Suprised by X ray result!!! Insurance dilema??

Alchemy

Alchemy

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Has this happened to anyone else! will try and keep short and sweet?

Took my horse to equine hospital as he hasnt been right on near hind (not lame just more stiff) he trotted up sound vets must of thought i was nuts for bringing him in. So they x rayed his hock (think to prove nothing wrong and i was worried for nothing) well even today i am totally surprised with what i saw. There was a screw in his hock, he had clearly at some point in his life before me ( i have had him nearly 9 years) he had surgery on his hock, also showed an old fracture to cannon bone too!! told he has bone spavin in the joint and the screw is just touching joint therfore causeing the swelling occasionally after exercise.

So i want my insurance company to pay for his x rays yesterday and bute (which he clearly needs) will this be covered as although i have never claimed and he has never been lame on this leg will they say its a pre existing condition even though i never knew/horse passed 5 star vetting.
 
Mmmm, tricky one.

Presumably you've already phoned them to give them a heads up and send the forms out to you. You'll have to chat to them about the findings though and find out what their position is.
 
Its worth a try but yes I would expect them to deem it as pre existing as there can 100% be no dispute that there was a problem previously even if you werent aware of it
 
Goldenstar said:
That's really bad luck I will be interested in what happens .
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Will keep you informed! TBH i am still really shocked about what was found and that no-one when i bought the horse nobody ever mentioned it. Hopefully because they only x rayed it may not be a huge bill which i may have to pay, although i am cross as 9 years paying £600 fully covered only to possibly end up paying for something that i knew nothing about and has never given him a days lameness since i have had him. grrrrrrrr
 
You're best off talking to the insurers. Failure to disclose information can void the policy. I doubt they could void it based on non-disclosure of the problem at the start of the policy as you say you had no idea and you can only go off what previous owner has disclosed. You also have a 5 stage vetting to back up the horse was sound at time of purchase/showing no signs of this problem and a 9 year long vet history showing the horse has never previously had a problem with this area. Failing to disclose the situation now you know about it could be a different matter, it really will be down to the individual insurers stance on things unfortunately.
Yes you may find they will (probably) decline the claim as being linked to a pre-existing medical condition (if the screw wasn't there it wouldn't be causing the current problem and horse had screw placed prior to the insurance starting) but if you're planning on paying the bill anyway, does it make any difference?
I'll be interested to hear the outcome either way tbh.
 
I would think they would exclude it as pre-existing and may go as far to say that if they'd known the horse had a screw in its leg at inception of the policy they would have excluded it. The question is though would that be a permanent exclusion, or would they remove it. The fact that your horse was fine for 9 years suggests that really it wasn't a problem!

Best bet would be to call them, submit a claim form and see what happens!

ETA: they can't get you for non-disclosure as you didn't know about the screw. It would purely be a case of a pre-existing problem
 
I'd have thought if any common sence applied then the 'pre existing' get out would only apply if you were aware of it, they take a copy of the vets cert so they are aware of anything relevant that you are aware of.
Surely there must be 100's of issues that could be pre existing but not causing a problem until later on, which they could wiggle out of on the basis that it was pre existing - almost all kissing spine for example - or do processes grow closer together over time??
If they get out of anything that they deem you should have known about then insurance is really getting less and less worth it unless you are spending £10k+ and xray everything pre purchase

That said OP you are dealing with insurance co's!! Good luck, I hope they are reasonabler with you - especially as you've had him for so long without issue.
 
I guess many other conditions could be argued as not pre-existing though and without proof the insurance company may well back down. The fact that there is a screw in the leg would stop any such arguement here
 
Polos Mum said:
I'd have thought if any common sence applied then the 'pre existing' get out would only apply if you were aware of it, they take a copy of the vets cert so they are aware of anything relevant that you are aware of.
Surely there must be 100's of issues that could be pre existing but not causing a problem until later on, which they could wiggle out of on the basis that it was pre existing - almost all kissing spine for example - or do processes grow closer together over time??
If they get out of anything that they deem you should have known about then insurance is really getting less and less worth it unless you are spending £10k+ and xray everything pre purchase

That said OP you are dealing with insurance co's!! Good luck, I hope they are reasonabler with you - especially as you've had him for so long without issue.
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Thanks Polos Mum. I assume the vets will send the insurance company the report of what they found. Realistically they are only paying for 6 x rays and hopefully the cost of hiring a small box to take him to vets. I have yet to ask for bute which i know i will need so i hope they will cover that. I am still truely shocked/Surprised! I hope my honesty and loyalty to this insurance company will hopefully pay off!!
 
According to my OH (who works in insurance) if your insurance company refuse the claim on the grounds that this is a pre-existing condition, you can demand they refund in full all premiums you've ever paid to them, on the grounds that if they won't pay out now for that condition, they never would have paid out for that condition. His company had to do this recently.
 
I would expect insurance to pay out but depends who you are insured with, you had 5 stage vetting and insurance accepted that as proof that the horse was sound and it is many years down the line
 
Wow, I take it at some point during the horses life one of his owners mis-sold didn't disclose the issue.

Fingers crossed the insurance helps you
 
Quick update!

vet said cost of x ray may not be that much more than excesss therefore would it be worth claiming! Although i have let insurance company know as i will need bute for this problem. When i hear from the insurance company for those who are interested i will let you know!
 
Yes I will be interested to hear. I got LOU for my WB and that must have been a pre-existing condition - Sue Dyson diagnosed it as chronic and he had likely had it since he was 2 yrs old. There was absolutely no quibble - he was a high value horse and he had had a 5 stage vetting prior to purchase which missed this.
 
Hello quick update have spoken to insurance and have sen them all the details vets report/picture of x ray/ original vetting. Lady on phone seemed confident that they will pay, as I said to her it will be my first and probably only claim on this policy (have decided to put him on a veteran policy next year)bin 9 years and the cost is only £500 with no further treatment needed well apart from bute as and when and As that's for his bone spavin and therefore a degenerative diease won't be covered anyway
 
Hi

Result :-) my insurance company have just called and are happy with my claim and will pay the £500 vets bill :-) as i was unaware and the vets confirmed this then they are happy, lady i spoke to said was quite unusual !!

Phew

all i want to do now is keep him as sound and supple and hopefully enjoy another 9 years! abeit only hacking and the odd local show
 
Alchemy said:
Hi

Result :-) my insurance company have just called and are happy with my claim and will pay the £500 vets bill :-) as i was unaware and the vets confirmed this then they are happy, lady i spoke to said was quite unusual !!

Phew

all i want to do now is keep him as sound and supple and hopefully enjoy another 9 years! abeit only hacking and the odd local show
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Odd/unusual situation.
Glad the insurance company were straight with you though - which company was it out of interest?
 
ihatework said:
Odd/unusual situation.
Glad the insurance company were straight with you though - which company was it out of interest?
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NFU :-), I did send them a letter with the vets report and copy of x -ray explaining and they said that as the vet had confirmed i never knew plus past vet records show no previous problems
 
That does surprise me, being NFU. Given all the hassle I had with them over my claim that they said was pre-existing, despite horse never having been seen a by a vet apart from normal vaccs etc all his life. And I was facing a £4k vet bill at that stage! Glad you got your pay out :)
 
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