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Help with E&L insurance claim not paying out

in Pets & pet care
14 replies 3.2K views
I have read with horror all the stories on this forum about E&L insurance, at the end of August our Bulldog died suddenly he was only 17 months old and was been treated for Pustular Demodex when suddenly he started coughing them turned blue and died we rushed him to the vet but there was nothing they could do.
We paid the vets to fill out the E&L forms and the Vet put for cause of death unknown.

E&L are refusing to accept the vets cause of death and are refusing to pay out on the policy.

I was wondering if any one has had any success with taking such cases to the Omburdsman or whether the small claims court is an option.

If only I had done more research on Pet insurance rather than going for the cheapest it would have saved the whole family a lot of grief.
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Replies

  • hethmarhethmar Forumite
    10.7K Posts
    Car Insurance Carver! Cashback Cashier
    Im very sorry to hear about your boy.

    It seems to me that the diagnosis from the vet is what they are using not to pay out so can you speak to the vet and ask him to help you?

    They are a dreadful company, my friend was waiting nearly a year to get paid out following the death of his Mastiff. But dont kick yourself over making a wrong choice. You could always speak to the CAB for advice.
  • Thank you we do miss him.

    We did speak to the Vet who said that Cause of death unknown was an acceptable reason. She said that even if she had performed an autopsy it would still be her likely cause of death. He was after all only 17 months old and hadnt had any other problems apart from the Demodex.

    From what I have read on here I guess that I should be grateful that E&L
    insurance paid out for the Demodex treatment.
  • Sorry to hear about your loss but E&L are a pain in the ######. To me, cause unknown is perfectly acceptable - it happens with humans where cause of death cannot be determined. Alternatively, I find sudden onset heart failure to be a useful explanation - no-one can query it. Keep badgering them - it is the only way but they will hide behind the smallest technicality.
  • trudijtrudij Forumite
    1.9K Posts
    Part of the Furniture Combo Breaker
    Forumite
    I agree - keep on at them. If only to be a pain in their backside.Ombudsman sounds like a plan - but still keep on at E&L - get a letter from your vet saying that in their opinion cause unknown is an acceptible explanation for an otherwise healthy (apart from the Demodex thing) 17 month old dog, and your claim should be treated as appropriate. Might help.

    What a horrible horrible shock for your family, im so so sorry for your loss.
    Do not meddle in the affairs of dragons, for you are crunchy and taste good with ketchup
  • Do I go back to them as I have had their final decision or should I start with the Ombudsman?

    I do not think that they should get out of paying as we took out the policy with the expectation that we would have reasonable cover and I think that they have let us down.
  • Go back to them, ask to speak to or write to a manager and ask them to reconsider. Try to get a letter from your vet and state your case politely but forcefully. Good luck
  • E&L should have a complaints process. Use that first. If they fail to admit the claim using that process, then the Ombudsman is your next step - and E&L should tell you this as part of their complaints process.
    Warning ..... I'm a peri-menopausal axe-wielding maniac ;)
  • Thanks for all the advice I will write back to them, I ll let you know how I get on
  • lazza_wlazza_w Forumite
    2.8K Posts
    Just a guess, but they may be trying to avoid paying out as, without an exact cause of death, you can not prove that it was not due to a congenital problem (ie a problem present at birth) that was not picked up before the death. If the death was a result of a congenital problem then they would be able to refuse payment on the basis that the problem was present before the insurance policy was taken out.

    Being a Bulldog the probability of there being congenital heart and respiratory problems is high - if anyone asked me to recommend a dog breed then a Bulldog would be one of the last on my list as they are entremely unhealthy dogs and most have long term welfare problems due to thei anatomy. That doesn't mean that I agree with E&L trying to avoid paying out - most insurance companies take the onset of a condition as being the time that it was first noticed by an owner or their vet. If they weren't apparent to you or your vet during routine examinations then it's reasonable to expect them to be covered.
    "To be is to do" - Socrates. "To do is to be" - Jean-Paul Sartre.
    "Do be do be do" - Frank Sinatra. "Scooby Dooby Doooo" - Scooby Doo. "Boop de Doop de Boo" - Betty Boo.
  • hethmarhethmar Forumite
    10.7K Posts
    Car Insurance Carver! Cashback Cashier
    Lazza, E and L try to avoid paying out for any dog.
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