Horse Insurance: Limits & Exclusions
Ages ago I had started a series about horse insurance, with tips on how to buy and explanations about coverages. When you get your policy, before you pay, that's the best time to ask questions. While horse insurance is helpful to you and your horse, you have to remember at the end of the day the insurance company is trying to make money. The result of that is some pretty air tight policy wordings that get them out of losing (too much) money.
Limits
Limits put a cap on the maximum amount an insurance company will pay for your horse. These are called policy limits. A policy limit is the maximum amount an insurance company will pay for the whole year it's covering your self-maiming miscreant. An occurrence limit is how much they'll pay for one specific claim. If you have a $10,000 limit on your major medical, that means the most they'll pay out in one year is $10K. So if you have surgery for $6K a month after your policy starts, you'll only have $4K if something else happens the rest of the year.
Sub-limits
This is something I've noticed more and more companies are applying to policies to 'stem the bleeding' from certain losses. The first insurance company I used for Runkle had sub-limits of $2,000 for lameness and diagnostics. Even though my policy limit was $7,500, they would only pay $2K in diagnostics for Runkle's splint. With all the types of imaging available today, you can blow through that two grand really fast.
Exclusions
Most people are familiar with this. Once you make a claim, the insurance company reserves the right to deny further claims related to that first claim. Some insurance companies will even ask for the pre-purchase exam when you buy a new horse, if you did one. Then they'll comb through whatever radiographs you took and any notes the vet left, and start throwing out your horse's flaws as they see them.
It's frustrating, because it feels like these things are 'out to get you'. And in a way, they are. Horse insurance is a for-profit industry - emphasis on the profit. If no one is making a profit, there won't be any insurance for anyone. The best ammunition you can use to protect yourself in this situation is education.
Read the policy when you receive it. Ask questions and don't assume anything. It's your responsibility to know exactly what's excluded so when disaster strikes you'll know explicitly where you stand. You don't want to pay for colic surgery only to find out that you spent several thousand dollars you don't have and your insurance company isn't going to help you with.
Limits
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| I maxed out every single limit I had on this horse |
This is something I've noticed more and more companies are applying to policies to 'stem the bleeding' from certain losses. The first insurance company I used for Runkle had sub-limits of $2,000 for lameness and diagnostics. Even though my policy limit was $7,500, they would only pay $2K in diagnostics for Runkle's splint. With all the types of imaging available today, you can blow through that two grand really fast.
Exclusions
Most people are familiar with this. Once you make a claim, the insurance company reserves the right to deny further claims related to that first claim. Some insurance companies will even ask for the pre-purchase exam when you buy a new horse, if you did one. Then they'll comb through whatever radiographs you took and any notes the vet left, and start throwing out your horse's flaws as they see them.
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| Have this super old picture of Spicy, many moons before I got him. |
Read the policy when you receive it. Ask questions and don't assume anything. It's your responsibility to know exactly what's excluded so when disaster strikes you'll know explicitly where you stand. You don't want to pay for colic surgery only to find out that you spent several thousand dollars you don't have and your insurance company isn't going to help you with.
Pet insurance is such a tough thing.
ReplyDeleteI personally have not insured any of my horses, as we don't have basic vet services nearby. The closest vet is 3 hours away and they don't even have radiology equipment. The closest clinic that has x-ray machines, ultrasound, and other diagnostic imaging is 6 hours away. And even moreso, the opportunity to send a horse to a college or to a surgical veterinary practice is not even practical, especially if the horse needs intervention NOW. The closest clinic that performs surgery is 10 hrs away, and that's if your horse makes it there.
The only thing insurance would be good for here is loss of life circumstances, which is unfortunate, but a reality.
The best person I had help me with horse insurance was a woman at the barn I worked at who sold insurance for a living to the alcohol industry - specifically distillers and distributors (super cool job with interesting and cool perks!). She knew exactly what everything meant lol
ReplyDeleteThe idea that making a claim on an injury means that same injury won’t be covered down the road, the “exclusions” clause, seems so counterproductive from an owners perspective. Like it almost forces you to be super aggressive in any initial treatment of literally anything, lest you choose conservatism but then have that injury crop back up again after a period and require more treatment...
ReplyDeleteEeyore isn't insured. I meant to but then he came up very lame a couple weeks into owning him and stayed that way for 9 months. So I couldn't insure him through that. then he came sound and I forgot. I keep meaning to look back into it. The medical coverage isn't that important to me, but the mortality is. I don't have a large chunk available to spend on another horse should he die suddenly, so I would be a bit out of luck. If I had a mortality payment, I could get another horse when I was emotionally ready.
ReplyDeleteRemus is not insured but he does have the colicare thru smartpak. This is interesting though for sure. I doubt I ever own a horse worth as much as others have but it is nice to get a snippet of what to look for (and look out for) Thanks!!
ReplyDeleteI just switched policies on Scout to one geared toward event horses... I'm hoping they will be just as prompt as my last company! I do see a trend of insurance companies requiring a vet to at least do a basic exam of a horse when starting a new policy and I think it's a really good thing!
ReplyDeleteShopping for Eli's insurance was eye opening after dealing with Penn's no hassle policy. I've already figured out I want to add a rider to the policy next year, a surgical only amount to give me better coverage for colic (3000 max colic surgery and smartpak's 10k colic care) and just in case something happens where he needs surgery like Mikey did that was unrelated to colic.
ReplyDelete