Equine Insurance--B.S. or for real??

[horsegurl]

Your thoughts on insuring your horse? I just rec’d $128 reimbursement on a $1300 claim for diagnostics. Insurance pays way less than they cover and after my $500 deductible, AND A COPAY THEY CHARGED ME…welllllll…

In another instance, I had a $2600 claim, got $1300 reimbursed. Ok, that was good, but…

I’ve had this horse only 1 year, so haven’t paid much into the company ($800), but thinking about not making the last payment, and not renewing. Mortality is “only” 15K in coverage, and seems more productive to start a savings account on the horses medical behalf. Lol, would I pay into it monthly?..lol…well that might be my problem!! BUT, it seems like these insurance companies want you to believe they are there to cover you, but they are only there to make a profit.

TIA

[Madison]

@horsegurl

Your thoughts on insuring your horse? I just rec’d $128 reimbursement on a $1300 claim for diagnostics. Insurance pays way less than they cover and after my $500 deductible, AND A COPAY THEY CHARGED ME…welllllll…

Sounds like you need to read and be more familiar with your policy documents - a diagnostic copay is common, is spelled out in the policy docs, and can be as high as 40%. If you don’t understand why parts of a claim were denied, you can ask your claim rep for an explanation and they can walk you through it. And if something is wrong or inconsistent, dont be afraid to push back. The specifics of policies vary so it’s a good idea to get the policy forms and review them prior to signing on for coverage.

Insurance is not BS - I’ve unfortunately been through several claims and received exactly what I should have under the terms of the policy. My last claim paid out over $8k with a ton of diagnostics, for which I didn’t pay a penny because I bought a policy rider that waived the diagnostic copay. Clearly that paid for itself many times over!!

[soloudinhere]

It’s a matter of scale. Okay, you might not get the small stuff reimbursed. But on a $7,000 hospital surgery bill, you might get $6000 back, and if the horse dies, you get another $15k. Just really depends on how you use it. I don’t make claims on my major medical unless it’s, well, major. I “self insure” for the regular horsekeeping costs and routine care, and my copay is waived on diagnostics.

I’ve always gotten the value of my premiums back at some point over two or three years of insurance. Just the way it is with horses.

[poltroon]

So you should absolutely do the analysis to figure out what this is worth to you for your horse and your situation.

If in general you are expecting to get more money back than you pay in, you’re likely to be disappointed. The way the insurance company makes money is that they price the product so across all their customers they take in more than they pay out. You, individually might “win” by having your horse die and getting a mortality payout, but the insurance company on the whole collected enough in premiums to cover that.

Some of the elements in my personal consideration were my current finances, whether I owed money on the horse, the value of the horse, the age of the horse, and my personal tolerance for doing the necessary paperwork for medical reimbursement.

[greysfordays]

Yes, I think it’s a very personal decision. For me, I’ve lost one horse who was neurological, and my other has had a very long and painful road battling ulcers. They were both insured. So I am generally ahead on insurance. But I think a lot about setting money aside, bc statistically, the insurance company has to make margin somehow. They just haven’t with me so far. One thing you can do is under insure your horses, which is what I did.

[hunter51]

It’s real and I am very grateful for it after using it to not only pay for his colic surgery, but for his mortality - if not for that, I would never have been able to afford another horse. Of course it’s not necessarily worth it for smaller medical things but to me, it’s worth the peace of mind that I could get a horse colic surgery or that his mortality was covered.

[Classic]

It’s the exclusions that get tricky. You are supposed to report every illness or problem, and if you report those, which is required but some folks don’t, they are then excluded.

[snaffle635]

@horsegurl

but they are only there to make a profit.

Yes, they are there to make a profit. That’s how insurance works. They expect that over a large population of customers, people will pay more to the insurance company than the insurance company will pay out in claims. It’s the same for all kinds of insurance - homeowners, renters, car insurance.

Just remember, you can’t get mortality coverage without medical coverage (at least that’s how my insurer works). So if you want the horse covered for the $15k in mortality, you need to buy the medical portion.

If I’m reading your post right, you’ve received $1,428 back from the insurance company, but only paid $800 in premiums. You’re ahead $628 because of the insurance.

Imagine how you’d feel with a $10,000 colic surgery and no insurance.

I would continue the policy.

[Jennifer1]

It is VERY important now in the equine insurance industry to really compare the carriers not only in their differences in premium but even more importantly what limitations, exclusions, coinsurance and sublimits are inside their major medical endorsements. This has become the most distinguishing difference between them and the value of your coverage is only as good as that difference. As an independent broker at Central Virginia Insurance, I write for all of the carriers. It is highly important that a broker help you compare the choices and figure out which carrier is right for you. All horse owners need a professional who is committed to helping you fully understand the policy and coverage so that you are not disappointed at claim time. Not all of the carriers have copays or sublimits… have a broker help you distinguish which ones!

[painthunter]

My broker just posted above…

My gelding just got dropped. Fully expected, as we maxed out his major medical the past 2 years on 2 separate claims. But I was paid out as expected, quickly and in full both years. Tons of diagnostics and surgery in one case. This is an almost 17 year old horse. I could have never done everything we did for him without major medical coverage and I am grateful for it as my horse is now healthy and on the road to recovery.

He now has Colicare (for what it’s worth) and a savings account…

[OldLadyYoungOTTB]

I just do mortality w/ a colic surgery rider. Otherwise it doesn’t seem economical, although it would depend on the value of your horse I’m sure.

[eclipse]

I was sure glad I had it when I actually needed it…2 majors medical of $10,000 on the same horse! It paid exactly how it said it would and I never would’ve been able to afford the medications if I hadn’t had it. Sure, on my previous horses, I’d sometimes questioned if I really needed it, but once I did, man I was sure glad I had it!

[Mac123]

If you can be disciplined enough to put $X away into a savings account, this can work well as long as you don’t have a catastrophic event.

But Insurance is really designed to protect you from those anyway.

I haven’t had a single claim on my mare in the 8 years I’ve owned her. But every time I’m tempted to cancel it, I just can’t. Even at the cost of the policies over the past 8 years, a single colic surgery or hospital stay or major injury could easily have costs that exceed that. And if she were to pass, I don’t have funds sitting around to replace her.

Insurance is a gamble. But you’re paying for protection in the event of a major injury or loss of the horse.

The best approach may well be a combination - a less expensive or more limited plan in conjunction with disciplined savings to cover the smaller incidents.

[gottagrey]

Well I’ve paid car insurance for probably 40 years. Never filed a claim. Homeowners for about 30 years., never a claim until 2 years ago. For some people their own medical insurance could be the same thing? So why should horse insurance be any different. Its all about the risk pool. As another poster mentioned, if you have a situation where its pretty close to a life or death decision and those big brown eyes look at you… having that resource makes that decision that much easier. I too had a weird situation where my horse had an undetected umbilical hernia which went through his abdominal wall. The vets at the barn hadn’t a clue what was going on other than refer to equine hospital. Is he insured. Yes. We get to the hospital. I gulp when they give me the estimate. 1/3 down now to proceed with surgery.This is after the surgeon tells me they have never seen anything like this before and how on earth did his abdominal wall rupture. You’re in a daze. But then there’s that horse of yours. He’s being stoic. He’s looking at you those big ,soft , wonderful kind eyes. You and your trainer are in tears as you lead him to surgery. What seems like an eternity in prepping him finally into the OR. I have to watch so I can “make the call” if necessary. Just because it’s 2am who needs, who can sleep right now. The equine insurer somehow understands through half sobs that your horse needs some sort of surgery. You feel somewhat more more at ease having talked to them. I look in on the operation and away. It’s both scary and intriguing. Finally the surgeon looks up at you and gives you a giant Thumbs up. Ah relief, joy. 5 years later, you’re galloping cross country on a horse dressed like an elf for a charity event. Was insurance worth it? You betcha, every last penny of it.

[Annabelle123]

@snaffle635

Just remember, you can’t get mortality coverage without medical coverage (at least that’s how my insurer works). So if you want the horse covered for the $15k in mortality, you need to buy the medical portion.

In my experience, its always been the opposite… You can’t insure for major medical without paying for mortality insurance, but you can insure for mortality alone.

We don’t carry insurance on any of the horses we own, as the carrying costs don’t make sense for us. Although we do generally recommend insurance to clients for at least the first year of owning a horse (until they get over the sticker shock of equine vet bills).

[PnkPanthr]

Honestly, I think it depends on your policy and your company. Same with human health insurance. For people, you can basically have a plan that you are paying X amount of dollars for that is cheap monthly, but is basically just a catastrophic plan with a high deductible and copay. Same with horse insurance.
I will never own a horse without it after what happened to me this week. My horse coliced badly, ended up having to go to the equine hospital by me awaiting potential surgery. It was $2500 deposit just to get her in the door and keep her there(granted, all the work that got done got pulled from the deposit), and then anything else after the $2500 got added. The surgery would have run me about 7-9k on top of the 2.5k I paid earlier. Plus the earlier emergency call to my vet for the colic before we made the decision to take her to the clinic. I have emergency colic coverage on my mortality insurance, plus 7500 major medical with a 500 deductible and 20% copay. If she had gone to surgery, the 3500 would have come off the top and the deductible and copay does not apply. So the break down would have been as follows:

$300 farm call
$2500 hospital stay and diagnostics and fluids
$8,000 colic surgery - 3500 = 4,500
= 7,300
-500 deductible

• 1,360 copay
  I owe : $1,860
  Insurance paid: $8,940

Now, my last insurance company would have been another story. But after the horrible experience I had with them last year, I switched and went with a new company that my vet recommended. My premium is $575 for the year split into three payments. Worth it in my book!! I think the moral of the story is (1) depends on your policy (2) how much you insurance your horse for mortality wise - the higher the value, the higher the premium.

[Daventry]

@snaffle635

Just remember, you can’t get mortality coverage without medical coverage (at least that’s how my insurer works). So if you want the horse covered for the $15k in mortality, you need to buy the medical portion.

This might be the way it is with your insurance company, but with every other equine insurance company I have ever worked with, it is exactly the opposite. A horse owner can purchase basic mortality insurance but you cannot purchase major medical by itself. A mortality insurance policy must be in place and then major medical can be added on top of the basic policy. I have never heard of an equine insurance company that allows you to only purchase major medical and then forcing you to have that in place before they will allow you to purchase basic mortality coverage. It is always the other way around.

[vxf111]

Do you read your policies?

I have been insuring horses for more than a decade with various different underwriters. I have never been surprised at what was paid. I have always felt it was a value. Some companies paid faster and with less hassle than others, but I have never had a company balk at paying what the policy said they would pay for.

If you don’t like the coverage, shop around and buy a policy with coverage you prefer.

[snaffle635]

@Daventry

This might be the way it is with your insurance company, but with every other equine insurance company I have ever worked with, it is exactly the opposite. A horse owner can purchase basic mortality insurance but you cannot purchase major medical by itself. A mortality insurance policy must be in place and then major medical can be added on top of the basic policy. I have never heard of an equine insurance company that allows you to only purchase major medical and then forcing you to have that in place before they will allow you to purchase basic mortality coverage. It is always the other way around.

Just went back to my insurer to check. You’re correct. Mortality must be in place in order to purchase medical, not vice versa as I previously stated. Thanks for setting me straight.

[IndysMom]

@OldLadyYoungOTTB

I just do mortality w/ a colic surgery rider. Otherwise it doesn’t seem economical, although it would depend on the value of your horse I’m sure.

This is what I switched to after having had the experience of denial, copays etc for major medical. I wish I’d saved the thousands that I paid over the years for the insurance I never used! However, it’s a gamble because you can end up with mega-$$$$. It all depends on what you are comfortable with risking.