Injured dog and insurance won't pay

AlissiaK

My not quite 2 year old Springer Spaniel has recently been diagnosed with damage to the cruciate ligament in one of her back legs and it is suspected that she is developing the same problem in the other leg. To repair the problem it has been suggested that she should have TPLO (tibial plateau leveling osteotomy) surgery. I have been quoted the cost of nearly £5,000 for both legs by one surgeon.

Having given them my insurance details (currently with esure) to look at redeeming the cost through the policy, the vets came back and said that they doubt esure will cover it because I first went to my local vet, intially thinking it was a sprain, 2 days before the beginning of the policy and this will be deemed a pre-existing medical condition.

I went to the vet who diagnosed lameness and gave us anti-inflamataries which appeared to improve the injury. But since (a few months later) it has returned and is worse. I checked with esures customer services who said this probably would be the case.

However, my dog has been fully insured since she was 10 weeks old. Before my policy with esure I was with M&S and because they increased my renewal I shopped around and transferred to esure within the last month of the policy ending with M&S (before the dog experienced her problem) so on the 30th of the month it transferred from one immediately to the other.

As the policy with M&S was still active when we first went to the vet I wonder if I have any rights to try and claim the costs through M&S.

Does anyone have any advice or been through anything similar. Also, £5,000 seems quite a lot, has anyone had this surgery done cheaper.

Thanks

Alissia

starrystarry

Hi Alissia,

I don't think you'll have much luck with M&S I'm afraid, their T&Cs say you're covered for "veterinary treatment carried out in the period of insurance". So you're covered for treatment during the term of the policy, rather than an injury sustained during the term of the policy. You could give them a ring and ask them, just to be sure.

I nearly got caught out in the same way when I switched my dog's insurance. I arranged to switch it a couple of weeks in advance, then the day before the new insurance came into force I noticed a growth/lump underneath the base of his tail. I'd never noticed it before because of where it was. I knew the new insurance company would refuse to pay out as it was obvious the lump had been there before the policy started. Fortunately it turned out to be benign so it didn't cost us much to sort out.

I don't know whether £5k is reasonable. I know it cost about £1400 when my dog's knee had to be rebuilt and that was only one leg and it was about 3 years ago. Could you get a second opinion?

Annisele

The Financial Ombudsman Service has a technical note on pet insurance. I'm not sure it helps you all that much (unless the "pre existing condition" terms weren't brought to your attention) but it might give you a starting point.