Insurance Claim advice

Jason87_2

Hi all,

I was hoping to get some opinions on my current situation.

I have had my dogs insured with Tesco from when I got them. I recently received my renewal which was much higher than the previous year, I give them a call and they couldn't really do much like they had in previous years so I decided to cancel and sign up with another provider. 

Unfortunately, on the day the insurance was due to run out with Tesco one of my dogs had a bad accident. I took them to the out of hours vets who said my dog would require surgery and its not something they could do and it would need to be completed by my own vet the next day.

The surgery was carried out the following day when the insurance with Tesco was up and they are refusing to accept the claim. My point is that when the accident happened the dog was still insured with them and it was not my fault that the surgery could not be completed when I took them to the out of hours vets. 

I know it's clutching at straws, but Tesco have contacted their underwriters to see if they will reinstate my policy but I can't see this happening as they will have to pay out thousands. 

Looking at other options I can see that I could log a complaint or pursue it with the Ombudsman, although it could be that I've just been extremely unlucky and will have to foot the bill. 

Any advice would be appreciated as I don't really understand the insurance policy booklet all that well.

Thanks

tacpot12

Tesco should not have refused to accept a claim for any treatment carried out by the Emergency Vets, but I think it is reasonable for them not to cover a claim for treatment by your own vet made after the policy had ended. I think the  policy booklet is clear enough as to how it says that they will pay vets bills incurred while the policy is in force, but not after it ends.

As a responsible pet owner you knew when the policy ended and that you needed to get insurance in place for the following day, but you didn't. This omission created an unfortunate trap where, even if you had tried to get new pet insurance in place on your return from the Emergency Vets (to start the next day), you would not have been covered because the injury was then Pre-existing. If you had taken out new insurance on the day before the injury, you might have been covered (This depends on the insurer; some have a time limit before they will cover accidents).

However this trap is not of Tesco's making, so I don't think a complaint to the Ombudsman is going to help. 

Sorry, I realise that my opinion is not going to be much comfort to you.

sheramber

I regret that is one of the hazards of changing pet insurance companies.

When I have changed i wrap my dogs in cotton wool until the change over is complete.

Jason87_2

tacpot12 said:

Tesco should not have refused to accept a claim for any treatment carried out by the Emergency Vets, but I think it is reasonable for them not to cover a claim for treatment by your own vet made after the policy had ended. I think the  policy booklet is clear enough as to how it says that they will pay vets bills incurred while the policy is in force, but not after it ends.

As a responsible pet owner you knew when the policy ended and that you needed to get insurance in place for the following day, but you didn't. This omission created an unfortunate trap where, even if you had tried to get new pet insurance in place on your return from the Emergency Vets (to start the next day), you would not have been covered because the injury was then Pre-existing. If you had taken out new insurance on the day before the injury, you might have been covered (This depends on the insurer; some have a time limit before they will cover accidents).

However this trap is not of Tesco's making, so I don't think a complaint to the Ombudsman is going to help. 

Sorry, I realise that my opinion is not going to be much comfort to you.

Thanks for your reply. I don't believe they will reject the claim for the emergency vet, but more so for the claim of the surgery.

In terms of having a new policy in place, I signed up for a new provider two days before the Tesco one ended, but unfortunately they don't cover anything for the first 14 days, plus the accident happened the day before the new policy kicked in so they won't want to know, although I will now have to contact the new provider as I'm sure this will now be classed a pre-existing medical condition? 

sheramber said:

I regret that is one of the hazards of changing pet insurance companies.

When I have changed i wrap my dogs in cotton wool until the change over is complete.

I agree, which is why I took my dogs to the same place I take them daily with no issues, it was just unfortunate that my dog jumped and landed the wrong way. I certainly won't be changing providers in future. It's more sickening that it happened the day before.

sheramber

If it was a cruciate repair then you will probably find an exclusion for cruciate damage on the other leg in the future.

Cruciate  weakness resulting in a tear can be due to genetics. The chance of the other leg being affected is 60%.

My dog tore one hers when she was three. She was able to resume doing agility with the vets encouragement. and no further problems.She is now 12 and is only now  showing signs of arthritis in that leg. 

She did however stop doing handbrake turns which probably led to the tear in the fist place.

If it is cruciate damage please follow the rehab instruction to the letter. Rehab is the most important part as it protects the other leg , which takes the strain until the damaged leg is sound again.

KxMx

I realise this doesn't help OP but whenever I changed insurers for my cat the old policy was never cancelled until the exclusion period on new policy had passed.

sheramber

I also overlap them but a claim during that time would be split between the two insurances  and probably with 2 excesses.

KxMx

If a claim had arisen I personally would have claimed on the old policy, subsequently stayed with them & cancelled the new. 

sheramber

 Accidents are normally covered immediately. It is only illness that is excluded for the first 14 days.

Petplan   now state they would pay out if you have other insurance you can claim on.  they used to say they would split the claim.

Other insurances We will not make any payment for any claim that results from an incident covered by any other insurance. If there is any other insurance under which you are entitled to make a claim you must report the incident to that insurance company and tell us their name and address and your policy and claim number with them