Pet Insurance Claim Help.

[nickofh]

Hello. I am looking for a little help on an issue with a pet claim please.

On the 1st of March I purchased a new pet policy with provider B , this policy was to start on the 19th March. I served notice to my existing insurer ( provider A ) that I did not wish the to renew at the end of the term on the 19th March. On the 12th March my dog injured his leg on walk and the following day was taken to vets to have it looked at. We were given pain meds and advised to crate rest for a week. Unfortunately it turned out to be a ligament rupture which required numerous visits and an operation etc with a cost of over £1000. We have fully paid this so the vets are not involved in this.

Provider A is stating that they will only pay the visit to the vets on the 12th March ( £40 and less than the excess ) and no following treatments. I don't think that it is unreasonable to expect them to pay as the injury happened whilst my dog was insured with them. I have not tried to make a claim on policy B as to my mind the injury was there when the policy actually begin although it was set up on the 1st. Can anyone provide any advice ? It has currently gone to their senior claims team and is going to customer relations.

I mean if it were a car that were crashed on the 12th the car claim would be paid by the insurers at the time, even if the repairs or claims were finished months down the line?

Thank you

Nick

[Saleen836]

If your policy didn't expire until the 19th then provider A is liable for all treatment costs (less excess),sounds like they are trying to fob you off

[SmoothCriminal]

Surely policy B will refuse to cover iit, as it will be classed as an existing condition?

Did you update policy b with the details before commencing

[Mexican cuties]

exactly, if its not pre existing then the provider would always put the treatment dates against the current policy year, and should process the claim accordingly, just wouldn't be covered after the policy has finished, and possibly now not with new provider. If its a crucia injury, you may find the new provider wont cover that even if it happens in another leg, as they would normally class it as pre existing condition. Definitely push for the claim to be processed with the current provider, not sure if the policy type currently you have is a condition for life cover, rather than for 12 months, but if its condition for life might be worth staying with them, in case this injury causes extra stress on the other legs.

good luck, let us know how you get on, always the fca option as well

[Mexican cuties]

sorry meant to add, that treatment dates after policy finished wouldn't be covered, but deffo should be for treatment on the dates the original policy was still live. Definitely raise an official complaint with them, if the outcome is still no, as they will have a timed procedure in place to respond. also can speak to financial ombudsman service 0300 123 9123 or 0800 0234 567 if you feel you aren't getting anywhere www.financial-ombudsman.org.uk. usually the provider will have a timed period where they have to come back with their outcome.

good luck

[Mexican cuties]

if the treatment dates were after the 19th, and the initial policy has then expired, then treatment after then wouldnt be covered

[TwigtheWonderkid]

Mexican cuties said:

if the treatment dates were after the 19th, and the initial policy has then expired, then treatment after then wouldnt be covered

Nope. There are two ways of covering claims, on a claims occurring basis (the date the incident happened is key) and on a claims made basis (the day you make the claim is key). Most policies are on a claims occurring basis. Only a few specialist policies (like professional indemnity) are on a claims made basis.

Pet insurance is on a claims occurring basis. The insurer covering the animal on the day the injury was sustained is liable costs arising from that incident, even if the costs are incurred after the policy has expired. Like the OP says, like having an accident whilst you car in insured with Aviva, but not getting it repaired until you are with Zurich. Aviva still have to pay.

[nickofh]

Hello there everyone.

Thank you for your replies. I see it is a little mixed but I am hoping for the best outcome. I have tried to be a responsible pet owner and there was never any gap in my cover or overlap periods. At the moment it has gone to the complaints department where I have tried to fully explain my situation and that it is causing me financial hardship etc.

I will keep checking here to see if there is anything I can use against them and to update people with the outcome if interested.

Thanks again.

Nick

[Nemophilist]

Did you manage to resolve this successfully?

Just starting to have issues with pet insurance paying out fully for an accepted claim and wondering if its worth going through the ombudsman

[nickofh]

Hello there.

Yes the issue was resolved and paid out. I didn't have to go to the FO it was handled by the underwriters complaints department I think.

I get the feeling that the only reason that they upheld my claim was that when I asked how to claim someone at their offices said fill out the claim form and send it in as normal , even though they knew that the insurance had expired. The only thing I had to do was pay an extra months premium , obviously I wasn't going to argue with that for becoming a grand better off.

I hope you have the same outcome ! If I can help let me know.