My Vets Advice and Bill

sheramber

BY dealing with the insurance company the vet submits a claim direct. He does not know what cover you have or what exclusions there are.
It is not his job to find out.

You are the person who took out the insurance and should know what you are and ore not covered for.

Out of interest why was the cost denied by the insurance company? 

born_again

adcenv said:

Imagine for arguments sake that your old mum walks in, all distressed, with her beloved pet and is told by the vet team...dont you worry ms simpson we will deal with all that nasty old insurance for you...and then send her a £x bill...how would people here feel about that?  Its wrong.  Either give full professional advice.  Or none at all.

I think Ill just rely on a civil court to decide this.  Every person has a duty of care when offering up advice.  By providing professional advice which a reasonable person might rely on is covered by Tort.  

I get what you are saying as a fellow dog owner.
But the vets did deal with the insurance company for you. They are not to know all the exclusions on every policy. 
The problem is the insurance you had did not cover all the fee's. So any argument is with the insurance company. 

adcenv

I appreciate everyones comments and taking the time to reply.  Ill be taking this to small claims court.  Its out of principle.  Ill post the decision up here as and when.

elsien

What is the reason that your insurer declined to pay out? Is it reasonable or is that the decision you should actually be challenging? 

Would it have made a difference to the decision about whether to treat or not, or would you have had your dog put to sleep earlier?

I’m with the other posters on this one. Your vet can facilitate a claim but they have no idea of the specifics of your policy and any exclusions so cannot say whether your claim would be covered or not. You were made aware of the potential cost before going ahead - the rest sounds down to miscommunication. 

visidigi

Firstly condolences for your loss.

Secondly, taking away the emotion of the situation the way in which a court would look at this is likely to be...

The way your opening post is written is you expected a party to pay out all circumstances and outcomes of the poorly pet purely because the vet was submitting the claim. 

You only checked the policy afterwards, not before, during or after and the way you've written the post implies that you may not have proceeded with the treatment of your pet if you had known it wasn't covered.

The vet said they would deal with the process for you, at no point did you inform them of the coverage you have, the excess due or the limits of if. Who submits the claim doesn't change the eligibility or amounts - if its a continued treatment of a preexisting condition for example then the yearly allowances will be lower, so the policy number itself doesn't provide the vet that information. The constraints and coverage are baked into the policy you buy, which would be down to you to know or at least query - before, during or after.

Unfortunately what happened weeks later, whilst sad and distressing, doesn't apply to the initial vet actions or processes they followed.

Any claim you bring to the initial vet of concern starts the moment you called them/entered their premises and the moment you left (as this is the point where charges ended and were filed for payment).

I fear your small claims court process will fail, principle or not, it comes across as deflection of responsibility on convenience not justification unfortunately.

Manxman_in_exile

Just playing Devil's Advocate, but I'd make a couple of points for and against the OP.

Against:

adcenv said:

...At this point the lady at the vets said to my very upset wife that ‘the practice could take our insurance forward on our behalf as it had a direct portal with the insurers'.  My wife took this advice on board believing that the vets were acting in our best interests and let them do this for us.  I then arrived at the vets.  Nobody made me aware this advice had been given to my wife.  We both went into see the vet and he then showed ME (not my wife) a consent form outlining POTENTIAL treatment (over £2k).  My wife and I agreed to the vet that we would be using our insurance and I then signed the form.  As I left the vets I said to my wife that we should call our vets and make sure we are covered for all that work before they do it.  To which my wife replied that it wasnt necessary because the vets were dealing with it for us...  

Regardless of whatever the vet's receptionist told the OP's wife, the OP and his wife seem to have agreed and consented to treatment before thinking of checking whether or not their insurance would cover it, and before the OP learned form his wife that the vets would "deal with the insurance" - whatever was meant or understood by that.  The OP had already consented to the vets carrying out the treatment.

For (perhaps - I am not a dog lover and have no idea how this works with vets and insurance, so apologies if I'm hopelessly wrong):

I can understand that when the OP's wife was told that the vets would "deal with the insurance", that the vets meant they would deal with the paperwork and billing etc, and not that they would check if the treatment was covered, because how would they know if it was covered or not.  But - by the same token - when it became clear to the vets what treatment was actually required as opposed to potentially or possibly required, shouldn't they have run the details of that treatment past the OP to confirm that it was covered and that the OP and his wife were happy to continue?  That's what I'd have expected, but I've no experience of dealing with vets or pet insurance so I don't know if that is reasonable or not.

I think I'd also have expected some kind of warning or advice from the vets or their staff that the OP and his wife should check the extent of their cover.  Or should that be obvious to the OP and I'm being too nanny state?

And - of course - there is always the possibility of a misunderstanding as to what was said to the OP or what that actually meant.  But I think I'd still expect the vet or their staff to have made it crystal clear:  "We'll do this for you, but you still need to do that yourself..."

elsien

Last time Gitdog needed urgent treatment, I had the estimate up front and the initial treatment wouldn’t have gone ahead without my consent. 

I could have called my insurer to check but I didn’t, because the treatment was going ahead either way. 
After the first night in, they called me and they offered further tests (along with quote) which I declined as I didn’t feel they were necessary at that point. 

In my experience it’s an ongoing discussion. OPs dog was in for 4 days. Plenty of time to call the insurer, check ongoing costs etc and decide what to do. The OP say they were initially quoted a possible cost of “over 2K” and the final bill was 2.8K. I suspect their initial over 2K price wasn’t far off the final bill. 

I can see how when they were upset then things may have got confused. But there were then another 4 days in a calmer frame of mind to check and ask more questions? 

TELLIT01

There is a big difference between the person at the vets saying they would inform the insurer, and them saying they would check the level of insurance with the insurer and let the OP know if they didn't have cover.  I suspect they did the former but the OP's wife thought they would do the latter.  Possibly mis-communication but it is still up the the OP to check what cover they have.

ComicGeek

TELLIT01 said:

There is a big difference between the person at the vets saying they would inform the insurer, and them saying they would check the level of insurance with the insurer and let the OP know if they didn't have cover.  I suspect they did the former but the OP's wife thought they would do the latter.  Possibly mis-communication but it is still up the the OP to check what cover they have.

When we've been to the vets, they have made the application directly to the insurers as a way of preventing us having to pay the vets directly and then reclaim it from the insurers ourselves - nothing more.

Aylesbury_Duck

adcenv said:

I appreciate everyones comments and taking the time to reply.  Ill be taking this to small claims court.  Its out of principle.  Ill post the decision up here as and when.

Unless I've misunderstood, it's you that owes the vet, so why would you be taking it to court?  What would you be suing for?  Have you paid the debt already?