The Hartford paid out a not-insignificant amount (maybe half the value of the policy) in MM on my little mare, and my renewal premium was almost exactly the same price as the year before the diagnostic carousel began. She had exclusions, of course, but the premiums were very fair and they definitely lost money on my policy. YMMV.
My insurance company paid the vet directly. It did not go through me.
There are different kinds of insurance now available for horses, and some people may need to phone the company and find out exactly how it works if the policy is confusing.
I currently have coverage that has a claims cap of less than $10k, but no exclusions, regardless of history. If a horse has some history then this is an option to consider. (Independent Equine Agents)
The real “medical” coverage that pays more but does have exclusions for prior conditions is another option.
Whatever you claim now, and however it affects renewal with your current company, there may be other options for future coverage. For some horses (especially younger, more valuable, active show horses) it may be better to stay with one company that provides true medical coverage. For other horses, the flat-rate capped coverage may be sufficient.
Keep asking your vet about prognosis and possibilities. Sometimes our decisions might change if we knew what the future was likely to hold.
Independent Equine Agents
800-346-8880
Ask for Rhonda. 
THX
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Not so bad because what are the chances the horse breaks a mandible again? Mine is excluded for Lyme and ulcers, which are the two most likely things 
