Featured Article (February 2006)

By Gwyn Donohue

I called his veterinarian. Voice mail. I called another vet. More voice mail. Finally, I called the only 24-hour equine veterinary facility in the area that I knew of—the Marion duPont Scott Equine Medical Center in Leesburg, Virginia.

They said, "Bring him in." They also said there was a $535 emergency fee, before treatment even began. My next call was to the EMO Agency, my equine insurance agent.

For the recreational horse owner, the decision to purchase horse health insurance can be difficult. The monthly costs of board, shoeing and other expenses quickly add up. Add a trailer, show fees and lessons, and you often have to have a very carefully managed budget.

Knowing I didn’t have enough savings to cover significant vet bills or to buy a new horse, I had obtained a Mortality and Major Medical policy shortly after buying Corry. I was about to find out if the $3,000 I’d spent in premiums over the past eight years was worth it.

Major Medical coverage, sometimes called Medical-Surgical, is the most common addition to Mortality coverage. You can’t get it by itself; it has to be part of a Mortality policy. It reimburses you for licensed veterinary costs incurred while your horse is being treated for an injury, illness, or disease.

In general, horses that are between the ages of 30 days and 15 years can be covered. Coverage for reoccurrence of certain past conditions, such as colic or lyme disease, is evaluated on a case-by-case basis. Some insurers may exclude treatment for that condition forever. Or, they may only require the horse go without another incident for a certain time period, usually a year.

Many policies cover 100% of medical costs related to a claim. Others may limit coverage to a portion for certain procedures, such as diagnostic testing. Some may set a time limit of four or five months per claim. Corry’s deep flesh wound took a long time to heal, and the 120-day limit expired. Luckily, there were only a few more follow-up vet visits before the wound completely closed. A more severe injury, or lengthy disease recovery, could easily exceed the time limit.

Elective or preventative health costs such as worming, vaccinations, massage, acupuncture or chiropractic are not included in Major Medical coverage. However, as holistic medicine becomes more common in the veterinary community certain therapies, if prescribed by a vet as part of treatment for an injury, may be covered.

Major Medical premiums are usually between $150 and $300 a year, depending on the amount of coverage. Insurers offer one or two levels to choose from, ranging from $5,000 to $10,000 of aggregate coverage. "Aggregate" means that the amount of your coverage is the total amount the company will pay out during the policy term, not per claim.

What does apply per claim is the deductible. Depending on the insurer and the policy, it can range from $250 to $500. Some policies also have a co-pay, where you are responsible for paying a percentage of the covered costs in addition to the deductible.

Major Medical coverage has only been around for about 10 years, and it’s seen a significant and steady increase in popularity among horse owners. This is due in part to the rising expenses of horse-keeping in general, as well as the more sophisticated and expensive diagnostics, drugs, and treatments veterinarians are now using.

Surgical-only medical coverage is also offered by some insurers. It only covers surgical procedures, and sometimes limited aftercare. The premium and deductible are less than Major Medical, but so is what’s covered. This can be an option for horses older than 15, who may no longer be eligible for Major Medical.

E. Sue Bopp, vice president of the EMO Agency, Inc. in Warrenton, Virginia, says insurers have to require Major Medical coverage to be part of a Mortality policy because it’s not profitable. "In general, insurers have to pay 99 percent of the money they collect in Major Medical premiums back out in claims."

As the industry has been faced with a dramatically increasing number and cost of claims, some insurers have left the equine insurance business altogether. Others have had to increase premiums by 50 or even 100 percent.

My experience left me a firm believer in the value of Major Medical coverage. I was stressed enough turning my schedule inside out to fit in daily hand walking and bandage changes. Not having to worry about paying a huge bill I hadn’t planned on was a relief. Filing a claim was simple, and everyone involved was prompt, pleasant and helpful. In the end, my policy covered more than $3,700, the majority of the costs.

Bopp advises anyone considering insurance to be comfortable with the agent, more than the premium. "There are a lot of agents out there, but not so many equine insurance companies," she says. "The rates you’ll find won’t vary that much, but the level of service you receive will."

If you’re thinking about insuring your horse, you should talk to horse-owning friends, trainers and vets for recommendations. When reviewing a policy, carefully evaluate what is and isn’t covered, under what conditions, and any time restrictions. The cheapest may not provide the best coverage or customer service. Before buying any insurance make sure you’re happy with what you’re buying, and who you’re buying it from.