INSURANCE

The rapid improvement in veterinary medicine over the past decade has made real the ability to diagnose and treat conditions that where previously unknown or untreatable. These diagnostic techniques and treatments can be prohibitively expensive and insuring your horse gives you peace of mind that you can offer your horse some of the best treatments available without the worry of the costs involved.

Our reception staff are trained to deal with any insurance queries that you may have. Please note that we are not Financial Advisers and therefore we can not recommend specific insurance products. Please contact an insurance adviser who will be able to help you decide which product is suitable for you.

Please click on the following link to open up the information sheet giving some important information regarding potential insurance claims.

PDF DocumentPriors Farm Insurance Information Sheet

Below is a guide to help you when you may be claiming for a condition. This guide lays out the responsibilities of the vet, the owner and the insurance company. The common types of insurance are described and some of the jargon used is explained.

RESPONSIBILITIES

Veterinary surgeons – we have a responsibility to the horse, regardless whether or not it is insured. This is particularly important in emergency and critical situations where the welfare of the horse is the primary concern.

Owners- You have a responsibility to the horse and must also ensure that the Terms and Conditions of the insurance policy are adhered to.

The insurers- They must ensure that the policy clearly details the extent and limitations of the cover. They must also fairly interpret the policy Terms and Conditions.

GENERAL INFORMATION

Equine policies are normally 12-month contracts. At the end of this period the policy may be renewed; however it will take in to account any change’s in the horse’s condition and value and may exclude any new condition. If a claim is made under a policy for a specific incident or condition the cover will normally extend for 12 months from the date of onset of the problem. Pre-existing conditions are not covered by the policies. Under certain circumstances Underwriters may accept cover on pre-existing conditions and can choose their own terms under which they are willing to provide insurance.

As veterinary surgeons we can offer an opinion on the significance of any condition and on an exclusion on the policy, but it is the insurer who will decide whether to exclude or include a specific risk.

Utmost good faith

an insurance policy is based on “utmost good faith”. This obliges both the insured and the insurer to disclose all material facts at inception or during the policy. As vets we have a responsibility to, upon request by either the owner or the insurer, completely disclose the clinical history or records in full without selection.

TYPES OF POLICY

Vet’s Fees Cover

Pays for non-routine vet’s bills after deduction of an excess. This type of cover will vary from Company to Company and from policy to policy. In addition the cost of this cover normally increases as the demands on the horse increase. No policy will pick up all the costs and some policies have restrictions on diagnostics and alternative/complementary treatment.

Details of the proposed treatment and its estimated cost can be provided by us to you prior to treatment. This will allow you to check with your insurer that the condition itself is actually covered and that there are no exclusions on particular diagnostics or treatments. It must be emphasised that this is your responsibility as owners and not ours as vets.

All Risks of Mortality

This policy applies to the intentional destruction on humane grounds of a horse with insurance cover for mortality. They do not refer to uninsured horses, or when an owner wishes to have a horse destroyed for economic reasons.

Emergency situations

As a guide the affected horse will need to meet the following requirements to satisfy a claim in an emergency. The horse must sustain 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. It is our responsibility as vets to destroy the horse immediately.

Non-emergency situations

The insurer should be contacted to give prior agreement or to allow a second opinion to be given by their consulting veterinary surgeon. If the attending vet and the consulting vet cannot reach an agreement, the owner or the attending vet can seek a third opinion.

Following destruction

Most policies require an appropriate post-mortem unless otherwise agreed by the insurer. You as an owner have a responsibility to contact the insurer to see if a post-mortem is required before the body is disposed of.

It must be recognised that the decision to destroy a horse will not automatically result in an insurer paying the insured value of the horse. No insurer will confirm a decision to pay a death claim until full details of the claim, including the clinical history have been disclosed, received and assessed.

Permanent Loss of Use

This is an optional cover and this covers the horse if it becomes permanently incapable of performing the tasks for which it is insured. Loss of use insurance does not cover for loss of value, lack of potential ability, lack of ability, blemish, behavioural problems or temporary incapacity.

Once it becomes apparent that a horse has an illness or disease that may lead to a loss of use claim you as an owner should immediately contact the insurer. A report will be required by the insurer detailing the case history, diagnosis and prognosis. The insurer will arrange for the case to be reviewed by their veterinary adviser. In some cases a second opinion will be required.

The length of time treatment should be carried out for will be agreed by the attending vet and by the veterinary adviser. Depending on the type of injury it can take several months to assess the permanency of the condition. Once a claim has been agreed you will be given two options: either keeping the horse in retirement or having the horse humanely destroyed. If the horse is kept in retirement they must be freeze marked with an ‘L’ within a circle by UK insurers.

Most companies require a current full five stage pre-purchase examination certificate for loss of use insurance. Accompanying radiographs may be required for horses of higher values (normally over £10,000)

Commonly Used Jargon

Inception date – the start date of the policy.

Extension periods – apply to expired policies when cover is extended beyond the expiry date of the policy normally for 12 months from the date of the onset of a condition.

Exclusions – noted conditions or risks that are not covered under the policy.

Pre-existing conditions – conditions that manifest before the inception date and are therefore not covered by the insurance.

Underwriter or the insurer – an insurance company, LLoyd’s syndicate or mutual insurer who accepts the risk that the insurance policy covers in return for payment of the premium. The insurer sets the rates and determines the Terms and Conditions of the policy.

Insurance Agent – an intermediary who has a contract to sell and administer policies on behalf of the Underwriter.

Insurance Broker – an intermediary who acts on behalf of the client.

The Financial Services Authority (FSA)

Regulates the general insurance industry and authorises individual companies allowing them to sell insurance products. You can check on the registration of a company by visiting the FSA’s website by clicking here www.fsa.gov.uk/register or by contacting the FSA.

Financial Ombudsmen Service – organisation which handles complaints by policyholders against insurance providers.

Material fact – any information which may influence the judgment of a prudent Underwriter in his assessment of risk.

Utmost good faith – a positive duty to disclose accurately and fully, all facts material to the risk being proposed, whether requested or not.

Co-insurance – an arrangement by which the insurer and the insured share, in a specified ratio, payment for losses covered by the policy after the excess has been paid. Sometimes referred to as co-payment.

Accidental visible external and violent injury only – cover where the insured can only claim on the policy for open surface injuries as a result of an accident.

Parts of this document have been reproduced with permission by BEVA from their publication “Guide to riding and sport horse insurance for veterinary surgeons”.