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insurance denied claim

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Last activity 2016-12-18 9:47 PM
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bluerose2001
Reg. Mar 2009
Posted 2016-12-03 12:19 PM
Subject: RE: insurance denied claim



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Bless you! We have a vehicle with them, but I now refuse to get equine insurance with them due to your story. Do you feel the agent that sold the policy is knowledgeable on horses or are they used to dealing with homes/auto? Just wondering if they even have a clue really.
I'm so sorry that you have to go through this. I lost one of my "family " members two years ago and still feel the loss. Especially after a really good run on a new horse just because it was supposed to have been with him.
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streakysox
Reg. Jul 2008
Posted 2016-12-03 6:48 PM
Subject: RE: insurance denied claim



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schnitkey - 2016-12-03 11:19 AM

Sorry that I have not posted an update. He was family and this denial has kicked hard in the gut. It is State Farm Ins. Our agent is trying to appeal. I will try filling in more details later so that those that are agents can help me fill out the appeal.

I have State Farm insurance and as a matter of fact, my truck is financed through them. I asked my agent about insuring a horse and was told they do not insure horses. Could it be another company through your State Farm agent? I can assure you that if my agent could sell me more insurance they would.
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Chandler's Mom
Reg. Jan 2015
Posted 2016-12-03 7:20 PM
Subject: RE: insurance denied claim



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schnitkey - 2016-12-03 11:19 AM

Sorry that I have not posted an update. He was family and this denial has kicked hard in the gut. It is State Farm Ins. Our agent is trying to appeal. I will try filling in more details later so that those that are agents can help me fill out the appeal.

I have no experience but I wanted to say how sorry I am about your loss. It would be heartbreaking no matter if the insurance was being hard to deal with or not.
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OhMax
Reg. Feb 2013
Posted 2016-12-04 7:37 AM
Subject: RE: insurance denied claim


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I would re read your policy...

We just had all of our policies required to bring my fiancé and i's insurance together. The only policy I could put on the horses and cattle through State Farm was liability - IE horse escapes and gets hit by car they pay for the accident and we have a little value on the animals. I don't know about act of god honestly, I suppose if there was a barn fire they'd cover them. our biggest concern was getting them under our liability umbrella as we are only a mile from the 4 lane highway.

I've not heard of State Farm covering major medical and such on animals... :-/


I would also add that for what it's worth State Farm was very expensive compared to the other quotes we had.

Edited by OhMax 2016-12-04 7:39 AM
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justcruzin
Reg. Oct 2003
Posted 2016-12-04 10:26 AM
Subject: RE: insurance denied claim



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FlyingJT - 2016-11-29 8:18 AM

Three 4 Luck - 2016-11-29 9:50 AM

 I support's Sloride's right to believe as they wish, but this was an inappropriate place to voice said beliefs. 

Anyway, like others said, insurance companies make money not paying claims. They hope people will let denials stand without a fight.  If you're willing to go toe to toe, you'll probably get paid. 

inappropriate place??? because you don't believe the same as her? It's ok for ladyjockey to post her beliefs but not Sloride. Such a hypocrite!!


Thank you!
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jewels
Reg. Jun 2006
Posted 2016-12-07 8:46 AM
Subject: RE: insurance denied claim



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ThreeCorners - 2016-12-03 10:19 AM

We have our horses insured with Wilkins Livestock and they have been great. We had a major medical claim last month and we had the check within 2 weeks. Horse colicked and the local vet refered her to the surgical center. I called our agent while she was enroute to the surgical center and he refered me directly to the adjuster. Kept in contact with the adjuster the whole 5 days she was in the hospital and they paid right off.
? With that said, you have to notify your insurance company the minute there is a problem and keep in contact through the whole process. If you dont communicate from the very beginning, they can be difficult and rightfully so. We even had a weanling get a roofing nail in his foot, didnt have major medical on him but still notified them. Had the vet x-ray before pulling the nail to be sure he didnt puncture anything in there. Had we NOT notified them, and the colt later developed a severe infection and we ended up having to put him down, they could have denied the mortality claim. Thank God that didnt happen. The moral of all this story is communicate from the very beginning!!

I notified mine in route to vet & was still denied.
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riversedgeqh
Reg. Feb 2008
Posted 2016-12-13 2:25 PM
Subject: RE: insurance denied claim



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If you don't get anywhere with your appeal, you can file a complaint with your state insurance commissioner's office.
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Hot Rod
Reg. Dec 2003
Posted 2016-12-16 4:21 PM
Subject: RE: insurance denied claim



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Vickie - 2016-12-01 11:10 AM I used LCI for many years, had two claims and they were great each time. 

I use LCI, as well.  Had one horse break a leg at a rodeo and they paid right away.    I've had lameness issues on my mare and they paid for her treatment.  Very satified with them.  
  
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nvrenuf
Reg. Nov 2004
Posted 2016-12-17 2:08 PM
Subject: RE: insurance denied claim



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jewels - 2016-12-03 8:31 AM

barrelracinbroke - 2016-12-01 2:02 PM

jewels - 2016-11-30 7:08 AM I did not get my money as well. I had vets write statements. Mine was colic and she died shortly after getting her to vet. Didn't even make it to the table and not able to end her suffering. It was terrible. I will tell you the carrier was Great American. I do not recommend this company to anyone!!!! If your insurance agent uses Great American - I would really consider getting new insurance. Also 2 years before she did she had to have PRP treatment done for a torn ligament.... I barely got my money for that. BARELY!!! I don't have anything insured at the moment and IDK if I ever will.

This surprises me. I've had a few different companies over the years but, for the past 4 years I've had Great American. I had a claim this year for a lameness that was difficult to find. Finally, after 2 MRI's on 2 different areas it was found. The claim was open for 5 months during this process. Great American covered everything from the MRI's to the treatments that included Tildren and Stem Cell. I know they have varying coverage you can choose but, my entire major medical benefit was exhausted and they paid easily and quickly.

I also have two close friends who had claims last year and they too had no issue getting paid. These cases were all lameness issues though and not a colic incident. I'm sorry for the loss of your horse. 

I know some people who use Great American & have got paid. I know some who use it & don't get paid. I had major medical on my horse, death, loss of use. With the prp treatment what got me is this and in all honesty - I think my honesty was what caused this issue. Every year I listed 3 vets that I use. One is my local vet & I used him for coggins, meds etc. Another vet I used was mainly for injections and then I would go to a vet that is 3 hours away if I thought my more local vets might not be getting something or if I was up that way or if we had a horse colic b/c they would be the one doing surgery. Anyways Great American contacted all 3 requesting records on ALL work I have done. Not just the horse in ? for the prp. What they finally told me was that they were trying to make sure I was taking this mare in as a grade mare. Okay fine I get that. I had taken another horse I owned in and she is grade & they injected her...... So they denied my claim b/c they said she had too many injections in 1 year in her hocks. My registered mare had been injected once & the other mare 2 times..... over a years time... so that made 3 total. The prop was for a torn suspensory not anything to do with hocks so I didn't understand that. Anways I called my vet & we both had to call insurance... then my vet had to send in a statement & description of both horses. Even though that was on records sent to insurance on ALL my horses. And I only had one insured. IMO they were just trying to not pay me. I get that people are dishonest & try to cheat the system & I take pride on being a honest person. But if I ever have another horse insured- I probably won't be real honest, I can think of a few things that probably would have helped me get my money for prp easier & money for the death. Also my two local vets called & told me that how much hell my insurance was giving them & how rude they were. One of them has done some surgeries & deals with insurance all the time and said my company was the worst he had ever dealt with. I wish I would have switched then - maybe I would have at least got my money to start over with another horse.
As for colic that's another long story... I will say she never healed from the suspensory & would not be able to run again. They denied loss of use b/c I could still use her for a broodmare. Which to this day I still don't understand that b/c I sure thought loss of use meant loss of running barrels. Anyways a year later she went on to colic. Anyways I try to be over it but I just dont' feel that any of that was right. But I am blessed b/c she did have 1 colt before passing & I am just now starting to run him & he is very nice. So at the end of the day, I should just move on. Sorry very long story & I tried to keep it short so I hope you understand all that.

I have great American as wel no problems in any of my claims
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chicks2
Reg. Mar 2007
Posted 2016-12-18 9:47 PM
Subject: RE: insurance denied claim


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riversedgeqh - 2016-12-13 2:25 PM

If you don't get anywhere with your appeal, you can file a complaint with your state insurance commissioner's office.

This.

Be sure your carefully read what is covered and not covered. Call the carrier and ask questions if you don't understand. These plans have restriction, especially for pre-existing. They typically use a point to point, not an original coverage date. For example, you are covered and your horse is diagnosed with a condition. Vets recommend conservative therapy before surgery, which you do. If you go through a renewal before the surgery is performed, it will then be be pre-existing.

Mortality is fairly straight forward and the premium is realtively inexpensive. Medical and other riders sometimes are limited, so be sure you read and understand what the coverage entails.

If you receive a denial and things just don't seem right, contact the state insurace board. Send them the details of the claim as well as copies of documents, denials, bills etc. State the facts as simply as possible and copy your insurance carrier on the letter.

I know sometimes it seems like the insurance company is making you jump through hoops, but there is fraud, and unfortunately the ones that follow the rules usually feel the consequences from those that don't.







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