Insurance Claims

The world of insurance can be a little daunting but we are here to help and hopefully reduce some of the stress involved. Horses and horse ownership can be an expensice business so we strongly advise our clients to insure their horses (vets fees), and themselves (third party/rider), against the unexpected.  Types of policy, premiums and levels of cover will vary from company to company, and however much we may moan about insurance and its associated costs when you actually need that cover you will be grateful!

IT IS IMPORTANT TO READ your policy document carefully BEFORE accepting.

  • Whilst cheaper premiums may look attractive do they give you the cover that you need?  With all insurance policy’s you will be required to pay an excess payment should you need to make a claim (this is usually paid to your veterinary practice and will be set against cost incurred for your horse’s treatment)
  • Be wary of policy’s that offer a percentage excess payment this can work out expensive it is wiser to go for a fixed excess payment on the policy.
  • Does your cover pay for hospitalisation charges?  Or supplements, alternative treatment or physio which may be recommended by the vet?

These are some of the things you need to check, prior to accepting your insurance cover.  You don’t want to be surprised with any unexpected charges that your insurance policy does not cover.

It is vital that you read the small print.

Don’t wait until you need to claim to find that you haven’t got the cover you require!

Ensure you have the best level of vets fees cover – generally it is £5000 but there some options to have lower cover i.e. £3000 - obviously you have to select the best cover that you can afford but be mindful that for example, a colic investigation, surgery, treatment and after care or even a complex lameness investigation may well take you past a limit of £3000

Once opened an insurance claim is generally termed ‘open’ for one year from the start of your claim (this will be the first date that your horse has been seen by the vet for the condition) you should be able to treat and claimfor this condition for one full year so for example if you have a horse with a joint issue you will be able to have that treated for one year ,which may involve initial examinations and  investigation, x-rays, pain relief, joint medications, and possible joint supplements (again check your policy some company’s will not pay out for supplements) make good use of the cover that is available to you to give your horse the best treatment for that year, you may, subject to the condition being claimed for and veterinary advice, with  joint treatments for example  be able to have up to three lots of joint medication treatment within that year period. 

Be aware that the insurance clock can tick away very quickly and before you know it, you will be surprised how quickly a year can pass, particularly if you r horse is required to have box rest or a rest period for the condition being treated.  For long term conditions, have or discuss a plan with the vet to achieve the best treatment and outcome for your horse in terms of your claim.  Keep in touch with your insurance company to know what amount of your vets fee cover is available as your claim and treatment progresses.  If your horse is on long term medication or treatment do not leave everything to the last month of your claim period, have a treatment plan throughout the year.

Your insurance will only cover the condition you are claiming for, for one year, after that you will have an exclusion placed on your policy.  Some conditions may have this exclusion lifted (some colic’s, coughs, skin conditions for example) if you can confirm to the insurance company that your horse has not suffered a re-occurrence of the condition within an acceptable period of time.

IMPORTANT – Many insurance companies are becoming very strict with their requirements. You are required to inform them of all veterinary conditions/investigations (other than routine care). We are aware of instances when clients have not informed them possibly because at the time the condition examined was not over the excess amount on the policy or possibly because the client did not expect the horse to suffer the condition again and because the insurance company were not initially informed they have refused to accept a claim.  As the policyholder you need to be aware of the terms and conditions of your policy PLEASE READ THEM CAREFULLY or speak to your insurance company if you are unsure.

Please remember that we are not responsible for collecting the money owing for a claim from your Insurance Company. We advise that you keep in regular contact with the company to monitor the claim’s progress. If there is a delay of more than 3 months or the Insurance Company considers you do not have a valid claim then payment will be requested within the usual payment terms of within 30 days of receipt of invoice. If a claim is refused please discuss the reasons with the Company; if you feel the claim has been incorrectly refused please contact us to see if we can help.

Understanding BEVA Guidelines

As a horse owner, particularly if your horse is insured, you will need to be aware of and understand the BEVA guidelines. These are professional guidelines laid down to the veterinary profession that vets and insurance companies adhere to.

As owners we are responsible for decisions in relation to the treatment of our horses, depending on the condition affecting your horse you ma decide that the kindest thing for your horse may be to put him/ her to sleep. This is likely to be one of the most difficult decisions you will have to make.

If your horse has suffered from a serious injury or condition that cannot be treated, then your horse will meet the criteria for euthanasia to avoid further suffering.

However, if your horse is suffering from a condition that can be treated with medication or surgery, or their condition can be managed, even if this means you can no longer ride them and they will have to be retired to pasture, then your horse WILL NOT meet the BEVA guidelines. In this instance an insurance company whilst likely to accept a claim and pay for veterinary treatment for up to one year, they will not pay out for the value of your horse should you decide that the best decision in terms of his/ her welfare is for euthanasia.

The is the official BEVA wording:

Paragraph 3 of the BEVA guidelines 1996 states than an affect horse will need to meet the following requirements to satisfy a claim under an ARM policy:

"That the insured horse sustains an injury or manifests an illness or disease that is so severe as to warrant immediate destruction to relieve incurable and excessive pain and that no other options of treatment are available to that horse at that time"

This essentially deals with the EMERGENCY situation, e.g. on a racecourse, at an event or at a road accident, where immediate action must be undertaken by the attending veterinary surgeon. The decision to advise an owner to destroy a horse on humane grounds must be the responsibility of the attending veterinary surgeon, based on his or her assessment of the clinical signs at the time of examination, regardless of whether or not the horse is insured. The vet's primary responsibility is to ensure the welfare of the horse.

For LESS URGENT cases in particular chronic illness or lameness cases where the horse's condition is deteriorating to the point at which euthanasia will be required. It is essential to keep insurers informed of the situation and to mutually agree or negotiate on appropriate course of action, if necessary involving their vet. Some cases may require a second opinion on behalf of the insures before euthanasia is undertaken.

If you need to make the sad decision to have your horse put to sleep then clarify the situation with both your vet and most importantly your insurance company.

If you have any questions, need advise or are unsure what to do then please give us a call and we will be happy to help.