as it can no longer fulfil its use.

Personally I think in the OPs particular case a 2nd vets opinion should be sought - that should be the insurer's vet - and, together with the backing of the OPs vet i would think this case will be agreed as being in the best interest of the horse and the most hmane thing to do. IF though the 2nd vets opinion is that the horse could benefit from further treatment (I see this as being unlikely) then the insurer is not then going to settle a loss of animal claim.
 
I've had my horse for 16 years and at no time has my insurance policy ever mentioned paying out in the event of her death so it is always a bill that I have just had to be prepared to meet. Reading the other posts I'm actually quite glad it will never be a subject I have to argue with them about - at least I know exactly where I stand.
 
I haven't read all of these but this happened to me last year so I completely empathise and can I say I am so so sorry that you've had to make this decision.

My old boy was diagnosed with severe navicular in June last year. We treated, tried everything bar a neurectomy (which I wasn't happy with on a personal level) but he just couldn't stay sound. We managed to work him for three days before he was crippled and I decided enough was enough. He was miserable and started to get dangerous when handled on the ground so I made the decision to PTS. I spoke to my insurance company and they spoke to my vets but as it didnt fall under BEVA then I had to pay for everything myself. I was gutted as although the money would have been nice I has assumed that was what I was paying my insurance for! I was particularly aggravated that they won't even cover disposal costs if the BEVA guidelines aren't met :(

The BEVA guidelines basically only cover PTS in an emergency situation for humane reasons - the argument over whether living on 2/3 bute a date is humane doesn't seem to fall into that category :(

If you want to have a look I found the BEVA guidelines here: http://www.fhvets.co.uk/facilities/BEVA Destruction of Horse Guidlines.pdf

When I posted on here though some people had been successful, I just wasnt :(
 
Sorry to hear of your loss.

BEVA guidelines apply to all equine insurers and it is down to the vet to state whether the horse meets the guidelines or not. As you've said your vet said your horse didn't meet the criteria, I'm not sure how the insurers would change their minds on this. However, most companies do employ a vet who acts to give an independant opinion, neither favouring the vet or company. You could get the vet NFU use for referrals to discuss this with your vet and give an opinion.

Unfortunately that is the case sometimes that although the kindest thing to do is PTS, if BEVA guidelines aren't met a claim is not valid. But maybe you can come to some sort of compromise over settlement so you may get a portion of the money?
 
Last edited:
It's worth asking your vet to talk to them. When my old mare was diagnosed with pedal ostiutus I had the option of 12 months box rest with a slim possibility of her becoming sound enough to ride, but never allowed turnout again, or pts. I immediatly went with pts.

The insurance company refused to pay out because she might just have come sound after the 12 months, but when I queried it and had my vet speak to them they did offer to pay disposal costs as a goodwill gesture.

Query it with them (preferably via your vet). It's worth trying.

I'm very sorry for your loss :(
 
Sorry for your loss.

Happened with my boy late last year, Insurance wouldnt pay a penny. Ended up costing me about 700 quid :(
 
I had the same problem with the same company. Horse was not even paddock sound on 2 bute a day, he also suffered from ulcers so it was only going to be a short term solution anyway. My vet told me to pts, it was the kindest thing for him, so I didn't think twice. When I spoke to the insurers they said as long as he was pts under BEVA rules it would be fine. I contacted my vet and she said it wasn't as he didn't meet the criteria. But I said he was crippled on 2 bute and in pain and you told me the best thing for him was pts, she agreed but said that unless they've pretty much broken a leg and need immediate destruction most insurance companies expect the horse to still be in discomfort and be kept going.

Yes it cost me nearly £1000 as I had him cremated and his ashes back but I was happier scrabbling for the cash knowing he was out of pain.

Hugs to you both x
 
OP i'm so sorry for your loss its always such a difficult decision and one that none of us really want to make.

But i just don't understand these Insurance companies because i had a completely different experience with them and I don't understand why they are not consistent.

Last year I came home to find my boy 9/10th lame on his near fore, massively swollen lower leg. I managed to get him over to the vets, and with ultra sound he was diagnosed with a near complete rupture of the DDFT, the vet told me that he would never be ridden again and it would be a min 12 months box rest with no garantee of recovery as he was 16, I was told that there were things they could do but the kindest option was to PTS. After nearly passing out at this news, i made the on the spot decision to be kind and PTS there and then before he even came out of sedation, to prevent any further suffering.

I called the insurance company to cancel the rest of my policy (1/2 way through), i explained what had happened and they told me i was insured for loss of horse. To cut a long story short a guy called to get the facts, he was really nice and kept on saying how sorry he was to hear my news (i couldnt stop crying). Within 2 weeks they cut a check for the vets fees, disposal (cremation), loss of horse and the remaining money on my policy.

So i just dont understand why they are being difficult in paying out for you. I hope you get it sorted as although it is a horrible thing to happen the money is one last thing for you to worry about.
 
Dab said:
OP i'm so sorry for your loss its always such a difficult decision and one that none of us really want to make.

But i just don't understand these Insurance companies because i had a completely different experience with them and I don't understand why they are not consistent.

Last year I came home to find my boy 9/10th lame on his near fore, massively swollen lower leg. I managed to get him over to the vets, and with ultra sound he was diagnosed with a near complete rupture of the DDFT, the vet told me that he would never be ridden again and it would be a min 12 months box rest with no garantee of recovery as he was 16, I was told that there were things they could do but the kindest option was to PTS. After nearly passing out at this news, i made the on the spot decision to be kind and PTS there and then before he even came out of sedation, to prevent any further suffering.

I called the insurance company to cancel the rest of my policy (1/2 way through), i explained what had happened and they told me i was insured for loss of horse. To cut a long story short a guy called to get the facts, he was really nice and kept on saying how sorry he was to hear my news (i couldnt stop crying). Within 2 weeks they cut a check for the vets fees, disposal (cremation), loss of horse and the remaining money on my policy.

So i just dont understand why they are being difficult in paying out for you. I hope you get it sorted as although it is a horrible thing to happen the money is one last thing for you to worry about.
Click to expand...

I'm so sorry for your loss but I think the difference between your claim and the OP's is that yours was more instant...and more like there was no other option.

Sadly with OP's horse there was the choice of Arthroscopy which in itself has a much longer recovery time than most vets expect and obviously carries an expense for the insurance company. If there is any whiff of a possible recovery, insurance companies won't pay out and you can kinda understand why.

OP have you considered turning him away with a quiet friend for a year? I only sugest this as I had all but given up on my filly who suffered OCD when she was 9 months old and had Arthroscopy at 16 months old... unfortunately after a long recovery period she still wasn't right and vet said she probably wouldn't come right so she went back to her breeder to live life as a horse in a nice big field. She is now sound (aged 4) and they are in the process of backing her. I know my girl had age on her side but time can be a healer.
 
Dab said:
OP i'm so sorry for your loss its always such a difficult decision and one that none of us really want to make.

But i just don't understand these Insurance companies because i had a completely different experience with them and I don't understand why they are not consistent.

Last year I came home to find my boy 9/10th lame on his near fore, massively swollen lower leg. I managed to get him over to the vets, and with ultra sound he was diagnosed with a near complete rupture of the DDFT, the vet told me that he would never be ridden again and it would be a min 12 months box rest with no garantee of recovery as he was 16, I was told that there were things they could do but the kindest option was to PTS. After nearly passing out at this news, i made the on the spot decision to be kind and PTS there and then before he even came out of sedation, to prevent any further suffering.

I called the insurance company to cancel the rest of my policy (1/2 way through), i explained what had happened and they told me i was insured for loss of horse. To cut a long story short a guy called to get the facts, he was really nice and kept on saying how sorry he was to hear my news (i couldnt stop crying). Within 2 weeks they cut a check for the vets fees, disposal (cremation), loss of horse and the remaining money on my policy.

So i just dont understand why they are being difficult in paying out for you. I hope you get it sorted as although it is a horrible thing to happen the money is one last thing for you to worry about.
Click to expand...

Because yours was a BEVA case he was 9/10th lame and would have been the case like a broken leg. Insurers are quite happy if the horse is ok ish on 2 bute a day and still a bit unlevel in the field. If the OPs horse was hopping around and could not weight bare at all and was as serious as your case then it would qualify and adhere to the BEVA rules.
 
lochpearl said:
Because yours was a BEVA case he was 9/10th lame and would have been the case like a broken leg. Insurers are quite happy if the horse is ok ish on 2 bute a day and still a bit unlevel in the field. If the OPs horse was hopping around and could not weight bare at all and was as serious as your case then it would qualify and adhere to the BEVA rules.
Click to expand...

Oh ok, sorry to be a loon, i thought it was similar because the Vet said there was things they could do, i.e. stem cell therapy, box rest, longterm paddock ornament. Its all very sad :(
 
Last edited:
I don't insure my old lad and have only ever insured one before against vet bills. I am surprised at the NFU they are normally very good. But like all insurance company's these days they will wriggle out of paying somehow. I do not insure anything except I did have gold membership with BHS which gives free third party insurance although I don't have that any more as he never leaves the field.

OP good luck but go for it with your vets help
 
You must log in or register to reply here.
Top