Pet Plan hydrotherapy claim rejected

Superdamo

Hi all,

My dog, Charlie, has been going to hydrotherapy for a year now after being referred by his vet for his osteochondrosis/arthritis. The therapy has had an amazing impact on his condition and now you can hardly tell he is lame despite his medication (which Pet Plan are paying for) being cut by a half. The vet has also seen a significant improvement.

Although the hydrotherapy centre is not a member of the Canine Hydrotherapy Association (a stated but recent requirement of any hydrotherapist that Pet Plan will pay), Pet Plan have been paying his costs for the last year. Unfortunately though, today I received a letter from them saying they have made a mistake by paying these costs and will no longer accept any further claims for treatment from this centre. I am unable to meet the costs myself so will have to stop the therapy.

I can appreciate that Pet Plan needs to ensure that any Tom, !!!!!! or Harry with a fake diploma and a bath doesn't scam them for an expensive swim but this guy has been a hydrotherapist for years, is qualified and is known to the vet so well she recommended him. His reason for not joining the CHA is that membership is expensive and proves nothing about the ability of any therapist that is a member. The suggestion is that Pet Plan are using this as a loophole for avoiding paying out on what is becoming and increasingly popular complimentary therapy. According to him, Pet Plan always paid for his treatments until they were taken over by Cornhill. So have his hydrotherapy skills deteriorated to the point that Pet Plan don't recognise them as effective enough to pay for anymore, or is Pet Plan more concerned with its new shareholders than providing clinically proven treatment for policy holders and their animals?

The irony is that his medication is likely to be increased now and the possibility of further surgery also more likely - all of which will be paid for by Pet Plan. Unless of course they decide that only veterinary proceedures conducted by vets whose names begin with X will be covered!

If anyone has any thoughts on how I might persuade Pet Plan to change their mind I would greatly appreciate it. As would Charlie whose otherwise fit and active life has been significantly enhanced with this therapy. Many thanks in advance for your help.

mattymoo

No direct experience of pet insurance but a similar thing occurs in commercial insurance with intruder alarm systems and sprinkler fire protection systems. I work as a surveyor and specify these systems when the insurers require them in order to provide cover.

In the case of intruder alarms, we look for NSI or SSAIB membership and with sprinklers, you need LPC certification (LPC = Loss Prevention Council).

We will not accept non approved companies because there is no body to check the workmanship. Occasionally we are asked to accept a non-approved firm but insurers are not inspection bodies - I certainly could not verify that a system had been installed correctly.

A similar thing also occurs with BUPA - the specialist and hospital have to be approved by them in order for your claim to be accepted.

I suspect Petplan are simply coming into line with the rest of the industry, possibly with some prompting from Allianz Cornhill.

If I understand correctly, there is nothing to stop you going to another hydrotherapist with the appropriate CHA membership. Perhaps ask Petplan to suggest someone so that there can be no future problems.

Your vet may need to rethink there use of your current hydrotherapist and I suspect market forces (the lack of business) will force them to register with CHA.

In the short term, you could ask your hydrotherapist to write a letter to Petplan defending his decision not to register with CHA and setting out their qualifications / experience / treatments available. I would give you no better than 50/50 odds that this will have any effect though.

Not what you wanted to hear, I know.

Superdamo

Thanks for the info. Not necessarily what I wanted to hear but much as I suspected and really appreciate your professional opinion.

Unfortunately I have already looked for the nearest CHA centre and seeing as their are only 40 in the country it is no suprise that the nearest one is over 50 miles away! It would be cheaper to stump up the therapy costs at my local centre and save on the diesel.

I also think it unlikely that the local centre will join the CHA. He has more than enough referrals coming in from local vets (with owners obviously wealthy enough to cover the costs out of their own pockets) and also feels that he will not be bullied into membership of an organisation that will cost him money and requires no more qualifications or higher standards than he has already.

Your suggestion for including his professional qualifications and reasons for not joining the CHA is an excellent one. My vet is also prepared to compile a clinical appraisal of his condition before and after hydrotherapy. Failing all this I suppose the commercial implications of further surgery and medication to control his worsening condition might make them think twice.

I don't suppose the fact they've set a precedent by paying thus far has any impact on this case?

mattymoo

Not sure about your last point. It is common for insurers to change the contract at renewals and insert clauses, additional covers or restrict covers etc. I always understood Petplan was one company that would not do this - remove cover for an existing condition.

It might be worth asking the hydrotherapist if he is working with other insurers such as Direct Line and More Than. I know that Pet Plan have always considered their product to be superior to these 2 (and others) so you could try the "If he is good enough for xx and yy insurers, then surely, I can expect my superior Pet Plan policy to meet the costs also?".

It appeals to their vanity and also makes them realise they have not met a customers expectations. It might result in them reconsidering their position.

Superdamo

Another great idea. Thanks again.

Regarding Pet Plan's cover for life, yes they do and this is the most galling thing. They have paid several thousand pounds in surgical and parmaceutical bills since Charlie was diagnosed with this incurable condition with no arguments and I have been immensely impressed with their speed of claim payment. So much so that I have recommended them to anyone looking for pet cover. Now we have found a treatment that really works, is not just harmless to him but does him the world of good, is saving Pet Plan on anti-inflammatories and possibly future surgery, and they won't pay. Seems a bit commercially short-sighted.

Still, following your advice it seems a charming/persuasive letter, backed up with recommendations from my vet and hydrotherapist, is the only course of action open to me. Many thanks again for your help and I'll keep you posted with the result.