Tesco/RSA pet insurance

Box_of_Frogs_2

There was no indication of a weakness or degeneration of the disc and my vet has confirmed this in writing.

I have escalated it to the Ombudsman now.

sallyj17

So sorry to hear about Ozzie.. that is so awful.


Glad to hear you have escalated it to the Financial Ombudsman but be prepared for it to take some months for them to reach a decision.


Not sure whether you have seen this from the Financial Ombudsman's technical information about pet insurance complaints. http://www.financial-ombudsman.org.uk/publications/technical_notes/pet-insurance.htm


Where the condition first became apparent very soon after the policy was taken out

Pet insurance policies do not usually cover conditions that arise within the first few days of the policy. Although we are unlikely to say that this is unfair, it is significant – so we will consider whether it was brought to the consumer’s attention.

Sometimes, we find the insurer just told the consumer to read the policy document at when the policy was sold. Even though this would have mentioned that cover did not begin immediately, we are unlikely to agree that the insurer sufficiently brought this fact to the consumer’s attention in this situation.

Where we see evidence that the issue was brought to the consumer’s attention – perhaps by giving them a factsheet – we may agree it was reasonable for an insurer to refuse to pay a claim. But this will only be the case if we think the consumer knew about the condition or any signs or symptoms that should have alerted them that there was a problem.

Sometimes, a consumer takes their pet to a vet with signs of a condition in the first few days after a policy starts. An insurer may reject a later claim for the condition, saying the consumer was aware of it at this early stage. Here, we would consider what the vet told the consumer. If we find that the consumer that was told there was no problem and that no treatment was necessary, we are unlikely to agree with the insurer’s decision."

Have highlighted in the bold the bit I think is probably most relevant to you. Good luck. Do let us know how you get on.

sheramber

He checked him over on Thursday, couldn't find anything wrong apart from a slight 'click' in his back, gave him a painkilling injection and told us to come back if he didn't improve.

Ozzy seemed to perk up Thursday night but on Friday, stopped running around like his normal self, refused water and by the evening, was walking very stiffly and arching his back. When I got him up on Saturday morning, his back legs were not working at all so I took him back to Companion Care and waited on their doorstep till they opened.

They did an x-ray during the day and called us back to say it looked like he had a back problem but he needed an MRI to confirm and they referred us to Fitzpatrick in Godalming. We took his straight there and they were waiting to receive us, confirmed he would have an MRI next day (today), but said the chances of recovery are only 50-60%. We will know more after the MRI.

But alll of the above , which happened within the first 14 days exclusion period , would suggest there was a problem

Box_of_Frogs_2

sheramber wrote: »

The insuarnce company are not considering a pre exisitng conditon. They consider it a condition that arose within the 14 day exclusion period.

e.g if your dog had had an accident- collided with another dog while playing or collided with a tree etc or jumped badly to retrieve a toy etc, slipped on the laminate flooring, or any other ocurrance that caused the slipped disc- then you would be covered within the 14 day period.

Hpwever, if the problem arose because of a weakness or degeneration of the disc this would be considered a conditon arising within the 14 days.

The first visit to the vet is the important date as that was the first indication of there being a problem, even of it was not fully diagnosed at that time.

sheramber wrote: »

He checked him over on Thursday, couldn't find anything wrong apart from a slight 'click' in his back, gave him a painkilling injection and told us to come back if he didn't improve.

Ozzy seemed to perk up Thursday night but on Friday, stopped running around like his normal self, refused water and by the evening, was walking very stiffly and arching his back. When I got him up on Saturday morning, his back legs were not working at all so I took him back to Companion Care and waited on their doorstep till they opened.

They did an x-ray during the day and called us back to say it looked like he had a back problem but he needed an MRI to confirm and they referred us to Fitzpatrick in Godalming. We took his straight there and they were waiting to receive us, confirmed he would have an MRI next day (today), but said the chances of recovery are only 50-60%. We will know more after the MRI.

But alll of the above , which happened within the first 14 days exclusion period , would suggest there was a problem

So what are you trying to say? It should or shouldn't be covered?

sheramber

Ignoring the Thursday visit to the vet, the visit to the vet and the referral on the Saturday is within the first 14 days of the policy so unless the condition was caused by an accident I would consider it would not be covered.