Horse Mortality Claims

When a potential loss occurs, timely action is essential.
Please ensure that everyone responsible for your horse(s) has access to the 24‑hour emergency claims number listed in your policy. Failure to report an illness, injury, surgery, or disease promptly may result in a denial of coverage. (Recent case law has defined “prompt” as within 14 days.)

During business hours, you are welcome to contact our office.
For after‑hours emergencies—or to expedite the process—contact the claims representative directly using the toll‑free number provided in your policy.

To help streamline your claim, please have the following information available:

• Policy number
• Horse’s name
• Nature of the loss
• Date of loss
• Attending veterinarian’s name and contact information
• Insured’s name and contact information

If the horse is deceased, a necropsy is required to determine the cause of death.

The fastest way to ensure timely claim resolution is through prompt communication with the adjuster, as well as timely submission of all veterinary reports and supporting documents.

Basic Guidelines for Equine Claims

• If a veterinarian is called, notify the insurance company immediately.
• Elective surgery (including castration) requires prior approval and may require additional coverage.
• Emergency, life‑saving surgery may proceed at your veterinarian’s discretion if there is no time to call—notify the adjuster as soon as possible.
• Permission is required before euthanasia, unless the attending veterinarian deems immediate euthanasia necessary to prevent inhumane suffering.
• A post‑mortem examination is required at the owner’s expense.

Common Reasons Mortality or Major Medical/Surgical Claims Are Denied

Understanding your policy and your obligations helps protect your coverage. Below are the five most common causes of claim denial:

1. The claim is reported after the policy has expired.

Mortality policies require notification before the expiration date for coverage to apply.

2. The claim is submitted too late.

All companies require immediate notice for any illness or injury. Courts have interpreted “immediate” to mean without delay.
Late reporting—including waiting weeks to report treatments—may result in denial.

3. Treatments were performed without confirming coverage.

Major Medical policies often exclude:

• Congenital or developmental conditions
• Corrective procedures (e.g., contracted tendons, club foot, hernias)
• Alternative therapies (chiropractic, massage, acupuncture, laser, etc.)
• Corrective or therapeutic shoeing
• Certain joint injections (varies by carrier)

Most policies do cover shockwave, IRAP, and PRP, but always confirm with the adjuster before authorizing treatment.

4. Experimental or non‑approved treatments.

Coverage applies only to approved uses of a treatment.
Example:

• Stem cell therapy may be covered for specific injuries, but not for EPM.
• Tildren may be covered for bone‑related conditions but not soft‑tissue injuries.

Always verify that the treatment aligns with accepted medical use for the diagnosed condition.

5. Pre‑existing conditions.

Horse insurance is re‑underwritten every year, and new conditions are typically excluded at renewal.
Some policies extend coverage on eligible conditions after expiration (30 days to 1 year depending on carrier), but only if the original condition was reported promptly.

Auto, Property & Liability Claims

If you experience an Auto, Property, or Equipment loss:

• Secure the property to prevent further damage.
• Gather all accident details.
• Notify our office or the carrier directly using the 24‑hour number in your policy.
• For liability claims, compile all facts as thoroughly as possible.

DO:

• Collect all accident details
• Obtain names, addresses & phone numbers of witnesses
• Collect information from police, fire, medical responders
• Report the incident to your carrier
• Take photos at the scene
• Make notes or diagrams promptly
• File a police report in the event of theft

DON’T:

• Disclose policy limits
• Admit fault
• Discuss the incident with anyone except your insurance representative

Workers’ Compensation Claims

A First Report of Injury form must be completed and submitted to your carrier.
This form is included with your Workers’ Compensation policy—if you need another copy, contact our office.

Key points:

• Filing this form is not an admission of liability.
• Report any injury or illness requiring medical care or time away from work.
• If incapacity lasts more than three calendar days, the form must be filed within 10 days (or sooner if required by your carrier).
• Failure to file promptly may result in penalties.
• Serious injury or death must be reported to the Department of Labor and your insurer within 48 hours.

Disclaimer

This information is intended as a general guide only. It does not replace or alter the actual terms and conditions of your policy.
You are responsible for reviewing your policy in full and complying with all requirements as stated.