Pet insurance - timing of diagnosis, renewal, treatment

Yorkie1

My mother has a 10-year old cat, insured with Coop since she got her as a rescue 6 years ago.

She had a routine vaccination appointment on last Friday (27 October), and she asked the vet to look at the cat's teeth as she hadn't been eating all of her dry food in the previous couple of days (of course, she's back to gobbling it down now!).

Diagnosis was provided re. a tooth. Treatment would probably be extraction, preceded by bloods & x-ray to identify how much surgery would be needed. Plus two follow-up appointments. Likely average cost £1,000. 

The insurance does cover dental treatment if "the pet had a dental examination by a vet in the 12 months before the first clinical signs of the injury/illness were seen, and any treatment recommended as a result of the last dental examination was carried out within 3 months of the examination taking place."

So it appears that the treatment would be covered, if it takes place by the end of Feb 2024. The excess would be £100, plus 20% co-pay owing to the age of the cat. 

What is puzzling me is when Mum has to tell the insurers. The policy is due for renewal on 14 November. The treatment has not yet been booked (it's not an emergency), but what is the situation if she allows the policy to renew without giving the insurers a heads-up?  Would the diagnosis become a 'pre-existing condition' that would be excluded from the renewed policy?

Or am I overthinking this? And she just tells the insurers when the treatment is booked?

Thanks for any thoughts.

cannugec5

Yorkie1 said:

My mother has a 10-year old cat, insured with Coop since she got her as a rescue 6 years ago.

She had a routine vaccination appointment on last Friday (27 October), and she asked the vet to look at the cat's teeth as she hadn't been eating all of her dry food in the previous couple of days (of course, she's back to gobbling it down now!).

Diagnosis was provided re. a tooth. Treatment would probably be extraction, preceded by bloods & x-ray to identify how much surgery would be needed. Plus two follow-up appointments. Likely average cost £1,000. 

The insurance does cover dental treatment if "the pet had a dental examination by a vet in the 12 months before the first clinical signs of the injury/illness were seen, and any treatment recommended as a result of the last dental examination was carried out within 3 months of the examination taking place."

So it appears that the treatment would be covered, if it takes place by the end of Feb 2024. The excess would be £100, plus 20% co-pay owing to the age of the cat. 

What is puzzling me is when Mum has to tell the insurers. The policy is due for renewal on 14 November. The treatment has not yet been booked (it's not an emergency), but what is the situation if she allows the policy to renew without giving the insurers a heads-up?  Would the diagnosis become a 'pre-existing condition' that would be excluded from the renewed policy?

Or am I overthinking this? And she just tells the insurers when the treatment is booked?

Thanks for any thoughts.

To me this is not clear cut. 

Asking the vet to examine the teeth because the cat is not eating surely demonstrates a ‘Clinical sign’. Thus an examination prior to clinical signs emerging is not demonstrated. Therefor IMHO there may be no insurance cover for this. 

However I might well be wrong. So, if it were me, I would ask the vets advice ( they must deal with insurance companies every day) and then, if they agree, contact the insurance company. I would not want to wait for renewal, as I agree with your presumption that this issue is now Pre-existing and a material change that should be notified prior to renewal. This might mean it is not covered upon renewal but might be covered NOW if the treatment plan is made. 

Good luck! 

elsien

If she makes a claim, then they will ask the vet to confirm when it was first noticed and realise it was before your renewal date. It doesn’t just go on a date of the procedure – when the Vet completes the paperwork and they have to give full details.

On that basis, I would suggest she needs to let them know before the policy renews. The better lifetime cover policies would cover it anyway; those that won’t cover it will decline cover when they get the vet report.
 FWIW my Vet always includes the dental check as routine on his reports so when he’s noticed a problem during the vaccination he always counts that as the annual routine check. 

Cloth_of_Gold

Why does it cost £1000 for a tooth extraction - that is way more than it would cost for a human? And why the need for a blood test? I'm not saying wither of these things is wrong, as someone who doesn't own any pets I'm genuinely interested.

elsien

Blood tests to test for kidney function, and anything else that might impact on the safety of a general anaesthetic.
Cost of dental treatment depends where in the country you are, the size of the animal and the amount of work that has to be done. 

I  paid 400 quid doggy canine extraction which is more than the quote because the canine tooth in question was quite reluctant to come out.  

However, I would expect the flow of appointments to be included and I agree that even if the  OP is London based that does seem high. Unless they’re using one of the specialist hospitals that have sprung up. 

It’s not really possible to compare costs for a human because we  shielded from the true cost of medical treatment by the  NHS.

Cloth_of_Gold

elsien said:

Blood tests to test for kidney function, and anything else that might impact on the safety of a general anaesthetic.
Cost of dental treatment depends where in the country you are, the size of the animal and the amount of work that has to be done. 

I  paid 400 quid doggy canine extraction which is more than the quote because the canine tooth in question was quite reluctant to come out.  

However, I would expect the flow of appointments to be included and I agree that even if the  OP is London based that does seem high. Unless they’re using one of the specialist hospitals that have sprung up. 

It’s not really possible to compare costs for a human because we  shielded from the true cost of medical treatment by the  NHS.

I hadn't thought about it requiring a GA.

I was comparing dental costs with private as it's very difficult to get an NHS dentist in many areas. I had a tooth out a 3 or 4 years years ago and the dentist thought it might be tricky as it was near as sinus so he used dental surgeon from a hospital that comes to the surgery every couple of weeks I think to deal with more complex cases. I think the extraction cost about £175, which was good considering the skill of the person involved (he does maxillofacial surgery). I think that £250 is probably about what you would expect to pay now for a general dentist to do it.

Anyway, sorry for going off topic and I hope the cat's operation is successful.

sheramber

When did the cat have a dental examination prior to this one?

That is the crucial timing- within the previous 12 months before the first clinical signs appeared.  So if it was at any time in the  12 months leading up to the date of the first signs- which will be noted in the vet's notes as when the client first noticed the signs, -  it will be covered.

Normally when your renewal invitation is sent it includes a statement that you must tell them of any change in the pet's condition. So, your mother should advise them about the need for dental treatment.  

Yorkie1

Thanks everyone. Yes, a GA will be needed for the x-ray and surgery.

I asked Mum whether the teeth were checked on previous vaccination visits and she says yes, so hopefully that aspect will be covered.

I will advise her to contact the insurers tomorrow, to get this sorted out before the renewal date of 14 November.

Yorkie1

Just to give an update for anyone else who may find this thread in the future.

The insurers were very good when she rang them to let them know of the outcome of the recent vet visit and to update the name on the policy (the cat's, not hers!). No increase in premiums for this renewal (though who knows for future years!).

The vets will say to the insurers that the treatment is for an "illness", which is what the policy requires, and will process the claim for my Mum. We shall just have to see whether the insurers agree, but it's all booked in and so on we go.

Yorkie1

Forgot to come back to give a final update to the thread.

The insurers accepted the claim, and reimbursed my Mum the amount of the claim, less the excess and age-related deduction. It took a few weeks to be processed though.