(This was originally published in the Summer 2015 edition of the Sonoma County Horse Journal)
“I’ll call UC Davis and let them know you’re coming.”
Those are not words a horse owner wants to hear from their veterinarian in the middle of the night after being up with a colicking horse. And while the horse’s welfare is the first concern, worry about the financial impact of an expensive treatment is often a close second. Equine insurance is one way to minimize that concern.
Horse owners should be aware of the various types of insurance that can protect and benefit them from financial loss that can occur as a result of their horse-related activities. Two broad categories of insurance are Mortality & Theft/Major Medical, and Liability. NOTE: much of the information below is based on information from one insurance company’s standard policy; coverage and requirements from other companies may differ.
Mortality & Theft/Major Medical
Mortality & Theft insurance is coverage that pays for your covered losses, subject to the policy limits, in the event of your horse’s death or theft. Major Medical is available as an endorsement on the mortality insurance and is not generally available separately from mortality insurance.
According to Jan Loewen of Jan Loewen Insurance in Santa Rosa, the process for obtaining mortality insurance is determined by the value of the horse. There are two types of policies—the “Agreed Value” type and the “Actual Cash Value” type. For the “Agreed Value” policy, the face value of the policy is determined at the time the policy is issued. One company has the “Hassle-Free” application for horses insured for less than $50,000. In this case, the owner can state the market value of the horse, subject to the approval of the insurance company. If the horse’s market value is over that limit, a more formal valuation process is required, sometimes including a veterinarian’s certificate of soundness. Once the value of the horse has been determined, that becomes the “agreed value” of the horse for insurance purposes. The “Actual Cash Value” type policy insures for the value of the horse at the time of death, which could potentially differ from the policy value.
Some mortality policies come with limited free emergency colic surgery coverage. A typical policy may cover up to $2,500 of expense—helpful, but not likely to cover the actual cost of surgery. Major medical insurance for additional coverage may be obtained as an endorsement. There are various levels of major medical insurance, but keep in mind that the horse typically needs to be insured for at least that amount of mortality insurance. Many policies offer $5,000 of major medical insurance, but the mortality coverage needs to be at least $5,000. If the major medical insurance is increased to $10,000, the mortality coverage needs to be at least $10,000.
How much does this cost? Rates and coverage vary with insurance companies, but a typical annual premium is 2.5-4% of the stated value of the horse. A typical major medical endorsement for $5,000 coverage may run $270 per year, increasing to $344 for $10,000 of coverage. The example policy I used for these figures states a deductible of $375 for $5,000 coverage and $500 for $10,000 coverage. Remember, rates vary from company to company and are subject to change, so these figures are used for an example only!
Does your horse qualify for insurance? Different insurance companies have different qualifications, but they tend to be similar in their requirements. Your horse’s age is a factor (the example policy I looked at covered horses between 91 days and 15 years, although this varies by policy and company). If you insure your horse at a young age, once they reach the maximum age, they will no longer be insurable. The horse should be in good health, on a regular preventive health program (vaccinations, worming, etc), and the policy application will ask for information about any pre-existing conditions. A pre-existing condition is likely to result in an exclusion of coverage for that condition and related conditions.
If your horse is not eligible for insurance or you can’t obtain the coverage you want, Jan points out that self-insuring is always an option. This simply means that you have the means available to cover your financial loss as a result of death, theft, or injury. Remember that the insurance companies are collecting premiums from a wide variety of clients, knowing that they will make money on some and lose money on others, and the premiums are spreading the risk over a large pool. If you are financially able to do so, you can consider using your own funds to cover your risk!
Liability Insurance
While mortality/major medical insurance is an important consideration, Jan feels that liability insurance is even more essential for the horse owner, as a claim can result in a much higher loss. Your mortality and medical insurance has a stated limit, but if you are liable for financial losses incurred by others as a result of injury or damage caused by your horse activities, the amount is only limited by a jury’s decision.
Whether your horse is kept at your home or boarded, check with your insurance agent to see if your homeowner’s policy covers horse-related damage or injury to others. It is likely that you will need additional coverage for this. This can be a rider on your homeowner’s policy or you can obtain separate coverage. If you board horses at your property, you could be on the hook for damages and injury resulting from that activity, depending on facts and law.
Equine professionals need business insurance for their operation. Typical types of insurance for the professional are general liability insurance, which insures activities at your facility, and Equine Professional Liability insurance, which could cover you when you are on the road (clinics, lessons at a client’s facility, etc). Additionally, if you board horses at your facility, you may want to consider care, custody and control insurance to cover your client’s horse if your negligence causes injury to the animal while under your care.
If you are a property owner and rent out your property to an equine professional, there are a couple considerations. You should have a contract with the professional stating that they must have a commercial liability policy with agreed-upon coverage. You may want to require that they name you and your family members to be additional insured parties on their policy. Get proof of insurance. As an extra precaution, you may want to obtain your own commercial policy for this activity, as you are now in the business of renting property.
Filing a Claim—Typical Reasons for Denial
During a December 2014 webinar hosted by EquestrianProfessional.com, attorney Julie L Fershtman (equinelaw.net) listed the most common reasons a mortality claim is denied. Read on for information, not only about filing a claim, but about understanding your policy.
- Late Notice: your insurance company should be notified as soon as possible in the event of the insured horse’s injury, illness or lameness. Keep your insurer’s contact information handy. Several companies have 24/7 phone lines that are available 365 days a year! They may have a say in what treatment is given and regarding surgical options. Even without a 24/7 line available, call your insurance company immediately even if you have to leave a message. Be sure to call the right number—your agent may not be the right person.
- Value Issues: This can be an issue if it turns out the horse was insured for more than its actual market value. As noted above, there are different levels of validation of the horse’s value at the time of application. If your policy states it will pay “actual cash value” and the horse is worth less than the policy, or if the insurance company has cause to believe that there was a misrepresentation of value, they might be justified in paying less. If your policy states an agreed value, as long as there are no impediments or policy issues, you should get the face value.
- Proper Care and Attention: A typical policy requires that you give your horse “proper care and attention”, although it does not define what that means.
- Euthanasia: In almost all cases, the insurance company must be consulted and give its consent before putting a horse down. The only exception is a dire emergency such as an accident when the veterinarian agrees that the horse must be euthanized immediately. There are a couple reasons for this. One is a typical “intentional destruction” exclusion. Another is the “proper care and attention” clause—perhaps euthanasia is not “proper care” in this case.
- Sound Health Clause: many policies contain a “conditions precedent” clause, meaning that they may exclude pre-existing conditions from coverage (especially if they were not disclosed). Typical exclusions include colic for a horse with a history of gastroenterological problems, or certain lameness issues for a horse with a history of a specific lameness.
- Post-Mortem Requirement: the insurance company may require a post-mortem (necropsy) be performed at the owner’s expense to determine cause of death. Read your policy or consult with your insurance company to know if this is required.
Affordability Issues
Obviously, there are a wide variety of policies a horse owner may need, and the cost of that insurance can add up quickly. How can you make it affordable? Of course, one way is to shop around. But Julie Fershtman cautions that a lower price might means less coverage. Be sure you know what you are buying!
When applying for liability insurance, be sure to disclose everything about your activity to your insurance company. Hiding information in the hopes of getting a lower rate can compromise your entire policy. The risk of not being adequately insured is high enough that, if you can’t afford the coverage, you should re-think engaging in that activity. If you are in the horse business, structure your pricing to include the cost of coverage.
Summary
This article covers some of the common types of insurance available to the horse owner. It is not an all-inclusive list; check with your insurance agent to make sure you have the appropriate coverage for your particular situation.