Horse claim or investigation CAN THIS BE RIGHT (EQUINE 1)

[nigel1804]

HI everyone ,

 

I'm normally found getting at the banks for their outrageous behaviour, but a couple of weeks ago I re insured my horse with the NFU.

 

They agreed I or my daughter could pay by direct debit etc......all well so far.

 

Unfortunately we noticed our horse having a slight limp at times and we called out a vet.

 

The vet came out and took him into the surgery for tests.

 

we Rang the NFU and they were al helpful in the what we could do and what we able to claim for.

 

After a week or so a lady from Equine 1 rang us to ask to come to our house to speak to us about the horse.THE QUESTIONS STARTED

 

where is the horse?

 

whats the stable owners name

 

when did we notice this ,

 

who lives in the house

 

etc etc normal questions about the horse?, the lady was taken up to the yard to see the horse, she then proceeded to ask who was the stable manager where was the yard owner and went off around the yard asking all and sundary questions. Now I was getting a little bit sick of the way in which she was so called putting a face to the claim just to understand the picture.

 

I found out today that said woman has contacted the yard manager and asked questions about our horse ,because she thought our yard manager might like to say something about us when were not there.......oh and the latest things were she wants our telephone records for my daughter and my wife from MAY then receipts for the saddles ........what the helll does this have to do with a claim for the horse'

 

I feel like I'm under a fraud investigation is this legal to ask for such personal information that is totally irrelevant to the horses problems can anyone tell me where I stand with this person and what should I say to the phone calls records

 

regards

 

Nigel 1804

[UKDomains]

Hi, I hope you are not sick of questions, as I would like to ask some as well. I have an equine veterinary background so might have some insight into the questions she asked.

 

Do you have a diagnosis what is causing the lameness in the horse?

Was the lameness observed during a walk or trot or both?

Saddles: Were they new saddles/new to the horse?

 

As to phone records, have you asked why she needs to know the records?

you say she is looking for records for May. When did you take out the insurance? If this was after May, maybe she is trying to determine if the horse was lame prior to the insurance starting.

[nigel1804]

Hi, I hope you are not sick of questions, as I would like to ask some as well. I have an equine veterinary background so might have some insight into the questions she asked.

 

Do you have a diagnosis what is causing the lameness in the horse?

Was the lameness observed during a walk or trot or both?

Saddles: Were they new saddles/new to the horse?

 

As to phone records, have you asked why she needs to know the records?

you say she is looking for records for May. When did you take out the insurance? If this was after May, maybe she is trying to determine if the horse was lame prior to the insurance starting.

 

Hi the diagnosis was navicular the saddle was a specially fit saddle .nothing what so ever to do with the diagnosis. Also why the intrusion into who lives in my house ages etc

 

Insurance was taken out 1st July . Lameness noted 18 /19 July. Same vet used since we had him but to me they are insinuating that my claim is false. My horse is of good stock he is by old Vic racehorse. I find it to be very intrusive a quite an insinuation that I'm a fraud.

 

Regards Nigel 1804

[UKDomains]

Hi Nigel,

 

Sorry to hear about the navicular. I'm guessing that because it is expensive to treat, and was diagnosed less than 3 weeks after your insurance started they are suspicious about it.

It does seem weird though some of the questions they are asking.

 

My suggestion would be to write them a letter, requesting detailed information why they need all this information.

However, I would strongly suggest you do supply them with all the information they require, as insurance companies are used to dealing with fraudulent claims, especially in the pet industry, and will look for the smallest excuse not to pay the vet. I have witnessed on many occasion brand new insurance on a condition that clearly has been present preceding the start of the insurance.

 

Please also do bear in mind that my advice has no legal basis, and can only offer my prospective from the veterinary side and having dealt with almost every equine insurance company in the UK. If anyone with more insurance knowledge than me can offer any assistance, please do.

Please keep us updated on the outcome.

[dacouc]

How old is the horse?

 

Did you have horse insurance for this horse before and if so when?

[unclebulgaria67]

Nigel. Put yourself in the Insurers shoes and think how this claim looks. Why has the Horse suddenly shown signs of a medical condition, weeks after an Insurance policy is taken out ? The Insurers have every right to investigate the claim as they see fit and your indignation which is understandable, could look as though you were trying to claim for something that started before the Insurance was arranged. You should let the Insurers investigate properly on the basis that you have given accurate information at all times and that there is nothing wrong with the claim submitted. If everyone says the horse was fit until very recently and te vet confirms it is probably a very recent condition, then I would hope there would be no problem with the claim.

[nigel1804]

YES, I appreciate the situation and i could understand the looking into the claim......But to ask for my daughters and my wife's phone records I think is pushing the boat out a bit far.......even asking right down to who lives in my house and what they do and lots of other personal questions totally irrelevant to the horse .

The police would have had to arrest me to look that far into any other form of crime. She can have the phone records for my wife as we are on a contract but don't know how you get the phone records for the "pay as you go" on my daughters old phone...any ideas.

I honestly feel like telling them to shove it up their ......; but maybe that's the game they want me to play.

 

This has really surprised me with the NFU

 

keep wriggling they will be wriggling a long time to try get out of this claim

 

thanks everyone

 

regards nigel1804

[unclebulgaria67]

Your daughter ( or person registered for the phone) can ask the PAYG phone company for a log of phone calls made, but there may be a fee for this, if you cannot log in online to access this. The reason they are asking, is whether there were a series of phone calls that appear connected to an event prior to the Insurance start date. For example, there may be phone calls between Mother/Father & Daughter & stable manager within a short space of time. This may indicate an event related to the horse before the Insurance was arranged.

 

The Insurers obviously believe that fraud is a possibility, hence why they are asking for all of this information. You should provide as much information as you can, as that is demonstrating that you have nothing to hide.

 

See the process through and see what happens. Hold your fire for later, when you can write a strong letter of complaint to the CEO of NFU.

[nigel1804]

ok will do many thanks for the help

 

regards nigel1804

[ScarletPimpernel]

Whilst noting that the insurer may be concerned about fraud because of a claim arising shortly after the policy inception, I see that OP says that the horse was re-insured - in other words, it was previously insured. That must go towards this being a new and unexpected occurrence rather than a policy taken out because the horse was showing symptoms.

[unclebulgaria67]

Whilst noting that the insurer may be concerned about fraud because of a claim arising shortly after the policy inception, I see that OP says that the horse was re-insured - in other words, it was previously insured. That must go towards this being a new and unexpected occurrence rather than a policy taken out because the horse was showing symptoms.

 

Yes, but it depends on whether there was a gap when the horse was not insured or the previous policy excluded the condition being covered for whatever reason.

 

NFU are a very good Insurance company, but from I have heard they are red hot on any 'signals' of fraud and will investigate fully. It is not that they are trying to avoid the claim, but rule out the possibility of fraud.

[dacouc]

NFU are a very good Insurance company, but from I have heard they are red hot on any 'signals' of fraud and will investigate full

 

Being a mutual, their members would rightly expect this.