Exclusions
Exclusions are noted conditions or risks that are not covered under your Insurance Policy.
General Exclusions
All insurance policies carry general exclusions, that is areas or circumstances when the policyholder is not covered. General exclusions will be stated in the terms and conditions of your insurance policy. You will normally find that there are general policy exclusions, relating to the policy as a whole, as well as exclusions applicable to certain sections of the policy. For instance, on an equine policy general exclusions may be listed under such sections as vets fee, personal accident and public liability cover.
It is therefore important to read your terms and conditions carefully when you receive them with your certificate of insurance and if you have any queries on any aspect of the cover to contact us.
Specific Exclusions
Specific exclusions are ones that apply to an individual policy. On an equine policy they can be in reference to an illness, injury or disease, which occurs or was diagnosed before the policy was taken out – a pre-existing condition. It could also be in relation to a noted condition or conformational fault that may pre dispose a horse to a specific condition, illness or injury.
At KBIS we will list any specific exclusions clearly on your certificate of insurance. Unlike general exclusions, specific exclusions can be re viewed and depending on the type of injury or illness may be removed after a certain period of time. We are always happy to discuss any specific exclusions on your policy and you can find out more about our exclusion review procedure here - KBIS Exclusion Review Procedure
Below are some commonly asked questions relating to specific exclusions
Will I have an exclusion placed on my policy if I make a claim?
Generally if you make a claim that condition will then be excluded in the next policy period, as in most cases it will mean that the horse will be pre disposed to that illness or injury again.
Depending on the condition the exclusion may be very specific to that individual circumstance or it may be more generic if it is viewed by professionals as being likely to predispose the horse to other related injuries or illnesses.
Although you will have an exclusion for the condition placed on a new policy i.e. at renewal, it is important to remember that your 12 or 15 months, depending on the policy you have, cover for that condition starts from the onset date of the injury or illness so you could still have cover in place for the condition under your old policy.
For example if your horse sustains an injury to its stifle on the 1st May 2015, on a 12 month policy you will be able to claim for any ongoing treatment up until the 30th April 2016. If your policy falls for renewal on the 1st August 2015 your new insurance policy for that horse will list a specific exclusion relating to the stifle injury but you will be still be covered for the injury under your old policy up until the 30th April 2016.
The reason the exclusion has to be placed on your policy at renewal and not at the end of the cover period is to avoid dual liability (a term which means that the insurers are liable for the same ‘loss’ under two or more policies)
Depending on the condition the exclusion may be very specific to that individual circumstance or it may be more generic if it is viewed by professionals as being likely to predispose the horse to other related injuries or illnesses.
Although you will have an exclusion for the condition placed on a new policy i.e. at renewal, it is important to remember that your 12 or 15 months, depending on the policy you have, cover for that condition starts from the onset date of the injury or illness so you could still have cover in place for the condition under your old policy.
For example if your horse sustains an injury to its stifle on the 1st May 2015, on a 12 month policy you will be able to claim for any ongoing treatment up until the 30th April 2016. If your policy falls for renewal on the 1st August 2015 your new insurance policy for that horse will list a specific exclusion relating to the stifle injury but you will be still be covered for the injury under your old policy up until the 30th April 2016.
The reason the exclusion has to be placed on your policy at renewal and not at the end of the cover period is to avoid dual liability (a term which means that the insurers are liable for the same ‘loss’ under two or more policies)
Does my exclusion related just to my vet fee cover?
A specific exclusion relates to all sections of cover you have taken out. For instance if your horse has had colic and you claimed for treatment under the vets fee cover you had in place, any subsequent exclusion placed on your policy relating to colic would apply to your vets fee cover and your mortality cover. It would also relate to loss of use cover if you had this in place.
How long will the exclusion be in place?
This is dependent upon the severity of the condition, the chance of re occurrence and whether it will then pre dispose the horse/pony to the condition or a related condition in the future.
Some conditions are very unlikely to be removed such as a tendon injury while in other cases we may review an exclusion after a certain time frame or at the next renewal. You can read about our exclusion review procedure here - KBIS Exclusion Review Procedure.
Some conditions are very unlikely to be removed such as a tendon injury while in other cases we may review an exclusion after a certain time frame or at the next renewal. You can read about our exclusion review procedure here - KBIS Exclusion Review Procedure.
Why is my exclusion very broad?
If the exclusion placed on your policy is very broad/non specific it is usually because we have not received enough information to allow us to apply a more appropriate exclusion. If this is the case supplying the onset date, the nature of the problem and any treatment your horse has received so far will help us to adjust the exclusion.
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