Insurance Claims

The following information is intended as a guide in the event of making a claim for veterinary fees, so both you (owner/policyholder) and us (Phoenix Equine) can work together to make your claim process as smooth as possible.

• When making a Vets Fee claim, you have two options:

1. You can pay for the treatment, then claim the money back from your insurance company
2. You can pay us the excess and request that your Insurer pays us direct. Your insurance company will deduct the excess before they settle the claim to us. Your insurance company will be able to advise you how much your excess is, as some excesses are a fixed amount; others are a percentage of the amount claimed. Please note – There may be other amounts deducted by your insurance company for which you will also be liable.

• Once you have decided you are going to make a claim, please contact your insurance company to let them know. It’s worth checking the following things;

1. Check the excess amount and format (a fixed fee, a percentage of the fees charged, or both)
2. Any exclusions that may affect the new claim
3. Policy cover and any extras which you may have cover for, such as physiotherapy, remedial farriery, rehabilitation, supplements etc.
4. If a claim form is required by your insurers, please request one be sent to you or download one from their website

• E-mail or post your completed claim form to us and pay the excess as soon as you decide you are making a claim. You will need to fully complete all the questions on your part of the form as incomplete forms or missing information will delay the claim. We cannot complete your section for you. Note that these Insurers have a different process;

1. For NFU policyholders: you just have to telephone them to provide your information over the phone and they will send us the Vets Fee claim form direct.
2. For Animal Friends policyholders: claims will be submitted online, and they don’t need a continuation form

• If the claim form, excess and administration fee are not received from you within 14 days from the date of the invoice, the invoice must be settled by you in full and you will need to arrange for the insurance company to reimburse you.

• We will endeavour to complete and submit your claim form to your Insurer within 14 days, but it can occasionally take longer than this depending on the vet’s workload, staff absences etc.  Once completed, we will submit your claim form direct to your insurance company, unless you have requested otherwise.

• Your claim form will be submitted to your insurance company along with the following documents:

1. The full clinical history (a record of all treatment and the clinical notes) since your horse has been registered with us
2. Invoices for all the treatment relating to the condition that’s being claimed for, up to the date the claim is submitted to Insurers. Any treatment after that date will be submitted as a claim continuation.

• To assess new claims, most insurers will request the full clinical history from every veterinary practice that your horse has been registered with while it has been owned by you. It is your responsibility to gather this information promptly and send it to your Insurers. Any history that relates to the existing condition will be taken into account, regardless of whether it was claimed for or not. We cannot omit or change clinical history as this contravenes our professional guidelines and may result in us being removed from the RCVS register which would prevent us from continuing to practice as vets.

• During visits for ongoing treatment, the vets will give you all the treatment options with price estimates to allow you to make informed decisions. They do not base their clinical decisions on whether or not the horse is insured.

• Please be aware that your insurer will not accept a claim for any illness or disease where clinical signs or symptoms manifested before your policy started. This will be classed as a ‘pre-existing condition’ which will not be covered.

• Insurers do not discuss or provide claim updates to us, so we strongly suggest you keep in contact with your insurance company on a regular basis until you know that your claim has been accepted. If insurers need further information from us, please let us know immediately. Due to the volume of claims we deal with, we cannot chase them on your behalf.

• Please be aware of the expiry date of your claim and let the vet know so that ongoing treatment can be planned. Most equine insurers set a 12 month claim limit from the onset date of the condition. The onset date is not necessarily the date we first saw the horse, but the date the symptoms were first manifested or seen.

• For continuation claims, you may need a continuation form from your insurance company – please check with them or us if unsure, as some companies allow us to just submit additional invoices. When we have submitted a continuation invoice to your Insurer, we will always send you a copy, so you can keep track of how much has been spent. Invoices and statements regarding your account will continue to be generated and sent to you until the balance on your account has been paid in full.

• It is your responsibility to monitor how much has been claimed and whether your claim limit has been reached or exceeded. Every insurance policy is different, so we are not aware of your vet’s fee limit unless you advise us.

The contract of insurance is between you and your insurance company. Phoenix Equine cannot be held responsible for invalid or rejected insurance claims. Please remember that the account with Phoenix Equine is the responsibility of the named account holder and irrespective of whether the claim is accepted, payment for your horse’s treatment remains your responsibility.