Pet plan - behavioural claims…. Do they pay out?!?

[Beth_C]

Hello, I have a claim that has just started for my horse. He was showing uneven steps and a lot of reluctance in being ridden. He has shown slight KS changes, mild SI inflammation and arthritic changes in back left Pastern.
vets are treating him and have said that because he isn’t lame, he is being categorised as a behavioural claim.
I thought nothing of this when the vets phoned as I have never had to claim before, but I now panicking as a friend has since told me that PP refused to pay out for behavioural issues. I can find nothing anywhere on my policy or online about anything to do with this so looking for advise/past experiences.

 

[conniegirl]

I had petplan pay out twice for a similar issue.
2 different horses

 

[Pearlsacarolsinger]

Hello, I have a claim that has just started for my horse. He was showing uneven steps and a lot of reluctance in being ridden. He has shown slight KS changes, mild SI inflammation and arthritic changes in back left Pastern.
vets are treating him and have said that because he isn’t lame, he is being categorised as a behavioural claim.
I thought nothing of this when the vets phoned as I have never had to claim before, but I now panicking as a friend has since told me that PP refused to pay out for behavioural issues. I can find nothing anywhere on my policy or online about anything to do with this so looking for advise/past experiences.

I would challenge the vet's categorisation. arthritic changes. inflammation and slight KS changes are not behavioural!

 

[Bellaboo18]

I would challenge the vet's categorisation. arthritic changes. inflammation and slight KS changes are not behavioural!

This. How can anyone say that's behavioural??
I've been really pleased with petplan and would be very surprised if they didnt pay out.

 

[ester]

uneven steps sounds pretty lame to me. It might have been 'behavioural' if nothing had been found (and that's been my understanding given what people have said before re. if nothing is found and claiming diagnostics on insurance) but it has.

 

[ihatework]

I would challenge the vet's categorisation. arthritic changes. inflammation and slight KS changes are not behavioural!

Agree - if the vets put behavioural on the form and say the veterinary findings are incidental and not causing clinical symptoms you may be stuffed.

What are the vets doing? If they are recommending treatment for any of these findings then they presumably have a reasonable suspicion of clinical symptoms ?‍

 

[Beth_C]

They are treating his SI and KS with injections. It baffled me that they continued to say that they are treating him as behavioural - they said he isn’t actually lame? Just in discomfort. But when they did his initial work up they found mild low-grade lameness in his near hind.
I think I will speak to them today and ask them to explain why they have said he is behavioural.

 

[ihatework]

They are treating his SI and KS with injections. It baffled me that they continued to say that they are treating him as behavioural - they said he isn’t actually lame? Just in discomfort. But when they did his initial work up they found mild low-grade lameness in his near hind.
I think I will speak to them today and ask them to explain why they have said he is behavioural.

Screen the insurance form before it goes in and don’t let them write behavioural on the form

 

[ester]

It seems weird to me, most vets would want to do what they could to ensure insurance settled the claim.
discomfort isn't behavioural.

 

[misst]

They are treating him for KS and lameness (uneven steps) so it is a medical proven condition... I don't understand why they would say this. I would speak to the senior vet and ask them to change the claim.

 

[AandK]

I thought behavioural was where no cause could be found for loss of performance etc? You have a cause, so how can it be a behaviour issue?!

 

[Beth_C]

I have spoken to my own vet (horse was referred to another vet) and they are going to phone them on Monday.
I am glad I was right to query this and thank you all for your replies so far.
Hopefully I get my horse back and his treatment has helped.

 

[criso]

There's a difference where no physical issues are found and behaviour is blamed and a physical problem causing a behavioural issue e.g. KS causing bucking or biting and kicking because of ulcers. In the latter it is the pain from a physical issue that is causing the behaviour.

I would not expect insurance to pay out for investigations where the vets don't find anything and conclude the issue is behavioural but I would in a case like yours where there is a clear physical problem.

However I would be nervous about how it is phrased. Is this a vet hospital he was referred to? I've always had a report when discharged which goes through all the clinical signs before going on to findings, diagnosis and treatment.