Pet insurance refusing to pay out... advice please?

brians_daughter

Hi all, our cat has been really ill and as I have pet insurance felt relaxed regarding costs etc. He has totted up £2,400 worth of vets fees between our vet and the specialist university animal hospital... Anyway, his pet insurance have refused to pay out as he isnt vaccinated...
The T&C's state ' you must ensure your pet is vaccinated in accordance with the recommendation of your vet'

HOWEVER, as he is an indoor cat both our vet and the vet at the university animal hospital said he didnt need vaccinating as he didnt go outside, infact the animal hospital vet said her cat is an indoor cat and she doesnt have her vaccinated either as she doesnt need it. So, surely i AM following my vets recommendation?

The illness in nothing to do with lack of vaccinations, if it was i could understand why they have refused.

As it stands I need to find £2,400, which I simply do not have, so being (or so I thought) a responsible owner I purchased pet insurance... Do I fight this or do I not have a leg to stand on?

Thanks in advance

lilac_lady

It's worth challenging the insurance companies decision. £2400 is a lot of money to pay out. Perhaps you could get letters from the vets who gave you advice about vaccinating your cat. I hope you win your case.

spookylukey

What insurance comapny are you with? I would understand if you were attempting to claim for an illness/condition that could have been prevented by vaccination but to refuse to pay out on an unrelated illness is shocking.

Have you formally complained to the insurance company in writing? If not I'd do that first, ideally with supporting evidence from your vet that the condition you are claiminig for is in no way connected to non-vaccination and in actual fact that you have complied with the policy T&C's as your pet's vaccination schedule (or lack of) WAS in line with the recommendation of the vet.

This might be the next step...

http://www.financial-ombudsman.org.uk/consumer/complaints.htm

Might also be worth posting on the insurance board as there are lots of experts on there, the principles are the same whether it's pet/car/home insurance.

brians_daughter

Hi thanks for that. No I havent done anything yet. I spoke to them about 20 mins before i posted and they told me i was liable for the costs as i hadnt kept to the T&C's. I am quite shocked as we ahve been with Sainsburys for a good few years and have always found them to be very very good..

Someone is calling me back, but in the meantime i will look at the link.
Thanks again

devildog

What about contacting Watchdog, they were running with stories about pet insurance and were requesting viewers to share their experiences!!

trudij

First thing to do is get your vets to write and tell the Insurance company that your cats are vaccinated as per their recommendations. Make sure they write the answer to exactly what the IC have said is wrong - then have a think about the Insurance Ombudsman...

good luck !

bouncydog1

Sainsbury's will only sell the policy so you need to have a look at the wording and see who it is underwritten by.

Don't start contacting watchdog etc. until all other avenues have been explored. Start by asking Sainsbury's to confirm in writing why the cover will not respond. (Not sure if you already have this in writing). Once you have this take the information to your vet and ask your vet, together with the university vet to write to the insurance company setting out the reasons why they believe that the policy terms and conditions have been complied with.

Once you have received a reply from insurers you will need to post either on here or the insurance site to see what the next step is. Hopefully the call you were having with them will have resolved the issue.

DebtMagnet

This thread is rather worrying as I have been researching this on and off for a while now.

I have a cat that I took from a rescue home who is partly feral and has never been comfortable with people and I accepted he would never be a lap-cat. He is an outdoor cat and I have a cat flap so he can come and go as he likes which suits him and me.

He has always been fully insured but due to the fact that he 'disappears' for weeks at a time his last booster appointment was missed and his subsequent one was canceled as he just wasn't around (I'd love to know where he goes!)

Anyway he has had a few scrapes over the years but I am now thinking that having read this thread, if he came back now with a problem that I wouldn't be covered?

I also have insurance for a cat that has recently decided to just come and live with me this year. I presume he is someones cat as he is very friendly. I took insurance out for him because I thought that if something happened then I could not see him suffer even if he is not my cat, and the fact he has chosen to live with me makes him my responsibility I presume? I have no idea if he has ever been vaccinated (I don't even know his real name!) and so again it seems that I have been paying all this money for nothing??

Has anybody else had any experience with stuff like this?

I really hope you get it sorted brians daughter and I'll be keeping my fingers crossed for you.

DM

welshmoneylover

That's a really interesting issue you've brought up OP, I hope you manage to get it sorted. But from what I've been reading on various pet forums, insurance companies are picking up on anything slight thing to avoid paying out. I'm starting to wonder whether pet insurance is another con!

Tropez

welshmoneylover wrote: »

That's a really interesting issue you've brought up OP, I hope you manage to get it sorted. But from what I've been reading on various pet forums, insurance companies are picking up on anything slight thing to avoid paying out. I'm starting to wonder whether pet insurance is another con!

Yes, it is unfortunately fairly standard for insurers to try and get out of coughing up by looking at cases where their T&Cs may not have been followed but insurance itself is not a con and when people do follow the T&Cs the majority of reputable companies will pay out. I have two of mine insured with Bank of Scotland and one insured with Aviva at present.

In the OPs case, as mentioned above, you need to get your vets to state in no uncertain terms that your cat was vaccinated in accordance with their recommendations so as to provide the insurer with no doubt as to the fact that you have not breached their terms and conditions.

brians_daughter

Thanks all. The ins co are writting to me, but the vets are already on the case! They have faxed over their opinions to the IC yesterday... TBH they cannot believe that they are refusing to pay out on such a condition as it is no way related to vaccinations. So, we will see what happens now.

In the meantime the vets have said dont worry about the costs and worst case if i do need to pay i can spread it over 24 months, again not ideal but at least i know if i do need to pay i can. I was dreading having bad feeling with the vet as shes been so good.

Will keep you updated.

I think 1 thing that does go in my favour is the policy also mentions yearly dental exams along with vaccinations and he always had dental checks, so i am hoping that shows i am responsible owner and am following vets advice.