NFU insurance exclusions

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SophieOtis1990

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Hi so my boy came in lame just over two weeks ago. Originally vet suspected issue in the foot and almost treated like abscess. We’ve jumped to X-rays of the foot and nothing found. Now talk of MRI etc. HE is insured BUT he had a claim in 2020 for proximal supensory desmitis. Now, I called them and they told me its condition linked so if not same condition the would cover…. But looking into this more it seems it might be any ligaments on same leg wouldn’t be covered?!!! What’s the point in insurance if that’s the case! So fustrating as vet hasn’t even nerve blocked before jumping into x rays so we can’t be 100% sure if leg or foot. If foot I believe would be covered. Anyone got any experience with similar with NFU…
 
SophieOtis1990 said:
Hi so my boy came in lame just over two weeks ago. Originally vet suspected issue in the foot and almost treated like abscess. We’ve jumped to X-rays of the foot and nothing found. Now talk of MRI etc. HE is insured BUT he had a claim in 2020 for proximal supensory desmitis. Now, I called them and they told me its condition linked so if not same condition the would cover…. But looking into this more it seems it might be any ligaments on same leg wouldn’t be covered?!!! What’s the point in insurance if that’s the case! So fustrating as vet hasn’t even nerve blocked before jumping into x rays so we can’t be 100% sure if leg or foot. If foot I believe would be covered. Anyone got any experience with similar with NFU…
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The exclusion would have been in your documentation and you can always ask for review at renewal time- often a vet letter will get exclusions revised or removed. Insurance companies need to make money from you, they aren’t a charity. For them, the risk of a horse that has already had a ligament injury makes the horse more liable to need pay out, so of course they will want to mitigate against that.
 
TheMule said:
The exclusion would have been in your documentation and you can always ask for review
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When I was with NFU, they didn't list specific conditions per horse but had general catch alls excluding any condition relating to a previous one

On the plus side I had 3 different claims on the same leg with the vet saying they weren't related.

In fact similar but the other way round so a claim for foot soft tissue issues which were resolved then some years later a suspensory ligament issue.
 
This will probably be one you need to argue and the success might depend on what the eventual new diagnosis is.

Assuming 2020 was hind PSD -

If this is a front limb lameness and it’s not a ligament desmitis then I’d be confident you could get it covered.

If it’s hind limb and ligament related then unlikely to get covered. If orthopedic/bone then it would be worth a try saying unrelated
 
It was a front and same leg. But vet is thinking it’s more foot related hence the x rays of the foot although I now think on reflection an nerve block to isolate would have been a more logical approach so have kind of queried that. I totally understand them excluding proximal suspensory as they have already paid out for that. But an unrelated ligament issue in the same leg won’t be linked to the previous condition. I pay a small fortune for insurance because I have claimed so whilst I appreciate they have to make money it also works both ways doesn’t it. I have flagged with bet before they did x rays so hoping they will support me in their wording so to speak. My renewal docs don’t list exclusion but says about not covering previous conditions. But then found a policy document online that says about ligaments in same leg or bilateral…. Bit of a minefield!
 
In my experience if your vet can word things in an optimal fashion the NFU are totally understanding and helpful. Last year my mare had totally inconclusive lameness investigation by my usual vet and spent up my claim money. I self referred to another practice whose report enabled another claim to be opened and the situation had a good outcome.
 
Midlifecrisis said:
In my experience if your vet can word things in an optimal fashion the NFU are totally understanding and helpful. Last year my mare had totally inconclusive lameness investigation by my usual vet and spent up my claim money. I self referred to another practice whose report enabled another claim to be opened and the situation had a good outcome.
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Hey, that’s good to hear. Overall NFU have always been fantastic. But I’m just a little concerned about racking up lots of fees without knowing where I stand. I’m a little frustrated that vets x rayed before nerve blocked as cheaper and helps identify where coming from …. Horse only had op 18 months ago and not ridden much with pregnancy so real shitty luck with lameness again. I was praying it was an abscess but doesn’t seem it was the case…. :( some self pity here lol
 
SophieOtis1990 said:
It was a front and same leg. But vet is thinking it’s more foot related hence the x rays of the foot although I now think on reflection an nerve block to isolate would have been a more logical approach so have kind of queried that. I totally understand them excluding proximal suspensory as they have already paid out for that. But an unrelated ligament issue in the same leg won’t be linked to the previous condition. I pay a small fortune for insurance because I have claimed so whilst I appreciate they have to make money it also works both ways doesn’t it. I have flagged with bet before they did x rays so hoping they will support me in their wording so to speak. My renewal docs don’t list exclusion but says about not covering previous conditions. But then found a policy document online that says about ligaments in same leg or bilateral…. Bit of a minefield!
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You will be on stickier ground with another ligament on same limb I’m afraid
 
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