Monday, 4 June 2012

NFU - Details of the Ombudsman's decision

I posted last week about the Ombudsman's decision against NFU and Catherine has generously given me the go-ahead to post the details of the decision here.


Basically, NFU had refused to allow Catherine's claim that rehab here should be covered under her policy. She was supported by her vet and previously NFU policy holders had been able to claim 50% of the cost of rehab.

However, in Catherine's case, and in a number of subsequent cases, NFU refused to meet the claim saying that rehab here no longer qualified under the terms of the policy, which seemed very unfair.

The Ombudsman process was appealed at the first instance by NFU and the subsequent appeal has taken 2 years but we at last have a final decision and the complaint against NFU has been upheld.
The decision turned on whether therapy by a "specialist" is limited only to vets and para-professionals or had a wider definition. The key paragraph of the decision reads:

"Navicular syndrome requires specific treatment to be carried out by an experienced professional and I do not consider that this is something which Miss Hodson could reasonably have been expected to perform herself.


Treatment carried out at Rockley Farm extends beyond simply exercising the horse on different surfaces as it requires expertise to assess the horse's initial condition and its subsequent state of health at each stage of the treatment, modifying that treatment if and when required...very few horse owners would have the necessary expertise or confidence to correctly identify and treat the medical issues involved...


I am satisfied that the treatment offered by Rockley Farm has proven efficacious results (while accepting that no treatment can guarantee 100% success) and does not represent some alternative therapy of dubious nature and quality that NFU...should not be obligated to provide cover for."

Fabulous news, massive thanks and congratulations to Catherine and I hope this will provide help to those of you struggling with NFU at the moment. Catherine is happy for me to share the wording of the decision in full with anyone who needs more info.

5 comments:

Niki said...

Great news! Well done.

Neets Human said...

That's fantastic .. hopefully it will clear the way for others.. onwards and upwards..

Indi said...

Wondering if any US insurers would cover this type of treatment???

Esther Stirling said...

That is wonderful news!

I'm really delighted both for the outcome of this decision and the success you've had with this horse (and many others!).

I wonder if I could see the wording of the full decision? I'm a litigation solicitor who specialises in equine law, and would be very interested to see their full reasoning. If you could e-mail it to me at esther.stirling@henmansllp.co.uk, that would be much appreciated. Many thanks!

Nic Barker said...

Thanks Esther - copy on its way to you :-)