Insurance broker / Horse surgery and horse health insurance in Germany / Policy wording archive
die Bayerische Pferde Kolik-OP-Versicherung: the policy wording in full
Kolik-OP-Versicherung für Pferde (Risikoträger Barmenia) nur für Bauchhöhlenoperationen wegen Kolik, bis zum 2fachen GOT-Satz, im Notdienst bis zum 4fachen, ohne Höchstbetrag je Operation und mit 14 Tagen Nachbehandlung.
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Everything about this policy
What the policy covers: 70 points, each with its clause
Quotes are shortened. The full German wording of each point is on the German page for die Bayerische Pferde Kolik-OP-Versicherung.
Basics and reimbursement
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Plan type: horse surgery only, colic surgery only or full horse health cover (surgery and treatment) | yes | „Es handelt sich um eine Kolik-Operationskostenversicherung für Pferde.“ | Informationsblatt, page 1 |
| Animals insured (horses, ponies, donkeys, mules and other equines) and link to one identified animal | not addressed | ||
| Annual maximum (reimbursement limit per policy year) | not addressed | ||
| Maximum per operation, per surgery day or per case | yes, up to the sum insured | „Es gibt keine Begrenzung auf eine Höchstentschädigung je Operation.“ | Informationsblatt, page 1 |
| Reimbursement up to which multiple of the veterinary fee scale (GOT in Germany; the applicable fee schedule in Austria and Spain) | yes | „Versichert sind die Kosten bis zum 2-fachen Satz der Gebührenordnung für Tierärzte (GOT)“ | Informationsblatt, page 1 |
| Reimbursement rate as a percentage of eligible costs (for example 80 or 100 percent) | not addressed | ||
| Fixed excess in euros (per invoice, per operation or per policy year) | not addressed | ||
| Percentage excess per invoice, with any minimum or maximum amount | not addressed | ||
| Higher excess or lower reimbursement from a certain age of the horse | not addressed | ||
| Free choice of vet, specialist and equine clinic | not addressed | ||
| Direct billing between insurer and vet or clinic | not addressed | ||
| Several horses in one policy (herd policy) and discount from the second horse | not addressed |
Eligibility, age and waiting periods
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Minimum age of the horse at inception (for example from birth or from the third month) | not addressed | ||
| Maximum age of the horse at inception | not addressed | ||
| End of cover or change of contract from a maximum age | not addressed | ||
| Reduced benefits or depreciation for older horses (for example from 14 years) | not addressed | ||
| Vet examination, certificate or health questions on application | yes | „müssen Sie die von uns gestellten Fragen unbedingt wahrheitsgemäß und vollständig …“ | Informationsblatt, page 1 |
| Requirement for an equine passport, microchip or brand as identification | not addressed | ||
| Exclusion or loading by use (active racing, trotting and polo horses, competition, breeding, commercial use) | not addressed | ||
| General waiting period for illness and surgery due to illness | not addressed | ||
| Waiting period for colic and abdominal surgery | yes | „jedoch nicht vor Ablauf der Wartezeit von 5 Tagen nach Abschluss der Versicherung.“ | Informationsblatt, page 2 |
| Waiting period for accidents | not addressed | ||
| Special waiting periods for certain conditions (for example joints, tendons, navicular disease, airways) | not addressed |
Surgery and clinic
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Surgery costs (procedure, anaesthesia or sedation, materials) | yes, up to the sum insured | „Versichert sind die Kosten bis zum 2-fachen Satz der Gebührenordnung für Tierärzte …“ | Informationsblatt, page 1 |
| What counts as surgery: general anaesthesia, standing surgery under sedation, minimally invasive procedures (arthroscopy, endoscopy, laser) | yes | „auch unter Teilnarkose (Sedierung/Lokalanesthesie/Standnarkose)“ | Informationsblatt, page 1 |
| Colic surgery (abdominal surgery) | yes, up to the sum insured | „aufgrund von Koliken veterinärmedizinisch notwendige Bauchhöhlen-Operationen“ | Informationsblatt, page 1 |
| Conservative colic treatment without surgery, including inpatient | no | „Diese sichert Sie ausschließlich gegen die finanziellen Folgen von veterinärmedizinisch …“ | Informationsblatt, page 1 |
| Fracture repair after accident (osteosynthesis) | no | „Alle Operationen, die keine Bauchhöhlen-Operationen aufgrund von Koliken sind.“ | Informationsblatt, page 1 |
| Examination and diagnostics before surgery (how many days before) | yes, up to the sum insured | „die Untersuchung, die zur Feststellung der Diagnose - die zu der Operation führt …“ | Informationsblatt, page 1 |
| Aftercare after surgery (number of days) | yes, up to the sum insured | „die Nachbehandlung bis zu 14 Tage nach der Operation“ | Informationsblatt, page 1 |
| Inpatient stay and care in the equine clinic | yes, up to the sum insured | „die Nachbehandlung bis zu 14 Tage nach der Operation - auch stationär.“ | Informationsblatt, page 1 |
| Medication and dressings related to the surgery | not addressed | ||
| Castration on medical grounds, including cryptorchids | no | „Alle Operationen, die keine Bauchhöhlen-Operationen aufgrund von Koliken sind.“ | Informationsblatt, page 1 |
| Elective castration (contribution or flat amount) | no | „Alle Operationen, die keine Bauchhöhlen-Operationen aufgrund von Koliken sind.“ | Informationsblatt, page 1 |
| Foaling assistance, caesarean section and surgery related to pregnancy | no | „Alle Operationen, die keine Bauchhöhlen-Operationen aufgrund von Koliken sind.“ | Informationsblatt, page 1 |
| Dental surgery (for example extraction under sedation or anaesthesia) | no | „Alle Operationen, die keine Bauchhöhlen-Operationen aufgrund von Koliken sind.“ | Informationsblatt, page 1 |
Pre-existing and typical equine conditions
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Cover for pre-existing conditions and findings known at inception | not addressed | ||
| Cover for earlier conditions after a symptom-free period | not addressed | ||
| Congenital and hereditary conditions and developmental disorders | not addressed | ||
| Osteochondrosis (OCD), chips and Birkeland fractures, often with a separate limit per surgery day | no | „Alle Operationen, die keine Bauchhöhlen-Operationen aufgrund von Koliken sind.“ | Informationsblatt, page 1 |
| Kissing spines (impinging dorsal spinous processes) | no | „Alle Operationen, die keine Bauchhöhlen-Operationen aufgrund von Koliken sind.“ | Informationsblatt, page 1 |
| Tendon and ligament injuries (conservative and surgical) | no | „Alle Operationen, die keine Bauchhöhlen-Operationen aufgrund von Koliken sind.“ | Informationsblatt, page 1 |
| Hoof conditions (laminitis, navicular disease, hoof surgery) | no | „Alle Operationen, die keine Bauchhöhlen-Operationen aufgrund von Koliken sind.“ | Informationsblatt, page 1 |
| Airway surgery (for example roaring) | no | „Alle Operationen, die keine Bauchhöhlen-Operationen aufgrund von Koliken sind.“ | Informationsblatt, page 1 |
| Tumour treatment (for example equine sarcoids, melanomas) | no | „Alle Operationen, die keine Bauchhöhlen-Operationen aufgrund von Koliken sind.“ | Informationsblatt, page 1 |
| Exclusion of cosmetic surgery and performance enhancing procedures | not addressed |
Treatment without surgery
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Outpatient treatment without surgery (examination, treatment, yard visit) | no | „Diese sichert Sie ausschließlich gegen die finanziellen Folgen von veterinärmedizinisch …“ | Informationsblatt, page 1 |
| Medication and dressings outside surgery | no | „Diese sichert Sie ausschließlich gegen die finanziellen Folgen von veterinärmedizinisch …“ | Informationsblatt, page 1 |
| Diagnostic imaging (X-ray, ultrasound, endoscopy, scintigraphy, MRI, CT) | no | „Diese sichert Sie ausschließlich gegen die finanziellen Folgen von veterinärmedizinisch …“ | Informationsblatt, page 1 |
| Physiotherapy, osteopathy and rehabilitation | no | „Diese sichert Sie ausschließlich gegen die finanziellen Folgen von veterinärmedizinisch …“ | Informationsblatt, page 1 |
| Alternative medicine (homeopathy, acupuncture, animal naturopath) | no | „Diese sichert Sie ausschließlich gegen die finanziellen Folgen von veterinärmedizinisch …“ | Informationsblatt, page 1 |
| Regenerative therapies (stem cells, PRP, IRAP) and shockwave therapy | no | „Diese sichert Sie ausschließlich gegen die finanziellen Folgen von veterinärmedizinisch …“ | Informationsblatt, page 1 |
| Remedial shoeing on veterinary prescription | no | „Diese sichert Sie ausschließlich gegen die finanziellen Folgen von veterinärmedizinisch …“ | Informationsblatt, page 1 |
| Dental treatment without surgery (rasping, correction) | no | „Diese sichert Sie ausschließlich gegen die finanziellen Folgen von veterinärmedizinisch …“ | Informationsblatt, page 1 |
| Prevention (vaccinations, worming, health check) as an annual allowance | no | „Diese sichert Sie ausschließlich gegen die finanziellen Folgen von veterinärmedizinisch …“ | Informationsblatt, page 1 |
Emergencies, abroad and end of life
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Emergency fee and out-of-hours surcharges | yes, up to the sum insured | „Zusätzlich zahlen wir die Notdienstgebühr nach der GOT.“ | Informationsblatt, page 1 |
| Reimbursement for out-of-hours care up to four times the fee scale | yes | „die im Rahmen der tierärztlichen Nofallversorgung durchgeführt werden, erstatten wir …“ | Informationsblatt, page 1 |
| Cover abroad (competitions, holidays; duration, Europe or neighbouring countries) | yes | „Bei vorübergehenden Auslandsaufenthalten besteht weltweit für bis zu 12 Monate …“ | Informationsblatt, page 1 |
| Euthanasia on veterinary advice and carcass disposal | not addressed | ||
| Benefit on death or emergency slaughter of the horse due to accident, illness or colic (equine mortality cover) | not addressed | ||
| Theft of the horse | not addressed |
Contract and duties
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Horse owner liability included | not addressed | ||
| Insurer's right to cancel after a claim | not addressed | ||
| Premium increase by age band of the horse | not addressed | ||
| Premium adjustment when treatment costs rise (for example new fee scale) | not addressed | ||
| Term, minimum term and notice periods | yes | „Die Versicherung gilt für die zunächst vereinbarte Dauer.“ | Informationsblatt, page 2 |
| Deadline for submitting invoices and reporting claims | yes | „Sie müssen uns außerdem jeden Schadensfall rechtzeitig anzeigen.“ | Informationsblatt, page 1 |
| Duties on keeping and care (vaccinations, worming, hoof care, appropriate housing), otherwise reduction | not addressed | ||
| Notification before planned surgery or cost estimate required | not addressed | ||
| Duty to provide vet report, X-rays or examination by the insurer's vet when claiming | not addressed |
Evaluated by NAMMERT from published policy wordings.
Despite care, a value may be misread;
legally only the wording of your own contract in the edition stated there applies.
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Policy wordings and provider
- Legal entity
- BA die Bayerische Allgemeine Versicherung AG, Barmenia Allgemeine Versicherungs-AG (Risikoträger laut Bedingungen)
- Distribution
- brokers and direct
- die Bayerische Pferd Kolik-OP, Informationsblatt (IPID) Edition: IPID A 6201 12/2020 Original from the insurer (PDF, German)
Full text of the wording
The full text exists only in German. It is printed on the German page for die Bayerische Pferde Kolik-OP-Versicherung and available as plain text.
Volltext die Bayerische Pferde Kolik-OP-Versicherung · As text (Markdown) die Bayerische Pferde Kolik-OP-Versicherung