PLEASE NOTE: Information in this article is correct at the time of publication, please contact DFA Law for current advice on older articles.
If you’ve been paying insurance policy premiums for years it’s fair to assume that when you make a claim on your equine insurance the insurers will pay out the full value of the claim, minus of course any excess. Or is it? It’s clear from a review of the Financial Ombudsman’s published case studies that insurers seem to be quick to turn down seemingly valid claims. Having a claim denied is not only expensive but also very stressful so how can you avoid or minimise the risk of a claim being denied?
- Liaise with your insurance company before buying a horse
Don’t just assume that the insurer will cover your newly acquired equine. Depending on the value of the horse the insurer may require a 5 stage vetting and/or X-rays before agreeing to fully insure. If a vet’s certificate reveals a problem expect the insurer to include a policy exclusion. Policy exclusions for a pre-existing problem is a good reason to renegotiate the price of the horse so there’s no downside in contacting the insurers before you proceed with the purchase. Also don’t wait to insure the horse until after the purchase. Even a few days’ delay could invalidate the vet’s pre purchase certificate meaning that you run the risk of your insurer not agreeing cover or cover being dependant on a further up to date vet’s report.
- Check the detail of your policy
Insurance policies may vary on their requirements regarding owners’ responsibilities regarding the care of the horse. Some policies require owners to keep up a recommended worming/dental/ Flu Tetanus vaccination regime. There have been instances where a claim for vets bills for colic has been delayed or even denied because the owner failed to produce evidence that a proper worming regime had been followed in a cases where worm infestation caused the colic incident.
Some insurers require that High-Viz clothing is worn whilst hacking which is not always worn by riders.
It’s therefore worth checking the detail of your policy so you are clear on your own obligations as the insured.
- Disclose all relevant facts
The premiums payable are based on the risk profile of the Insured. Failing to disclose details of any history which may increase the risk profile will give the insurer an easy ‘get out’ and a reason to deny a claim.
A few years ago a claim was turned down by the insurer for a claim for vets bills and loss of horse following a serious trailer accident in which a horse had to be put down after the trailer in which the horse was travelling overturned. The insurer refused to pay out the claim because it considered that the Insured had failed’ to take reasonable precaution to prevent accidents, illness, loss or damage, which was a policy requirement. The reason for their decision was based on the fact that two years prior to the accident which caused the loss the horse suffered a minor injury from a similar accident which was not disclosed to the insurer. The reason the earlier accident had not been disclosed was because the injury suffered by the horse in the earlier accident was so minor the Insured had not considered it relevant. The lesson here is to disclose everything, even if there’s a risk that your premium will increase as a result.
- Change of location
If you move your horse to a new yard don’t forget to inform your insurers. Even if you move your horse on a temporary basis whilst on holiday livery it’s always wise to inform your insurers.
- Making a Claim
If you have to make a claim make sure you follow the specific procedure prescribed by your insurance company. For instance, if you need to obtain pre- treatment authorisation it’s imperative that you do this, unless of course you are unable to do so because out of hours emergency treatment is required.
If you experience any problems in settling your claim and you are unable to resolve after exhausting the insurers own internal complaints procedure, the Financial Ombudsman Service is available and will look into your complaint. Further details can be found at http://www.financial-ombudsman.org.uk/