Pet insurance claim question
Discussion
Hi all, my kitten fell out the window and chipped his tooth on the 7th of June
My insurance was valid for 4 weeks starting the on the 10th of May, so by my calculation it expired on the 7th.
Anyway, fast forward to today, I noticed his chin is getting a lump and upon closer inspection i see an entry hole inside his gum and what i initially thought was just a scrape on the outside... So it looks like the fang has snapped and either went clean through his own chin, which is now getting infected, or it stayed inside and his own body is now treating it as a foreign object, hence the swelling.
My question is- can I claim on expired insurance policy, on the basis that the cause of the claim was still within the policy cover time?
My insurance was valid for 4 weeks starting the on the 10th of May, so by my calculation it expired on the 7th.
Anyway, fast forward to today, I noticed his chin is getting a lump and upon closer inspection i see an entry hole inside his gum and what i initially thought was just a scrape on the outside... So it looks like the fang has snapped and either went clean through his own chin, which is now getting infected, or it stayed inside and his own body is now treating it as a foreign object, hence the swelling.
My question is- can I claim on expired insurance policy, on the basis that the cause of the claim was still within the policy cover time?
Jasandjules said:
What do the terms of the policy say? Do you have to notify them of a claim within X period of time? (even then you could argue that you were not aware of a potential claim until today). Does the vet say it is a continuation of the first accident?
Didn't want to bore anyone with the vet story in fear of sidetracking the thread, but I called the vet in advance yesterday and specifically asked if i could have a late appointment, but having explained the problem ensured it was ok to see the cat close to end of biz day....turned up half hour early just in case. got seen later than the appointment. and told that it's strange i was allowed to book so late and there is nothing useful they would be able to do that day...
Having explained the injury and the incident in detail the Vet turns around and goes - oh but he is missing a whole fang!
...
anyway was going to try and get him seen by another company tomorrow, but was warned that if the fang is indeed inside his chin i am looking at round about £500 for the procedure...
The terms state I should notify them as soon as possible. So just waiting for 9am to call them.
isee said:
Bah, forget it, the insurers reckon it expired the day before...
That doesn't matter so much depending on how reasonable it is etc. IF the vet didn't think there was a problem initially and now you realise there is a problem then you ARE notifiying them as soon as possible i.e. as soon as you became aware of an issue. ETA and 4 calendar weeks from 10 May = 7th June..... But what does the policy say about the time period as well......
Edited by Jasandjules on Friday 15th June 09:14
Jasandjules said:
That doesn't matter so much depending on how reasonable it is etc. IF the vet didn't think there was a problem initially and now you realise there is a problem then you ARE notifiying them as soon as possible i.e. as soon as you became aware of an issue.
ETA and 4 calendar weeks from 10 May = 7th June..... But what does the policy say about the time period as well......
Well my brochure says it started on the 10th, the insurer's system says the 9th (the date the breeder notified them of this complimentary insurance).ETA and 4 calendar weeks from 10 May = 7th June..... But what does the policy say about the time period as well......
Edited by Jasandjules on Friday 15th June 09:14
I asked what they think about me taking him to the vets AFTER the expiry and she told me that it is very unlikely they would honor it (provided we agreed that the insurance started on the 10th in the first place) seeing as I could say that the incident happened any date i like but if i only just took the pet to the vet now and not striaght away...
basically as far as they are concerned I am a liar and a cheat already. I had an architect around my home when it happened and he saw it happen, but apaprently that won't be proof enough.
whatever... what's the point of paying for insurance if you have to pay the full vet fees PLUS the insurance premium?
I am a little confused with this one. Let me know if I have read it wrong.
You got cat from breeder with 4 weeks complimentary insurance.
This has expired and you have not arranged your own insurance.
You have not had any vets bills during the period the insurance was valid for.
You are now looking at getting a bill and want to back date it so you don't have to pay more than the excess.
You are complaining that you have to pay for vets bills as well as your complimentary insurance that you did not pay for in the first place which has expired anyway and does not cover said vets bill.
You got cat from breeder with 4 weeks complimentary insurance.
This has expired and you have not arranged your own insurance.
You have not had any vets bills during the period the insurance was valid for.
You are now looking at getting a bill and want to back date it so you don't have to pay more than the excess.
You are complaining that you have to pay for vets bills as well as your complimentary insurance that you did not pay for in the first place which has expired anyway and does not cover said vets bill.
Edited by RB Will on Friday 15th June 10:36
RB Will said:
I am a little confused with this one. Let me know if I have read it wrong.
- You got cat from breeder with 4 weeks complimentary insurance. - correct
- You have not had any vets bills during the period the insurance was valid for. - correct
- You are now looking at getting a bill and want to back date it so you don't have to pay more than the excess. - incorrect, the incident happened on the day the insurance expired (according to my voucher, though not according to the insurer's system, they said it started on the 9th of May, my voucher says it started on the 10th). At the time of incident no necessity to go to the Vet was apparent. Noticed an issue on wednesday evening, saw the vet thursday, though no treatment or proper diagnostics took place due to Vet's poor appointment management. (booked with another vet for this evening fyi)
- You are complaining that you have to pay for vets bills as well as your complimentary insurance that you did not pay for in the first place which has expired anyway and does not cover said vets bill. - Incorrect I am complaining that if the insurers can't take my word for proof of the incident, what is the point of paying the premium in the first place since quite a few incidents will rely on owner's word...
OP, you'll need to read the insurance documents very carefully, certainly I haven't heard anyone of claiming retrospectively on an eexpired pet insurance policy.
Definately first step is to put a claim form in, if they refuse it you can then start going through their complaint procedures and eventually to the insurance ombudsman if you need to.
How old is the kitten? Its kitten teeth will fall out eventually anyway, this may be nothing to worry about it.
Definately first step is to put a claim form in, if they refuse it you can then start going through their complaint procedures and eventually to the insurance ombudsman if you need to.
How old is the kitten? Its kitten teeth will fall out eventually anyway, this may be nothing to worry about it.
Jasandjules said:
The vet will easily be able to confirm that an incident was not yesterday by the state of the injury.
I would be surprised if the vet could confidently state precisely how old the injury is, which will be critical to the claim.gd49 said:
I would be surprised if the vet could confidently state precisely how old the injury is, which will be critical to the claim.
Yeah, I am wondering if I want all that hassle.Am not worried about the chipped tooth am worried about the broken off piece being inside his lower jaw and festering there.
Technically this is not a retrospective claim, if you were on a holiday abroad and had a cut to your finger. came back home and a week later that cut became gangrenous. Your holiday insurance may not cover an accident at home, but this gangrene arose due to an accident on holiday wouldn't you say?
anyway, thanks for all the comments will see how it goes.
isee said:
- You are now looking at getting a bill and want to back date it so you don't have to pay more than the excess. - incorrect, the incident happened on the day the insurance expired (according to my voucher, though not according to the insurer's system, they said it started on the 9th of May, my voucher says it started on the 10th). At the time of incident no necessity to go to the Vet was apparent. Noticed an issue on wednesday evening, saw the vet thursday, though no treatment or proper diagnostics took place due to Vet's poor appointment management. (booked with another vet for this evening fyi)
This is how it has worked with my dog.
isee said:
- You are complaining that you have to pay for vets bills as well as your complimentary insurance that you did not pay for in the first place which has expired anyway and does not cover said vets bill. - Incorrect I am complaining that if the insurers can't take my word for proof of the incident, what is the point of paying the premium in the first place since quite a few incidents will rely on owner's word...
Well normally you would have your own paid for insurance which covers 365 days a year so they will not have to ask the question of date as they know they have you covered.
You say you now have your own insurance now anyway so why are you not claiming off that, which I presume would cover it?
isee said:
Technically this is not a retrospective claim, if you were on a holiday abroad and had a cut to your finger. came back home and a week later that cut became gangrenous. Your holiday insurance may not cover an accident at home, but this gangrene arose due to an accident on holiday wouldn't you say?
Why would your holiday insurance cover it? you had no medical bills to pay while on holiday and would be treated by the NHS when you got back so what would you be claiming for? Edited by RB Will on Friday 15th June 11:41
isee]B Will said:
stuff [\quote]
Ok, didn't know that it works from the day of the bill...
Wouldn't that mean a lot of people could get new insurance, then wait a day or two, then claim??
Most insurance will exclude illnesses for the first 2 or 4 weeks of the policy to try and avoid this happening. It's usually immediate cover for accidents.Ok, didn't know that it works from the day of the bill...
Wouldn't that mean a lot of people could get new insurance, then wait a day or two, then claim??
Anyone determined would be able to defraud the pet insurance industry for a variety of pre-existing conditions - there's no centralised database of pet's clinical history, so claims are usually dependent on what the owner has told the vet.
isee said:
Wouldn't that mean a lot of people could get new insurance, then wait a day or two, then claim??
Not sure as from experience the vet has to fill in part of the claim form or would at least be contacted about it so if the dates don't match up I expect they would throw your claim back at you.I would go with the current policy. If they feel the need they can persue the original company. In our case as it was the first time we had a Kitten rather than an older "rescue" we decided to have Insurance until we knew Minnie's character. It was as well we did. We still have Minnie despite her losing a leg. The bills are around £2000 for the emergency care, surgery and aftercare. She's still a feisty little Monster though.
As I said with pet insurance I presume it is the bill you are insuring yourself against not any accidents so unfortunately for your new insurer they are covering you when you had the bill.
It is a bit fairer that way as at least you have paid this insurer something where with the old one you would be taking money from them when you had not given them any.
Just using my example again. Dog went a bit off her food and had the squits, few days of this and I took her to vets who had a look and asked me to get samples of everything that came out of the dog, they did blood tests and gave her special food. All this took 1-2 weeks I only received the bill when it was all done and we had results. The claim was dated for the day the bill was paid not when I first went to the vet.
(I am still happy to be corrected if I have got this wrong, just makes most sense to me like this)
It is a bit fairer that way as at least you have paid this insurer something where with the old one you would be taking money from them when you had not given them any.
Just using my example again. Dog went a bit off her food and had the squits, few days of this and I took her to vets who had a look and asked me to get samples of everything that came out of the dog, they did blood tests and gave her special food. All this took 1-2 weeks I only received the bill when it was all done and we had results. The claim was dated for the day the bill was paid not when I first went to the vet.
(I am still happy to be corrected if I have got this wrong, just makes most sense to me like this)
Did you not continue the ins cover? If you did it will be covered.
However it will only be covered if the vet saw your pet during the time of the policy life and noted the injuries, then the claim can be backdated.
If the pet wasn't seen at the time (I'm hoping it was as it should have been) and the vets are only seeing it post expiry the insurance co are not likely to honour it even if the vet can say the injury is older. (sometimes a well worded letter from a vet may sway the argument but ins have the right to refuse)
Sorry if repeating advice short on time so not read all replies.
However it will only be covered if the vet saw your pet during the time of the policy life and noted the injuries, then the claim can be backdated.
If the pet wasn't seen at the time (I'm hoping it was as it should have been) and the vets are only seeing it post expiry the insurance co are not likely to honour it even if the vet can say the injury is older. (sometimes a well worded letter from a vet may sway the argument but ins have the right to refuse)
Sorry if repeating advice short on time so not read all replies.
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