PTS..BB the cob is gone and insurance problems.

[TrasaM]

On the 4th of September at approximately 8 pm my friend's horse BB was shot. It was an awful decision to have to make. He was just 7 years old. He'd had an ongoing problem with his stifle locking and recurrent lameness for the past 18 months. He was nerve blocked in late spring and the vet could not find any problem other than the left stifle so friend was advised to bute and rest then return to work gradually. It had been the same advice the year before with always the same advice. In August I filmed him being ridden and he was horribly lame so it was agreed that he would go to Newmarket for a full diagnostics. It was pre agreed with the insurers that they would pay for the diagnostis but they would not pay for any treatment to his left stifle as time had expired on this as vet had diagnosed it earlier. So diagnostics were done and it was found that because of the stifle problem he'd chNged how he used his legs and bony growths had developed on both stifles. He also had three areas of kissing spine and changes had occurred to his front feet. Insurer refused to pay saying that all issues were due to the initial problem so therefore not a new condition. After much debate and 5/7 vet opinion that surgery was not a good option and he should be euthanised to save any further pain, my friend decided that this was what she must do. We bought him home and on the day he was due to be shot Insurer phoned to say that they were one NOT paying for anything .. Diagnostics, euthanasia or loss of use and denied that they'd agreed both verbally and in writing to do so. I've seen the letter and they left themselves a very wide exemption clause that you could drive a HGV through. This on too of the awful decision to have him pts has taken a terrible toll in my friend. She can't afford to pay the vets and the bill exceeds £3k not to mention the other costs, transport and knacker man, she's since had to fork out for.
I know I'm not allowed to mention the insurers name on here but they are very well known and not some cheap option. My OH has helped draft a letter to them and friend is contacting the ombudsman for help.
On a personal level this is a horse who I rode regularly and loved. I've never seen a horse pts before and whilst impressed about the speed and efficiency of the knackerman, seeing him lying dead in his paddock was just awful.
We are angry and upset .. Where exactly is the point of insurance when they can try to wiggle out of their obligation like this. Meanwhile local vets are " extremely sorry for the outcome and feel responsible" Yes they bloody should.. Had it been an option to leave his corpse at there gateway with a sign saying Horse owners Beware this Vets, we'd have done so. T
Thank you for reading and am happy to mention the insurer to anyone who asks.

 

[SadKen]

What a sad story. A brave decision and best for the horse, but awful for those he leaves behind.

Re the insurance, when I need to complain, I go straight to the CEO via email. Google 'ceo email addresses' and look for the right one on the list, or even just phone up and ask for it. You may need to pass some barriers and do some googling to get it, but once you do send an email with the letter as an attachment making your point in a short and businesslike manner. Waffling won't help as it lets them go off on a tangent.

Ask for a final response and be ready to escalate to the Ombudsman or even small claims. Legal advice would be very useful, and the BHS helpline might be a good place to start if your friend is a member.

All the best with this one - I'd be interested to know the insurers if you can PM.

 

[Greylegs]

Firstly, i'm so sorry for both you, your friend and her horse that you've all had to go through this. It's distressing enough to have to have a horse PTS (especially one so young) but to have the £$%@£ insurance company messing about like this is just too much on top.

If they are who I think they are , then I too have had huge issues with them in the past over a completely different issue (stolen tack) where I argued to a standstill over payment and still got no satisfaction. I think it's part of the way insurance companies do business to do everything in their power to avoid paying out on any claim. I sometimes ask myself whether it's worth having insurance at all when things like this happen!

I hope you sort it out <<<HUGS>>> to you both and RIP poor BB.

 

[Fuzzypuff]

So sorry, it sounds to have been an awful experience for your friend, so sad

Whether you will get anywhere on the claim for diagnostics and treatment will depend on the conditions for the policy, which are different for every company. However, with regards to claiming for pts, as far as I'm aware all insurance companies state that they will only pay for pts if BEVA guidelines are met, which you will find here: http://www.fhvets.co.uk/facilities/BEVA Destruction of Horse Guidlines.pdf It does sound unfortunately like in this case they were not met, as it wasn't a case of immediate pts being required. Unfortunately although much of the time pts is the best option even if it isn't necessary for it to be immediate, insurance companies are unable to cover this - if they did they would leave themselves open to fraudulent claims of horses being pts when it wasn't necessary in order for people to claim. The vet should have known the situation with the BEVA guidelines and discussed this with your friend beforehand

 

[TrasaM]

The cost of PTS is not the issue.. The cost of the diagnostics IS. They agreed it then did a U turn.

 

[_GG_]

The cost of PTS is not the issue.. The cost of the diagnostics IS. They agreed it then did a U turn.

This. Ombudsman is the best option, but they will advise to write and give the insurers time to respond, so your friend is looking at some time before this can get sorted. To that end, I suggest she CC the vets in on all correspondence with the insurance company and ombudsmen as that will keep them in the loop and they'll be far more inclined to work with your friend which could relieve some of the stress.

I am so sorry for your friend and you, but I am incredibly pleased to hear that she was able to make such a difficult decision and save her horse from future pain. I hope that can be of some comfort to her and you.

xx

 

[TrasaM]

_GG_ thank you . Yes that's the process she's going through now plus I've sent her a link to this thread so she can read responses. She has indeed been very very brave and taken the right decision. It's so hard when they outwardly look healthy yet you know that they will only get worse over time so putting them through pain just to have extra time with them would be selfish and cruel. If there had been a chance he could have lived pain free he would have been retired but with multiple issues keeping him on painkillers just to let him go through the day was not an option.

 

[_GG_]

_GG_ thank you . Yes that's the process she's going through now plus I've sent her a link to this thread so she can read responses. She has indeed been very very brave and taken the right decision. It's so hard when they outwardly look healthy yet you know that they will only get worse over time so putting them through pain just to have extra time with them would be selfish and cruel. If there had been a chance he could have lived pain free he would have been retired but with multiple issues keeping him on painkillers just to let him go through the day was not an option.

Tell her to read the link in my signature...it might help her xx

 

[Pearlsasinger]

A similar situation is why we stopped insuring.

I am so sorry for you, your friend and the horse. Well done to the owner for making the best decision for the horse, I think that is what insurance companies rely on.

It is very difficult in the aftermath of pts to have the strength to pursue the company to fulfil their obligations but I do hope your friend can find that strength. Some good suggestions above about the route to take.
Good luck!

 

[Greylegs]

Tell her to read the link in my signature...it might help her xx

...out of interest, I've just read your piece. It's a well written and thoughtful discussion and I applaud you for writing and publishing it. Well Done and Thank you.

 

[TrasaM]

Tell her to read the link in my signature...it might help her xx

That is beautifully written. I've copied a link to FB because another friend is about to day goodbye to her horse this week also. Thank you

 

[_GG_]

...out of interest, I've just read your piece. It's a well written and thoughtful discussion and I applaud you for writing and publishing it. Well Done and Thank you.

That is beautifully written. I've copied a link to FB because another friend is about to day goodbye to her horse this week also. Thank you

Thank you. I wrote it through many tears and I am aware that I may end up seeming like a broken record, but I've had some feedback already that it has helped people and that was the point, so I am really pleased to hear that you feel it may help your friend TrasaM.

xxx

 

[Annagain]

The cost of PTS is not the issue.. The cost of the diagnostics IS. They agreed it then did a U turn.

So sorry to read what you and your friend are going through.

I had a similar issue, my boy has melanonas under his tail which were excluded from his insurance. New growths appeared on his sheath and vet was 80% certain they were melanomas but also feared they could be more serious carcinomas which would require immediate treatment so a biposy was needed. Insurance would over cover biopsy if it turned out to be carcinoma but not if it turned out to be melanoma, but I could only find out if it was carcinoma by having the biopsy.

We couldn't take the chance so he had to have it done. It turned out to be melanoma so I had to pay for the biopsy. I can understand not paying for treatment if it turned out to be melanoma, but to refuse to pay for a biopsy for something that could be far more serious is ludicrous. Somebody else might be struggling to pay their insurance which then means they don't have the money to pay for diagnostics and it could have very serious consquences.

 

[Emma_H]

So sorry for your loss.

Don't give up, I had to fight for the death claim when my old boy was PTS. He had a lypoma strangling his gut, the vet told me he wouldn't operate as he was 21 so he was PTS. Insurance co said I could have had him operated on so no claim pay out.

It upset me so much, because if I could have had the op I would have but my vet said no.
Insurance Co in essence told me I had had him PTS for no reason.

I fought with the help of the vet and the claim was paid.

PTS has to be within guidelines so let your vet do the talking.

Good luck xx

 

[TrasaM]

So sorry to read what you and your friend are going through.

I had a similar issue, my boy has melanonas under his tail which were excluded from his insurance. New growths appeared on his sheath and vet was 80% certain they were melanomas but also feared they could be more serious carcinomas which would require immediate treatment so a biposy was needed. Insurance would over cover biopsy if it turned out to be carcinoma but not if it turned out to be melanoma, but I could only find out if it was carcinoma by having the biopsy.

We couldn't take the chance so he had to have it done. It turned out to be melanoma so I had to pay for the biopsy. I can understand not paying for treatment if it turned out to be melanoma, but to refuse to pay for a biopsy for something that could be far more serious is ludicrous. Somebody else might be struggling to pay their insurance which then means they don't have the money to pay for diagnostics and it could have very serious consquences.

Exactly the same.. Retrospective withdrawal of offer to pay for diagnostics. It's only the insurers assessors who are linking the conditions as far as I know too. Also whilst they said offer was discretionary they did not explicitly state that if problems were linked to initial problem that it would not be covered. It was left vague enough for them to wiggle out! I think I vaguely remember that exclusion causes must be explicit and not implied. Need to look that up too. Am I correct in thinking that NM would not have proceeded with the tests if they had not been given the go ahead?

 

[TrasaM]

So sorry for your loss.

Don't give up, I had to fight for the death claim when my old boy was PTS. He had a lypoma strangling his gut, the vet told me he wouldn't operate as he was 21 so he was PTS. Insurance co said I could have had him operated on so no claim pay out.

It upset me so much, because if I could have had the op I would have but my vet said no.
Insurance Co in essence told me I had had him PTS for no reason.

I fought with the help of the vet and the claim was paid.

PTS has to be within guidelines so let your vet do the talking.

Good luck xx

Vets are on side this one too. So awful that you were put through that as well but encouraging that you won. Friend was told by them that she was putting him down for practical reasons and not due to his condition. How awful to be told that when she'd cried for days over the decision and went through with it on the vets advice. Also loss of use not covered because that was also linked to his original problem !

 

[Slightlyconfused]

I had the same with a lameness work up and xrays on my mare.

They knew she had vet out previously as she had clicky back legs, he said could be arthritis but as she is sound no need to xray and left it. we changed to a closer vet and a year later she went lame. phoned insurance company and my dad an I spoke to three different people and the all said yes she still has time to have a lameness workup and treatment for arthritis in hocks as she was only a few months away from her mature policy.

£2000 vet bill after work up and joint injections into both hocks and they turned round and said nope, sorry she has had the vet out before for clicky back legs so it is a previous condition.

it wasn't until my dad got hold of a manager and they got the recordings of the conversations with the people we spoke to that they agreed to pay.

good luck and sending hugs to both you and your friend

 

[starry23]

I'm very sorry to hear about BB. Having recently had my horse PTS I know how heartbroken you and his owner will be.

With regards to the insurance I am actually very shocked that they ever agreed to pay for the claim before the work was carried out and the vet sent off the claim form, especially as there is a pre-existing condition that could potentially affect the other leg (I switched insurers last year as my insurance price rocketed and I only needed insurance for a retired horse not a ridden one - the new insurers excluded both front leg even though only one had issues but that was their reasoning)! Having dealt with my insurers a lot last year every time I phoned them to discuss what was happening with my horse they always said that in no uncertain terms that they could not guarantee that they will pay out on a claim until they have all the information. You say there was a letter that stated they would pay - that should help with any complaint. I am also surprised at the vets for admitting some form of liability!

Definitely take it to the ombudsman - a friend is currently fighting for a pay out after issues between vets/insurers.

I hope you get somewhere with it, it is not a nice thing to have to deal with, especially after losing a horse.

 

[TrasaM]

Thank you .. It seems that some people have been successful in getting these type of decisions overturned.. Fingers crossed she can get it resolved then

 

[Clannad48]

Thank you. I wrote it through many tears and I am aware that I may end up seeming like a broken record, but I've had some feedback already that it has helped people and that was the point, so I am really pleased to hear that you feel it may help your friend TrasaM.

xxx

Not wanting to hijack the thread but I too have read your piece, a beautifully written account of what it really means to love a horse or for that matter any other animal. I really think this should be a 'sticky' and compulsory reading for every horse owner - current or prospective.

OP I think that your friend may have to be prepared for the 'long haul' with the insurers on this, as per other advice already given she must keep the vets in the loop. Whilst the financial aspects are hard at least she has some small comfort in knowing that she did the right thing for her horse.

 

[TrasaM]

Just returned from seeing another friend's horse being sent off to the big meadow in the sky. Such a lovely soul but with winter coming and recurrent abscesses and Cushings it was his time to leave. Such a hard decision to have to make and it being the right decision does not seem to make it much easier..at least not straight away. So he went happily munching on mints and apples and lush green grass. Sleep tight old boy . You were a very special horse.

 

[EventingMum]

So sorry to hear what your friend is going through - we had to say goodbye to one of our old faithfulls last week, it was awful but definetely his time to go.

As far as the insurance goes this seems to be the way some companies are working these days. A pony on loan to our RDA group had to have a sinus operation last year. Before going the insurance company verbally gave the go ahead for the operation saying it would be covered but when the bill was submitted they refused to pay and gave a number of reasons which were ridiculous - eventually they said the real reason was that the pony was no longer insured with them from the renewal date which was a few days after the operation. The pony wasn't reinsured as the RDA group had given up the loan and she returned to her owner. It seems that you buy insurance for a year but in actual fact if you claim towards the end of that period you have to commit to the next year so they will honour their contract with you. Sadly this has left our RDA group 1K out of pocket which they can ill afford so they are now trying to complain to the ombudsman.

 

[_GG_]

Just returned from seeing another friend's horse being sent off to the big meadow in the sky. Such a lovely soul but with winter coming and recurrent abscesses and Cushings it was his time to leave. Such a hard decision to have to make and it being the right decision does not seem to make it much easier..at least not straight away. So he went happily munching on mints and apples and lush green grass. Sleep tight old boy . You were a very special horse.

It is much nicer to hear of a horse leaving the world as a happy soul than when it's done a little too late. Hope you and your friend are ok. xxx

 

[TrasaM]

Update
Well after a well worded letter of complaint plus contacting the ombudsman my friend received a letter which stated;
" we don't understand why you got the impression that we were not going to pay for the diagnostics. We will settle this amount as already agreed by letter on xxxdate"

However they then started to quibble over the interest! And said that they are not liable for it! Trying it on or what!

What they did by rescinding the offer to pay on the actual day BB was pts caused so much upset and suffering. Yet they now come back and say ..you silly thing you..of course we agreed to pay!
Stage 2 will be trying to get the cost for loss of use which they also refused to pay ..after the event as they said it was her choice to do this!

 

[TrasaM]

It is much nicer to hear of a horse leaving the world as a happy soul than when it's done a little too late. Hope you and your friend are ok. xxx

Thank you. He was such a lovely soul. Really strange though. A new horse arrived the day after Zeus was shot. He spooked at the spot where the body had lain but after a little while he went and stood quietly beside it with his head down. There was no blood and he didn't know Zeus. Such special animals

 

[_GG_]

Thank you. He was such a lovely soul. Really strange though. A new horse arrived the day after Zeus was shot. He spooked at the spot where the body had lain but after a little while he went and stood quietly beside it with his head down. There was no blood and he didn't know Zeus. Such special animals

They are, special indeed. Xx

 

[Pinkvboots]

Thank you. He was such a lovely soul. Really strange though. A new horse arrived the day after Zeus was shot. He spooked at the spot where the body had lain but after a little while he went and stood quietly beside it with his head down. There was no blood and he didn't know Zeus. Such special animals

Sorry for your loss and glad you got the insurance to pay out, my gelding ran to the spot my old mare was pts everyday for a week wickering and pawing the ground, broke my heart it did

 

[Goldenstar]

Update
Well after a well worded letter of complaint plus contacting the ombudsman my friend received a letter which stated;
" we don't understand why you got the impression that we were not going to pay for the diagnostics. We will settle this amount as already agreed by letter on xxxdate"

However they then started to quibble over the interest! And said that they are not liable for it! Trying it on or what!

What they did by rescinding the offer to pay on the actual day BB was pts caused so much upset and suffering. Yet they now come back and say ..you silly thing you..of course we agreed to pay!
Stage 2 will be trying to get the cost for loss of use which they also refused to pay ..after the event as they said it was her choice to do this!

I am glad you got the vets bill paid .
I think you will struggle with the LOU now the horse is PTS .
fatty is a LOU and it was a detailed procedure to get it , two vets appointed by the insurance company examined him at a university vet school and advised PTS ( where his owner would got full payout ) the owner opted for LOU and a reduced pay out but everything had to be agreed before any action was taken.

 

[3OldPonies]

A similar situation is why we stopped insuring.

I am so sorry for you, your friend and the horse. Well done to the owner for making the best decision for the horse, I think that is what insurance companies rely on.

It is very difficult in the aftermath of pts to have the strength to pursue the company to fulfil their obligations but I do hope your friend can find that strength. Some good suggestions above about the route to take.
Good luck!

So very sorry to hear of what has happened, I can't add much more than is in the quote above, but big hugs to you both.