A second colic operation: will the insurer pay?

When a horse has to go back under the knife for the same colic, the fear of runaway costs is very real. Here is a clear account of how Barmenia handles the "extended insured event", and when the insurer pays for that second operation too.

The shock that arrives twice: a second colic operation

Colic is among the most threatening emergencies in a horse's life. When a horse shows colic symptoms again after surgery, or a complication such as an obstruction forces a second operation, it hits the owner hard both emotionally and financially. Figures from equine practice suggest that roughly one horse in ten is affected by colic each year. Most cases are managed conservatively, but the moment surgery becomes necessary, the animal's life is at stake.

The financial burden is severe. Since the veterinary fee schedule (GOT) was reformed, colic surgery including anaesthesia, the clinic stay and aftercare typically costs 5,000 to 12,000 euros, and considerably more where the case is complex and inpatient aftercare drags on. If the horse has to be operated on a second time within days or weeks, the pressing question for a worried owner is immediate: does horse surgery insurance cover that second procedure in full, or does a limit bite?

• Diagnostics and fresh preparation for anaesthesia when a recurrence is suspected
• A second surgical procedure (repeat laparotomy) under general anaesthetic
• Intensive-care monitoring and medication afterwards
• A longer inpatient stay at the equine clinic

The extended insured event at Barmenia

The contractual basis for covering a repeat procedure is the conditions of Barmenia Allgemeine Versicherungs-AG (AVB Pferde-OP-Kosten, as at 01.01.2024). Clause 2.1.2.3 sets out the extended insured event without ambiguity: where several operations are veterinarily necessary because of the same illness or the same accident, those operations, their respective pre-operative examinations and their aftercare all count as one connected insured event.

That clause gives owners real certainty. A follow-up procedure for the same cause — releasing an adhesion, say, or a further displacement of the intestine shortly after the first operation — is not treated as a separate new claim with a new waiting period. Instead, the insured event ends only when the aftercare period following the last operation performed expires. The cost of several operations therefore stays covered within the limits agreed.

• Every follow-up operation assessed together, as a single insured event
• The necessary work-up before each individual operation covered
• Aftercare covered continuously until the deadline following the last operation
• No fresh general waiting period for a follow-up procedure

Waiting period and the timing of the first symptoms

For the insurer to pay for colic surgery, the basic conditions of cover have to be met. For abdominal surgery (colic), clause 2.2.2 sets a waiting period of five days — very fair by market standards. That short deadline means a newly signed contract responds quickly in an emergency.

What decides the claim, though, is when the very first symptoms appeared. If clinically relevant signs of colic, or the first diagnosis, predate the start of cover or fall inside the five-day waiting period, that illness and every consequence of it are permanently excluded. If the colic first appears after those five days have run, both the first procedure and a medically necessary second operation arising from the same course of illness are covered.

• Start of cover: the date the policy schedule gives for cover taking effect
• Colic waiting period: five days from the start of cover for procedures in the abdomen
• Freedom from symptoms: no clinical signs whatsoever before that deadline
• Permanent exclusion: symptoms before or during the waiting period end cover for that condition

Costs and limits: cover tailored to an emergency

Even where several procedures for one colic count as a single connected insured event, total reimbursement is bounded by the limits in the policy. Barmenia caps its liability through the maximum agreed in the schedule per operation and per policy year, and through sublimits for the inpatient stay and for diagnostics. If two consecutive operations approach that ceiling, the policyholder carries what is left.

The reimbursement rate under the veterinary fee schedule deserves particular attention. Colic surgery often happens at night, at the weekend or on a public holiday, as an emergency call-out, and vets may then bill up to four times the GOT rate. Policies that cover the full four-times rate and carry no percentage excess give you the most financial headroom when complications force a second procedure at a higher GOT rate.

• Check the annual maximum and the reimbursement ceiling per claim
• Secure a reimbursement rate covering emergency call-outs up to four times the GOT rate
• Check the daily allowance and the ceilings for a stay at the equine clinic
• Budget for the excess agreed per insured event

Prognosis and survival rates after colic surgery

Beyond the money, what weighs heaviest is whether the horse will survive a repeat laparotomy. The research here is solid, and it is encouraging. A multi-centre study involving the universities of Bologna, Perugia and Turin analysed the course of illness in 451 horses that needed colic surgery. Of the horses operated on, 68.5 per cent recovered well enough to be discharged from the clinic and return to their home stable.

Once a horse has come through the critical phase of anaesthesia and getting back to its feet, the probability of survival over the rest of the treatment rises to around 80 per cent. Where the finances are settled by a reliable policy, owner and vet can decide on a medically indicated second operation without hesitating — which gives the horse its best chance of full recovery.

Expert advice on your own policy

A second colic operation is a dramatic event, but clauses such as the extended insured event (clause 2.1.2.3 of Barmenia's conditions) protect owners transparently. As long as the first colic appeared after the five-day waiting period and the limit you chose is generous enough, the cost of the follow-up procedure and the extended aftercare is covered as well.

As a digital marketplace and comparison platform, nextsure helps you analyse policies transparently and match them to what you actually need. With independent advice and a fully digital application, nextsure helps you find tailored cover so that you are protected without complications when it matters.

• Check the conditions for reimbursement rates up to four times the GOT rate
• Verify the waiting periods for abdominal surgery in your contract
• Set the annual maximum against what clinics actually charge
• Take independent digital advice so no gaps are left