Puffin Insurance - payment by credit card...and definition of pre-existing conditions

XRS200

I think this would be excluded as a pre existing condition due to the fact it has been diagnosed.

aroominyork

I think it's less straightforward. Puffin's terms say "any illness or injury (including clinical signs) which happen before the policy starts will not be covered and will be considered as a pre-existing condition." So it comes down to the definition of clinical signs. You can google this and find different definitions but, for example, lawinsider.com (whoever they are) say "Clinical Signs means changes in the normal healthy state, bodily function, or behavior of Your Pet observed by You, a Veterinarian, or other observer." By that definition, his dysplasia is definitely not pre-existing.

Puffin's definition in their policy document is very vague and this would strenghen my case. "We do not cover any illness, behavioural illness, injury or accident that your pet had or showed clinical signs of having before the policy started. This usually includes illnesses and injuries that can happen again or may appear in different parts of your pet’s body. For example, if your pet had an ear infection in the left ear before you took out your current policy, your insurance will not cover the cost of treatment for any future infections in either ear, regardless of whether you made a claim under a previous policy or if it’s the other ear that never had the infection previously." The fact they refer to illnesses and injuries that might happen again suggests a pre-existing condition had already manifested itself. Again, that puts me in a strong position.

XRS200

I would say it's an illness before the policy starts.  I don't think the clinical signs part matters unless it's not diagnosed.

aroominyork

Well, let's hope we never need to find out! 

DullGreyGuy

aroominyork said:

I think it's less straightforward. Puffin's terms say "any illness or injury (including clinical signs) which happen before the policy starts will not be covered and will be considered as a pre-existing condition." So it comes down to the definition of clinical signs. You can google this and find different definitions but, for example, lawinsider.com (whoever they are) say "Clinical Signs means changes in the normal healthy state, bodily function, or behavior of Your Pet observed by You, a Veterinarian, or other observer." By that definition, his dysplasia is definitely not pre-existing.

Puffin's definition in their policy document is very vague and this would strenghen my case. "We do not cover any illness, behavioural illness, injury or accident that your pet had or showed clinical signs of having before the policy started. This usually includes illnesses and injuries that can happen again or may appear in different parts of your pet’s body. For example, if your pet had an ear infection in the left ear before you took out your current policy, your insurance will not cover the cost of treatment for any future infections in either ear, regardless of whether you made a claim under a previous policy or if it’s the other ear that never had the infection previously." The fact they refer to illnesses and injuries that might happen again suggests a pre-existing condition had already manifested itself. Again, that puts me in a strong position.

I think that "clinical signs" is a harder definition to avoid given they are explicitly adding it as an addition to illness and injury. The vet has observed something that is different to the normal healthy state and so that is "clinical signs" rather than something you or I would spot by visual examination alone. 

Ultimately you can always debate and complain etc but I think you'd have a better argument with one that defines it based on symptoms and/or treatment rather than clinical observations. 

aroominyork

I would counter that the vet did not observe it. It was shown by an x-ray.

DullGreyGuy

aroominyork said:

I would counter that the vet did not observe it. It was shown by an x-ray.

I'd argue the opposite... the x-ray is just an image, observation is looking at an image and knowing what the hell you are looking at. 

I'm ok at x-rays and MRIs but having seen a recent ultrasound of my abdomen I had no idea if they were looking at liver, kidney, spleen or I'm 8 months pregnant

aroominyork

I think, DullGreyGuy, you are conflating clinical signs and diagnostic tests. Unless a pet lawyer is on the forum, perhaps we have knocked this back and forth as much as we usefully can. PS Congrats - you are never too old.

DullGreyGuy

aroominyork said:
PS Congrats - you are never too old.

Not too old, but the wrong sex