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How to File an Insurance Claim

Read this before you have to

So, you’ve purchased insurance for your horse to protect your financial and emotional investment. “Great,” you think, “Check that off the list!” But wait. There’s a little more work to be done. You’ve filed your policy, but what happens when you need it? It’s best – as the Boy Scouts say – to Be Prepared. While no one likes to think about the potential for tragedy, horses seem to be prone to illness, accidents and injury. So, what’s involved in the claims process, and how can you make it easier?

BEFORE YOU MAKE A CLAIM

Make sure you read your policy and know what will be covered in case of an emergency. The time to review your policy and understand its coverages is NOT when you make a claim. Your policy may not cover expenses incurred more than 60 days prior to your claims notice and veterinary travel fees may also be excluded. Your policy most likely covers most medications; however, certain medications and/or treatments might have veterinary diagnostic tests required in order to be eligible for coverage. Only by reading your policy BEFORE an emergency will help you understand what is included and what will not be covered.

A toll-free number should be printed on your policy, and someone with the claims department of your insurance company should be available to help you any time, day or night. You may want to enter that number in your phone for ease of access in the unforeseen future.

Keep your horse's bill of sale, proof of payment (such as the cancelled check or documentation of a wire transfer), registration papers, performance and/or breeding records in the event you file a mortality claim, as these will likely be requested by the insurance company during the claims process.

WHEN TO MAKE A CLAIM

First and foremost, make sure your horse is getting proper veterinary attention if he/she suffers injury, illness, lameness, accident or disease. You must use all reasonable means possible to save the life of your horse.

It is also very important that you notify the claims office immediately if your horse is being seen by a vet for other than routine maintenance care, otherwise, coverage availability under your policy could be jeopardized. This is required because minor treatments can lead to more serious and sometimes life-threatening conditions. If the horse is hospitalized, your policy might require that the insurance company be notified within a certain time frame. If euthanasia is recommended, know what steps must be taken for a claim to be valid.

Please also note that if you are in a position where you are considering euthanizing your horse, it is very important that you contact the insurance company prior to putting the horse down and talk to an adjuster who can advise you and your vet as to the policy requirements. Not contacting the company could forfeit any possible coverage under your policy. Please make sure anyone who has the care, custody and control of your horse is also aware of these requirements.

In addition, if your horse dies, you must contact the insurance company immediately, and make sure not to bury or otherwise dispose of the horse, as the insurance company may require a necropsy and a death certificate.

Immediate notice must also be given to the company if the horse is going to undergo any sort of veterinary procedure, medical or surgical (including, but not limited to, castration). Failure to notify the insurance company in advance of castration may result in the automatic denial in the event of a Mortality claim.

Claims are not just for medical coverage or mortality: if any theft or any crime is involved, call the local police before filing your claim. And remember, to ensure your claim, proof of loss usually must be filed within 60 days of the death or loss of your horse.

MAKING THE CLAIM CALL

When notifying your carrier of a claim involving your horse, remember to have the following information ready:

• Policy number
• Insured's name and contact information
• Submitter’s name and contact information (if other than the Insured)
• Name of the horse
• Nature of the loss/ symptoms or injury sustained
• Date of loss
• Name and contact information for the attending veterinarian
• Name and contact information of the equine clinic or hospital (if used)
• Trainer contact information

Once you have submitted your initial claim, make sure your carrier confirms that claim through email or a written copy. Also, don’t neglect to file a police report if one is needed.

Regardless of the circumstances, never ask or expect your veterinarian to report a claim to the insurance company. This is your responsibility as the owner. Also, don’t expect your equine veterinarian to be an insurance expert. If you have questions regarding your policy, ask your insurance agent rather than your veterinarian. Too, if there is something that your insurance company requires, make sure your veterinarian receives the request in writing.

PAYMENT OF CLAIMS

All invoices regarding the care of your horse will be sent to you (as the customer), not the insurance company. You may have a deductible or co-pay that is your responsibility, or the bill may include charges that the policy does not cover. You will send the bills onto your insurance company, but make sure to keep copies for your files.

Your insurance company may also request a report from all veterinarians who have attended to your horse. This report will provide them with the diagnosis and recommended treatment. Your policy may also require that you file the vet report and the invoices within a defined time period after the onset of medical treatment.

Payments for all covered charges will be issued by your insurance company in the name of the policyholder. The best way to hasten the time between a loss and a payment is to give the company adjuster a prompt response to all requests for specific items or further details. In addition, a quick response from the attending veterinarian including forms or documents needed by the adjuster is very helpful in expediting a claim.

No one ever wants to make a claim, but you purchased insurance for your horse in the event it would be necessary in the future. Make sure you are knowledgeable about your policy and its coverages. If you do your research today, your claims process won’t be full of surprises tomorrow.

For more information, contact us direct at: Equidae Insurance, Inc. 608 Virginia Street East, Suite 302 Charleston, WV 25301 p. (304) 346-1198 f. (304) 345-3535

Stacey Halloran, Agent
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