Insurance - Unfair Exclusions - Hardly Worth Renewing

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Mithras

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My insurance renewal has just come in from KBIS at £588. this is for an 8 year old mare, undervalued at £5000, basic cover. Is for vet's fees and all the usual death, loss of use, pesonal cover, etc but excluding 3rd party liability which I have through another source.

I've never claimed.

Yet there are 3 exclusions on my policy:

"all claims in respect of the right hock other than accidental external injuries involving an open wound and any related conditions"

"all claims in respect of any wind problems and any related conditions"

"all claims in respect of any right fore lameness other than accidental external injuries involving an open wound and any related conditions"

The reasons for these excusions is that she had a cracked bone near her right hock which healed with veterinary supervision but not treatment (before I bought her 2 years ago). She also had strangles as a foal and makes a slight noise sometimes when exerted but doesn't stop her doing anything, lives on straw, no discharge, cough, etc..

The other one exculding the whole of the right foreleg is what really gets me. It results from what was obviously a passing, almost flippant comment on my vet's report when I bought her that she was slightly stiff on turning a circle on it, and her shoes should be checked for a good fit. She has actually never been lame, despite being in hard, competitive work, has never had so much as a swelling. I have asked them 2 years in a row to remove this particular exclusion but they say they wont unless I get another vet's report saying her right foreleg is fine - more good money after bad?

So I have a young, sound horse for whom I have never claimed, and half her legs are excluded, despite there being nothing wrong with them, along with her wind. You take out insurance for peace of mind, and I'm not getting any with these OTT exclusions. What if she happens to damage a tendon on her rear fore? I'll get nothing.

What a waste of money. No doubt another insurance company will be the same as you have to disclose everything. IMHO they are being less than honest back in keeping excessively imaginaitve exclusions. And despite telling them 3 times, they cant even spell her name right, which is a common English dictionary word(!), so I guess I've actually been paying to insure a non-existent horse!
 
Definately worth talking to your usual vet about the exclusions and asking him if it is worth to argue about it. I bought a horse in the early nineties who passed the vet, but there was a note on the vets certificate mentioning that he had slightly 'curby' hocks.
When I went to insure him, they excluded his hocks completely. I was working at an Equine practice at the time and they encouraged me to contact the vet who vetted the horse (I was living up North.. horse was in near Leicester).
I contacted him and he wrote a letter for me to the insurance company saying it was unfair to make the exclusion, the horse had a minor conformation fault that would only affect value if he was a show horse. He was bought for eventing and in his opinion this would not affect the horse at all. (The vet in question is often an official vet at Badminton so knows what he is talking about!)
the insurance company then amended the policy and the exclusion was lifted ! (by the way.. the horse never had a days problem with his hocks!)
Remember, often these policies are looked over by people who maybe do not have that much knowledge... see a comment on the vet history or vets certiificate and then 'to be on the safe side' slap an exclusion on it... it is always worth to discuss..especially if your vet agrees it is not fair and would be prepared to write something for you (I know... he will charge you as well..... but it might be worth it in the long run)

Let us know if you do try and get anything lifted
 
Oooohhhh, best not get me going about insurance! Suffice to say I took out a new policy last October for a horse I have owned for 18 years and still, despite a vets report, haven't managed to get an acceptable set of exclusions. She chipped her splint bone about 10 years ago and has never been lame with it, had minimal unsoundness in a front leg (and now has natural balanced shoeing) about 6 years ago and poked herself in the eye whilst in the field 2 years ago. The eye is excluded, the front foot and associated structures and the hind leg - so we don't even have any accidental cover on the 2 legs! This horse generally hunts about 20 days a season and is probably the soundest horse we have ever owned! I hate insurance *grumbles away under her breath*
 
Its a good idea but unfortunately the vet I got to vet her worked for the uni place near Edinburgh and has undoubtedly moved on now. Current vet might do it but might insist on coming out to examine her in person - just more money and hassle for the "privilege" of paying them nearly £600 to insure 3 of her legs and not her wind!

As a lawyer, I actually disagree with the theory behind exclusions, or at least the way it is practised. Insurance is a contract ubberimae fidei , or in the utmost good faith. That means you have to disclose everything that might affect the contract of insurance. But a contract is a bilateral agreement. It is not just one party who must act ubberimae fidei. The insurance company should not "over-use" information provided to excessively exclude. Of course, insurance compnaies have come to use exclusions as a sort of catch all for reducing their payouts. But theres a balance between actually providing insurance cover and meaninglessly excluding things, and I guess for me that balance isn't there any more.
 
Insurance is all about risk, and anything they consider an unacceptable risk, they will either not insure, or will insure at over inflated prices.

In short, they will cover anything that they don't think they will have to pay out for, anything else is a 'risk'.

After dealing with E&L, I told my OH that I thought the insurance premium was robbery, as when you actually have the audacity to claim, they try their best to avoid paying out.
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I don't bother to insure anymore horse is a veteran so just use BHS gold. When other horse was insured they excluded all four legs and hoofs. It was a bogger to ride my feet kept touching the floor. lol
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p.s. only ever claimed twice in 10 years once for sunday call out for laminitus horse couldn't move never had it again. Other for removal of small lump on shoulder size of a 50p piece.
 
Horse insurance is expensive because the insurance companies don't want any more business, they've got more than enough. If you have access to cash quickly (e.g. credit card/savings), and liability insurance anyway, it might be better to consider saving the insurance cash in a vets fees account and paying for any treatment yourself, that way you have full control over what is worth paying for, especially given that with limited cover for vet's fees, investigations including MRIs plus any surgery would be pretty close to that limit.

Even the best insurance companies try to get out of paying on horse claims.
 
who was your vet? PM if you like, I might be bale to tell you if they are still there, also in contact with a couple who are no longer practicing but still involved with other projects.
 
DONT ever use E&L, my vet says it stands for "excuses and Lies" as he has never heard of them paying out.

my horses WHOLE hind leg was excluded when i claimed for lameness, despite it being due to mud fever, and not actulay requiring any treatment at all. The WHOLE leg, i find this unbeliveable.
 
ha i think i can beat you on the exclusions, ive got a horse who has all 4 legs excluded, his spine excluded, colic excluded and his pelvis excluded. I no longer insure him because all i could insure was his head neck and tail. this is because the silly plonker chucked himself out of the jockey door of a trailer, made a mess of his legs, put his back out slightly and there was a slight queary about his pelvis. Legs have healed with no scars and he was only lame for a few days after his accident dispite having chunks the size of dinner plates out of him, his back was very quickly put right by a chiropractor and the concerns over his pelvis were found to be nothing.
 
Hmm, this being an insurance post I feel obliged to comment seeing as I am one of those responsible for placiong exclusions/terms on policies!!!

My first comment would be - that premium seems very reasonable if covering Loss of Use and Vets Fees? All I can work out from that is KBIS must charge a fortune for PL cover!

As far as the exclusions go, unfortunately this is based on the views of the underwriter who has handled the policy/renewal . They may or may not have horse knowledge and the company may or may not have certain criteria and standard exclusions that are to apply. This does not mean you are necessarily going to agree with them!

I guess i am quite lucky as I tend to look at each policy on its own merits and feel i am quite 'fair' when it comes to the wordings of exclusions.

Based on this example, personally I would apply an exclusion to the hock for anything that may relate to that previous bone chip. If the horse has not suffered any wind problems then i would not be worried about that. I would have requested further information though with regards to the stiffness of the forelimb. Generally further details from the policyholder would suffice unless we were suspicious there was something more sinister going on in the foot/leg. However I wouldn't exclude the whole leg, that is a very broad exclusion to place especially without having actually had any veterinary report/diagnosis!

I would go back to them and ask more questions about the terms and yes ask around other insurers, see what their terms would be and what premiums they offer.

We're not all ignorant when it comes to whether or not to place terms on policies. I am pretty aware what problems are going to be long term/re-occurring and what aren't. Unfortunately yes some problems will get excluded as insurance companies will do not want to have to keep paying out for the same problem over and over again - at the end of the day insurance companies are businesses. Plus, in general (with maybe one exception) providing claims abide by the policy terms then there should be no 'excuses' for an insurance policy to settle a claim!
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I have always found KBIS very reasonable when it comes to negotiating removal of exclusions, so I'd call them TBH and discuss it with them. Your fees sound about right though - I have my novice eventer insured with them for a similar amount (also undervalued), for up to intermediate eventing and for LoU and it doesn't cost me an awful lot more than that - think mine's around the £700-£750 mark.

KBIS are also super about paying out, as I found with my last horse.
 
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Horse insurance is expensive because the insurance companies don't want any more business, they've got more than enough.

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What on earth makes you say that? Insurance is so expensive because OTHER clients make claims, often big claims these days with the high veterinary costs and increasing treatments available. The Insurance Companies want to make huge profits after paying out for claims.

To the OP. Unfortunately there have been issues with your horse previously, no matter how insignificant, but they will exclude anything they think they can. Give them a call and threaten to move your business elsewhere, they DO want your business.
 
I have known people to change the horse's name on their new policy so that the insurance company can't trace previous claims!!! ie they use their stable names instead of competition name or vice versa, not that I am suggesting this!
 
I had same prob with KBIS. They were great at paying out no quibbles, but a bacterial infection on the chest meant they excluded that, plus the hind legs - suspensory problems (fair enough Big payout), but also any back or lameness problems arising from the suspensory problems! So i rang Shearwaters, go the vet to do basic vstting to say sound in wind & limb cost me £150 to £200 & they took her on with just the hind suspensory ligaments excluded. Great result. Everything else now covered
 
i bought a pony a few years back had a 5 stage vetting and vet said there was slight inflexibilty in back as she was unfit. my insurers excluded her back, the vet even contacted them (not my ususal vet) and said it was nothing clinically wrong just an observation . i had to have another vet out 6months later to get the pony's back checked then they lifted the restriction. it cost me over £100 for call out and a letter. then the vet put on letter 14.2 bay gelding and she was a mare and the insurers never picked up on that
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