Pet insurance not paying out!

lowla

They've just notified me by email that they have completed their assessment of my recent claim. However, they are unable to pay this claim because of gaps in my cat's history re. vet surgery registration. The vets are claiming directly from the insurance. Bill almost £3k! 

We were registered with one vet when he was a kitten 2 years ago then moved home. I never got round to registering my cat with another vet in our new area until he got sick (this claim). So there is a two year gap between us moving home and us registering with another vet. I've gone through the T&Cs of our policy and nowhere does it say the cat must have a full veterinary history. The only thing i can find that comes close is that they won't pay out for illness that could have prevented if i'd kept his immunisations up to date. The vet has confirmed that his recent illness had nothing to do with falling behind on immunisations. 

We just never thought to register with a new vet until we actually needed to see a vet. He's an indoor cat and usually very healthy. 

Does anyone have any advice? Waiting on the vets inevitably calling me later as the insurance will have emailed them too. 

MalMonroe

Well, I'd definitely fight this one. When our indoor cat was ill, also nothing to do with immunisations - which she had had but that was irrelevant - I paid the vet bill and then claimed from the insurance. Of course, there was an excess, there always is but the whole bill was £250 and excess £50. They paid up without a murmur. Not sure why your vet is claiming directly from the insurance company either, and didn't know that was a thing they could do. 

Please do challenge this - especially as you can't find any reference to what they say in the Ts and Cs, and ask them to explain fully what they mean. That really is a lot of money to lose, especially when you have been paying your premiums in all good faith. I also don't see what a gap in vet registrations has to do with the insurance claim. They really do need to give a full explanation. Good luck but as I say, don't let them win! 

Birseh_

Who was the insurance with can I ask?

sheramber

Your cat could have been  treated by a vet during these two years . You cannot prove that your cat was not treated during that time.
Registration with a vet would  prove that you had not consulted them.
So you do not have a full veterinary history. There  is a gap in the history which is not accounted for.

Vegastare

Just to say I made a claim for my dog last year - he was 11 then and first claim I made with company in 11 years.  When I completed the form it asked for name and addresses of previous vets ( I have used 3) and they contacted the other 2 who called me to ask could they disclose my dogs history to the insurance company.... several weeks later they paid the vet. 
I certainly feel you need to challenge this - and why have they not looked into past vets history.  Sadly I think it is the nature of insurance that they look for loop holes!!
Say you are happy for them to speak to your previous vet regarding past visits....I to think a gap in vet registration has little to do with a claim -

Not sure with cats - but assume insurance works the same

Nebulous2

My dog insurance requires an annual medical and dental health check. We received an email saying they would allow some leeway during the lockdown. Does yours expect the same?

sheramber

Vegastare said:

Just to say I made a claim for my dog last year - he was 11 then and first claim I made with company in 11 years.  When I completed the form it asked for name and addresses of previous vets ( I have used 3) and they contacted the other 2 who called me to ask could they disclose my dogs history to the insurance company.... several weeks later they paid the vet. 
I certainly feel you need to challenge this - and why have they not looked into past vets history.  Sadly I think it is the nature of insurance that they look for loop holes!!
Say you are happy for them to speak to your previous vet regarding past visits....I to think a gap in vet registration has little to do with a claim -

Not sure with cats - but assume insurance works the same

Lack of registration is very relevant as  there is no proof that the cat did not  suffer any illness or condition in that time.
 Checking with previous    vets is standard practice but with a 2 year gap with no veterinary record means there  is now way to prove the cat did not have any condition which may  be relevant to the current claim.
By all  means follow the complaint procedure detailed in your policy document but I do not think you will have success as you admit it is a requirement of the insurance to  have a full veterinary history, which you do not have.

lowla

Thanks for the replies. 
 
No, it doesn't say anywhere in my policy that my animal must have a full veterinary registration history with no gaps in order for the insurance to be valid. There is nothing that even comes close to this except what I mentioned earlier about falling behind on immunisations (not relevant in this case). Surely then the onus is on them to prove my pet has been ill/injured before rather than on me to prove my pet hasn't? It doesn't say anywhere in my policy that I need to prove this under the part that details my rights and responsibilities. 

It says this in the policy: we may need to see your pet’s records from any vet who has treated it and any other information about your pet before your claim is paid. If the vet charges for this information, you will have to pay.

Again, that doesn't equate to "your pet must be registered with a vet at all times in order for any claims to be valid". 

I've put in a complaint and asked for someone to look over the claim again. 

Sandtree

Who is the insurer?

You need to ask them on what grounds they are looking to avoid the claim is on. Is it, as you are assuming, a clause in the policybook or is there a Q or accepted assumption in the quote and buy process which states your pet has a full medical history/continuous vet registration.

I don't know enough about vets to know if their concerns are truly justified or not (which is independent to the Q on if it is grounds to decline). I mean even if registered with a vet could you not in theory have had treatment elsewhere which your registered vet is unaware of.

Vegastare

My pet insurance (dog) does require a annual check/vacz etc too.  So that may be the reason my insurance claim was paid.  

Jumblebumble

sheramber said:

Your cat could have been  treated by a vet during these two years . You cannot prove that your cat was not treated during that time.
Registration with a vet would  prove that you had not consulted them.
So you do not have a full veterinary history. There  is a gap in the history which is not accounted for.

So what!
 The OP is as far as we can see under no obligation to either register the cat or prove anything 

Your argument falls over as the  cat could have been treated by a vet somewhere else whilst on holiday so being registered at another vet would prove absolutely nothing would it ?
The cat might not be the same cat as the insured one in any event