Appealing pet insurance exclusions

dmt491

Last year we adopted a mature dog (approx 4 years old) from a rescue who had taken him from the pound. We have vet records from the rescue and then from his time with us, but obviously not before that.

We recently applied for pet insurance with Every Paw who reviewed the limited vet records and have applied two exclusions to his policy -

1. Exclusion condition - Skin Problems

Medical Notes - 21/06/18 - skin dermatitis ventral area with inverted nipples

Date to be reviewed if applicable 15-01-2021

2. Exclusion condition - Histiocytoma

Medical Notes - 23/07/18 - tiny mass on L upper lip, pink, 2mm, looks like histiocytoma

Exclusion is not reviewable

We would like to appeal these exclusions on the basis that the previous conditions are no longer an issue. The tiny pink bit on his lip dropped off (and was not actually diagnosed as histiocytoma - it was just mentioned that it might be that) and the dermatitis arose from stress due to his circumstances at the time. Once he came to us, he quickly recovered and hasn't had any issues. We also think it is inappropriate to exclude all skin problems on the basis of a minor bout of dermatitis which quickly cleared up.

We asked our vets if they could help us appeal, but they said they couldn't assist.

Does anyone have any experience of appealing exclusions? What do we need to do / submit / prepare to provide a good case for removing the exclusions (particularly the general exclusion relating to all skin problems)?

elsien

I looked into appealing an exclusion for all foot conditions (dog had had some sort of skin rash just prior to being insured) on the grounds that that would exclude accidents such as cut paw or torn dew claw which I thought was unfair. I was told that the vet wouid need to send full records then they would review.
Never got round to making the appeal in the end, and when dog needed a toe amputated due to a tumour, the vet was aware of the exclusion and stated in his report that it was completely unrelated to any previous condition. The insurer paid up.


It might be slightly different in your case because the insurer already has the full medical history such as it is. Have you now taken out the insurance, or have you checked with other insurers to see how they would view it?

dmt491

The insurance policy started despite (but subject to) the exclusions - but we can appeal and/or cancel the policy at any time.

We certainly could check with other insurers, perhaps that is the next logical step. I wonder if Every Paw would reconsider their own exclusions if other providers were willing to take a different stance (i.e. match others' offering)? I don't have any prior knowledge of them, they just came up with a competitive offer on the comparison sites.