Pet Insurance Not Paying Out

Chrispy90

Hi there,

My name is Chris and my dog's name is Roxi. Her insurer is Direct Line and they are refusing to pay for her lump removal for 2 reasons.
- There was a previous condition that she had tartar on her teeth and vet recommended dental cleaning. The lump was under a tooth.
- The diagnosis was in Poland and even though the procedure in the UK, they said they don't cover anything outside of the UK.

I can't afford this honestly and I don't know what to do. I think it's unfair that they're not paying out and would like advise on how to fight it, or if there is no point.

Thanks and Kind Regards,
Chris

sp1920

Hi Chris, if the vet recommended tarter removal and you had this procedure carried out, I can’t see that they have any grounds to refuse. If you didn’t, they probably do - every pet insurance policy I’ve had requires an annual dental check to be carried out and acted on. If no luck you could try the PDSA though I think they means test before they help you these days. Good luck.

KxMx

I'm guessing because of the previous dental advice, oral and mouth are now excluded? And that is why the lump claim has been rejected?

I was with Pet Plan for my Cat and had similar. Because of previous dental advice an exclusion was placed. However after she had been treatment free for 2 years with annual check ups, I successfully got the exclusion removed.

Direct Line may consider this if the timing is right. Worth a try.

Might there be a

Chrispy90

Thanks,

I carried out the dental cleaning (not asking that to be covered) and during the cleaning is when the vet found there to be a lump. We then returned to the vet in the UK to have the lump removed. Reviewing the history, the lump was caused by a gingivitis, discovered by biopsy. So there was no way of knowing before the procedure.

Is there any chance of fighting this? Should I suck it up and pay? How would you move forward?

Kind regards,
Chris

sheramber

Can you explain why the first treatment was done in Poland?

Was this before you took out the insurance with Direct Line?

Claddagh_Noir

Hi Chris,

You can try and fight it but any time you go to the vet, they note everything, no matter how trivial. I realised that when I asked for my pet's notes. My vet a couple of years ago wrote that my dog was aggressive and needed to be muzzled when he was being looked over in the vet's office. He was actually a bit aloof because the vet was a stranger, he wasn't a threat.

See if you can request the complete notes for your pet.

All the best.

Chrispy90

The teeth clean was done in Poland because it was cheaper and wasn't going to be covered by insurance anyway. I have full notes from the vet now. She was insured before the teeth cleaning- after the initial health check when we rescued her.

sheramber

When you are not happy with your insurances decision you should follow the complaint procedure.

https://www.directline.com/complaints

I would recommend you complain in writing stating it is a complaint. Keep a copy.