Insurance respiratory exclusion

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Udall

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We have previously had our vet out to our Shetland for what our vet believes was an allergic reaction to something, most likely dust. It usually happens when we bring them in overnight during the winter. On his vet history our vet had marked him down as having an asthma related illness.

We recently had to have our vet out again for similar symptoms and this time we got him scoped and it was identified that he had a bacterial infection which cleared up with antibiotics.

We have tried to claim the cost through our insurance, they requested his history and have refused the claim and back dated an exclusion for everything respiratory related.

We didn’t realise that you needed to inform them about every illness even if you didn’t claim, which I now know you should do. The insurance company have advised that they would exclude everything respiratory related for life because asthma can be classed as an umbrella illness and cover multiple things. When submitting our claim our vet did make it clear that this was a bacterial infection.

I do feel that excluding everything respiratory related is a little unfair given this latest issue is not the same as an Asthma related illness, but I wondered if anyone had any luck pushing back on a full respiratory exclusion?
 
Every insurance company is different and not all of them slap on an exclusion at the drop of a hat but the main well known ones do.
I remember I was with SEIS about 10 years ago and after a coffee yard discussion about ulcers. I happened to call my insurance to check if im covered on my policy! I got a letter the next day excluding them!! I was fuming. BB never had ulcers I was only asking. Punished for asking a question. I subsequently moved immediately.
In fact in 10 years I had the vet out for colic twice both needing hospital stays no other injuries or anything.
Ive found Insurance Emporium the best and even when BB did colic they didnt exclude it.
 
Sometimes you can “argue” it. My horse had an exclusion put on both front legs and tendon/ligament damage.
I thought this really unfair as he had damaged a tendon by striking into himself, so a complete unlucky accident.
They did agree to lift the exclusion and switched it to the injured tendon on the injured leg being excluded which I was happy enough with.
 
Barton Bounty said:
Every insurance company is different and not all of them slap on an exclusion at the drop of a hat but the main well known ones do.
I remember I was with SEIS about 10 years ago and after a coffee yard discussion about ulcers. I happened to call my insurance to check if im covered on my policy! I got a letter the next day excluding them!! I was fuming. BB never had ulcers I was only asking. Punished for asking a question. I subsequently moved immediately.
In fact in 10 years I had the vet out for colic twice both needing hospital stays no other injuries or anything.
Ive found Insurance Emporium the best and even when BB did colic they didnt exclude it.
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Wow that’s scary! Thank you, I will look into the Insurance Emporium when his renewal is next due.
 
poiuytrewq said:
Sometimes you can “argue” it. My horse had an exclusion put on both front legs and tendon/ligament damage.
I thought this really unfair as he had damaged a tendon by striking into himself, so a complete unlucky accident.
They did agree to lift the exclusion and switched it to the injured tendon on the injured leg being excluded which I was happy enough with.
Click to expand...
Glad you managed to get yours amended, we have asked to raise a complaint and will see if we get anywhere with it. Thanks
 
I had an exclusion on the whole respiratory system after a pot of ventapulmin on a bill. I had to get my vets to provide a statement that it was for my other horse. There was nothing in the clinical history about breathing. Same insurers wanted to exclude a whole leg for an overreach.

I do find these days they ask for the clinical history from the vets so you get a heads up at renewal about exclusions and can argue them.
 
Insurance companies are regulated by the financial ombudsman https://www.financial-ombudsman.org.uk/consumers/complaints-can-help/insurance/pet-insurance so if you think that refusing to cover this claim is unfair go to them - this would also cover cases of excessive exclusions by the way. You do have to follow the correct process and if goes to the ombudsman it's not quick to resolve but companies often fold at the formal complaints process as there are consequences for them if they are refusing claims incorrectly.

The magic words are "I want to make a formal complaint, how do I do that?"
 
Barton Bounty said:
Every insurance company is different and not all of them slap on an exclusion at the drop of a hat but the main well known ones do.
I remember I was with SEIS about 10 years ago and after a coffee yard discussion about ulcers. I happened to call my insurance to check if im covered on my policy! I got a letter the next day excluding them!! I was fuming. BB never had ulcers I was only asking. Punished for asking a question. I subsequently moved immediately.
In fact in 10 years I had the vet out for colic twice both needing hospital stays no other injuries or anything.
Ive found Insurance Emporium the best and even when BB did colic they didnt exclude it.
Click to expand...

Tris had a resistant redworm burden that caused damage to his gut as a yearling, SEIS then excluded 'weight loss and and related conditions' 🙃 I always found them easy to deal with and they paid put quickly, but between weird exclusions and my premiums going mad, I decided it was best to switch.
 
You can try and get it removed sometimes a letter from your vet can change the outcome.

You could argue that a bacterial infection doesn't mean the horse has asthma and try and get some part of the exclusion put back on.

I did it with a lameness issue on the same leg my vet did a letter to say that the second issue was not connected to the first and they let me do a separate claim.
 
Jinx94 said:
Tris had a resistant redworm burden that caused damage to his gut as a yearling, SEIS then excluded 'weight loss and and related conditions' 🙃 I always found them easy to deal with and they paid put quickly, but between weird exclusions and my premiums going mad, I decided it was best to switch.
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I just think its extremely unfair. I mean, mostly you pay insurance and hardly use it
 
Udall said:
We have previously had our vet out to our Shetland for what our vet believes was an allergic reaction to something, most likely dust. It usually happens when we bring them in overnight during the winter. On his vet history our vet had marked him down as having an asthma related illness.

We recently had to have our vet out again for similar symptoms and this time we got him scoped and it was identified that he had a bacterial infection which cleared up with antibiotics.

We have tried to claim the cost through our insurance, they requested his history and have refused the claim and back dated an exclusion for everything respiratory related.

We didn’t realise that you needed to inform them about every illness even if you didn’t claim, which I now know you should do. The insurance company have advised that they would exclude everything respiratory related for life because asthma can be classed as an umbrella illness and cover multiple things. When submitting our claim our vet did make it clear that this was a bacterial infection.

I do feel that excluding everything respiratory related is a little unfair given this latest issue is not the same as an Asthma related illness, but I wondered if anyone had any luck pushing back on a full respiratory exclusion?
Click to expand...
Yes you can appeal exclusions, they may want more veterinary info.
 
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