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Q11)  Who makes judgment calls on insurance?

In the event of an insured horse's death, the cause of death must be determined before any claim can be adjusted. This determination may require only a certificate from the horse-owner's veterinarian, or it may require the presence of a company-appointed veterinarian. A necropsy may be called for - each situation is different, and the depth of the company's investigation will depend on the conditions of the death, and on the amount for which the horse was insured.

If an insured and injured horse is covered by loss-of-use insurance, the decision regarding his future use will usually be made by the owner's veterinarian. If that veterinarian gives an opinion that the horse's injury is career-ending, the insurance company will generally pay out. In the event that a veterinarian designated by the insurance company disagrees with the opinion of the owner's veterinarian, an arbitrator will be appointed and the case will be resolved by arbitration.

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