Pet Insurance issue - They're refusing to pay

ptrichardson

Hi, Hoping someone can help.

We've had a cat for over 3 years, and when we bought him, he was insured with Pet Plan. We kept that policy going for the next years.

Then this June, we bought a new kitten, also pre-insured from Pet Plan.

When they wrote to us to advise the free insurance for the kitten was ending, my wife called to continue the policy. Their advisor recommended their multi-pet plan, as it had a small saving. My wife agreed to this.

As the older cat's policy ran from June2012-2012, and the kitten's free insurance ended in August2012, the new multi pet insurance plan started in August 2012.


We received a cheque from Pet Plan for the policy that we'd already had for the older cat 2 days after the new policy started.


The problem is, we knew the cat needed an eye operation in May. With us getting the new kitten, we decided to delay it by a few months (it wasn't anything serious). Before we knew it, 6 months had passed, and he's in the surgery today.

The insurance company are refusing to pay as they claim its a pre-existing condition. They claim that because the nature of the policy changed, the under-writers will not cover this.


I've tried explaining that there's no way we would accept a £25 annual policy saving when we knew there was a £1,000 vet's bill coming along in the near-future. But they won't budge.


Anyone got an advice? Can they do this?
Please ask any questions if I've missed out details that are important.

TIA


(NB - Sorry, I've posted this in insurance and in the Pet forums, wasn't sure which was more correct - hope that's ok)

krlyr

I'm sorry but to me it sounds like you started a new policy in August. If the condition was diagnosed in May, it would be a pre-existing condition.
Your only argument may be that you were misled in the information given by the advisor to change the older cat's policy, but this could be hard to prove (they may be able to find a recording of the call too which may not necessary support your argument either) and ultimately most pet insurance companies I've used/know of make it very clear in their policy terms and paperwork that pre-existing conditions are excluded.

ptrichardson

Hi.

We didn't get any paperwork to alert us to this. It wasn't mentioned on the call. All we wanted was to continue the policy for the kitten, we had no intention of changing anything for Monty - it was their advisor who pushed my wife into that choice.

We would never have taken out a new "brand new" policy - we knew he might need a £1000 operation. So yes, looks like we've been mislead.

They are going to listen to the call. I guess I'd have make a FoI request to get it myself. Of course, if its favourable to us, I'm sure it will be "lost" anyway.

krlyr

Was there any paperwork alongside the cheque for the refund of Monty's existing policy?

ptrichardson

krlyr wrote: »

Was there any paperwork alongside the cheque for the refund of Monty's existing policy?

We got a letter dated 28th August which was just a cheque with supporting letter (the type with the tear off at the bottom).

On 28th July, we got a pack with a "welcome letter", a payment plan (starting 1st Sept) and 2 X Policy Documents.
The cover for those 2 both started on the day that Belle's original (free) insurance ended (like I said, we only called in the first place to extend this cover)


In the cover details, it does say "with a covered for life policy your vet fees benefit is renewed each year provided there is no break in cover."


There was no break in cover - the person on the phone confirmed that.
However, she spoke to the underwriters, and although there was no break in cover, they are somehow saying that there was a break in underwriting, or something - didn't make 100% sense to me (or her, I think).
She mentioned a few times that it was due to us "upgrading the policy". We never asked to do that, its actually due to the "classic" policy not being compatible with the "multipet" products that they sell - so it had to be changed to the new product.


What I can't get my head around is that we've tried to do the right thing from day 1 - we took out the policy the breeder recommended, and we've ensured there wasn't a day when the 2 of them were covered.
Now some technicality is being pulled on us which is going to cost me £1000.

Surely there's something I can do about this, it just doesn't seem right.

krlyr

What did the supporting letter say? Do you still have it to hand?

ptrichardson

krlyr wrote: »

What did the supporting letter say? Do you still have it to hand?

Sure:
i48.tinypic.com/ws4oi8.jpg


I know it sounds like a brand new policy, but that's to be expected - they wouldn't have a template for "Thanks you've moved your old policy and renewed a separate existing one" :-)

krlyr

To be honest that is the way I would expect a company to do it - if it were simply a discount for insuring a second pet then I wouldn't expect them to alter Monty's policy at all, but it sounds like you moved Monty to a new multi-pet policy - ending his existing policy in the process.
I am no legal expert but with that kind of paperwork I imagine your only defence will be proving that the advisor specifically said you would remain covered for any existing conditions, because I would say Petplan have made it quite clear it was a new policy Monty was being moved to, sorry.
Kick up enough of a fuss and get through to the right person and they may offer to cover his condition as a goodwill gesture though so worth persuing but I'm not sure you'd have much luck legally without that phone conversation recording (if it backs you up)

ptrichardson

That seems to be exactly what they've done.

What they never explained is that his "lifelong" cover would start from scratch. Which would have been the red flag to us.

We knew he had a £1000 operation possibly to come, so if we'd known, we'd never have accepted it.

pawsies

There's a section in dog magazines (and I presume cat magazines 'Your Cat') where you can ask an expert about insurance problems and they usually resolve them for you by contacting the company. Many times I've read that the insurance company will solve it for goodwill so maybe this is the way to go?

ptrichardson

Yeh, I'll follow their standard complaints process if the response I get isn't good.

The issue seems to have been caused by an usual set of circumstances - ergo, the 6 month delay between diagnosis and treatment.

I guess we should have brought it up - and if we'd planned to do a multi-pet policy, we'd have thought about it. But the person on the phone caught us on the hop - we'd only called to extend a single policy.