Horse insurance exclusions can be a bone of contention for many owners, so it is important to understand why exclusions are placed on some health conditions before you take out, renew or switch an equine insurance policy.
Typically exclusions are placed on pre-existing conditions that existed before your equine insurance policy started.
“SEIB places exclusions from the start of each policy period, which generally runs for 12 months,” says Andy Burnett, equestrian schemes underwriting specialist. “This means from policy activation, or from renewal thereafter.
“In either circumstance, the excluded conditions would be deemed pre-existing to that policy period.”
When taking out a new policy, you must always disclose pre-existing conditions.
“Be honest with your broker,” says Lawrence Gill. “Insurers are here to help and want to help, but we can’t pay out for pre-existing conditions.
“Insurance is here to protect against the unexpected. If we know what is pre-existing (and therefore more likely to recur) we can be clear about what we can and cannot cover from the outset.
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“Insurers might review some conditions after a certain amount of time. It is worth discussing with your insurer if some time has passed since the injury or illness.”
Lawrence adds that trying to hide pre-existing conditions and then claiming for them constitutes fraud.
“We ask for a full veterinary history as part of the claim process and will investigate any discrepancies that arise,” Lawrence adds. “Claiming fraudulently means your insurer could cause the policy to be voided.”
What is an exclusion?
When it comes to horse insurance, pre-existing conditions are excluded from policies. But what does this mean?
Francis Martin, CEO of the Insurance Emporium, says: “To put it simply, an exclusion could be a specific condition, circumstance, item or type of loss that the policy does not cover due to an increased insurance risk.”
He adds that there are two main types of exclusions.
“General exclusions, set out in the policy wording, apply to all policies. You can find ours below the insurance table of benefits on our website.
“Meanwhile, specific exclusions apply to an individual policy. They usually exclude cover for a particular condition, risk, or circumstance identified during underwriting.”
Andy adds that exclusions provide clarity and transparency: “This means policyholders fully understand what their policy does and does not cover.
“SEIB works closely with veterinary advisers to ensure that exclusions are proportionate, fair and based on appropriate professional guidance.”
Equine insurance typically covers health conditions that arise for the first time during a period of insurance (often one year), then exclude it after that.
(Image credit: Andrew Sydenham)
How do horse insurance exclusions work?
Before applying an exclusion on a horse insurance policy, insurers will determine which part(s) of a horse’s anatomy to exclude from the policy. Many insurers will provide cover for around a year following the onset of a condition or injury. However, you should always check the policy wording or contact your insurer for clarification if you are unsure.
Francis Martin explains the process at the Insurance Emporium: “When determining the correct exclusion to place, we consult our exclusion matrix. We created this after using the services of an independent veterinary consultant.
“For example, when presented with the increased risk of a tendon or ligament condition, we place the exclusion for the affected and opposing tendon or ligament.
“If a claim is submitted for an illness, injury or disease and the claim is accepted within the normal terms of your cover, the Insurance Emporium will continue to provide cover up to 365 days from the onset of the condition or up to the maximum amount recoverable, whichever comes first, irrespective of the date on the exclusion.”
Agria works differently to many other equine insurance providers as it does not place exclusions on conditions that develop during the period of insurance, as long as you renew your Agria lifetime policy each year, with no break in cover.
“This means if your horse develops a condition like kissing spines while insured with Agria, then this condition remains covered for treatment should they flare up again in future,” says underwriting manager Alexandra Gillam.
Agria does typically exclude any pre-existing conditions that have affected the horse prior to their lifetime policy being taken out, in the same way as other providers.
Are pre-existing conditions always excluded from horse insurance?
Broadly speaking, yes.
Francis Martin says: “You should disclose any pre-existing conditions, clinical signs or circumstances, whether you have claimed for them or not.
“This is so your insurer can accurately determine any specific increased risks.
“We would also encourage you to review your insurance cover and terms and conditions carefully, as not all insurers offer the same cover with the same general exclusions.”
Anthony Burnett says SEIB is able to reduce or remove exclusions in cases where the exclusions are not permanent.
“Whether an exclusion can be reduced or removed and to what extent depends on the nature of the exclusion and the circumstances surrounding why it was placed,” he adds.
Is it possible to remove horse insurance exclusions?
In some circumstances, yes. However, exclusion removal or amendment depends on the condition and the insurer.
Katie Jackman, UK underwriting assistant for Petcover, says: “Most of our exclusions allow the client to remove or reduce the exclusion. This will depend on the conditions, treatment and severity, but most can be reduced or removed.
“Our exclusions specifically state dates. Therefore, clients clearly understand when they come into effect, and if they are a reviewable or non-reviewable exclusion.
“If they are reviewable [giving the possiblity to remove or reduce them] we will include details on how this can be done.”
A horse owner and rider with more than 20 years experience, Bethany has been writing for equestrian publications since 2017. Over the course of her career, she has reported from major British Riding Clubs and British Dressage championships, covered Badminton Horse Trials and interviewed equestrian sport’s best athletes. Her work can also be found in Country Life, The Field and Breathe magazine.
