Question for vet re insurance

PoGee

I adopted an older kitten (had been returned twice to sspca by previous adopters) in 2012. Clean bill of health till 2016 when a young vet had said she heard a heart murmur and wanted to do tests. The cat was fine - no sign of discomfort, breathing issues or reduced activity. At the time I felt she wanted me to pay for unnecessary tests. Same practice, more experienced vet next year said - no heart murmur. Been to a few vets each year for vaccinations, different practices who all said - no murmur but because of the 2016 vet, I put down he had been flagged up with a murmur, when taking out insurance in 2019. I took it out then, as our younger insured cat was shot with an air gun around that time.
Forward to 2024, older cat had an abscess. Took to emergency vet as became unwell over weekend. Vet said 'no issues with heart, no murmur'. Took him to regular vet for follow up, who said heart was too fast but not same as heart murmur so the extra x-ray will be covered under insurance as not the same condition.
But when I checked the insurance small wording, it says no heart conditions covered. This is the first time I'm claiming.
Can I argue that it was just one inexperienced vet who picked up the murmur and all other vets said that there is/was no murmur?

elsien

You have nothing to lose. You could ask the vets to confirm via their records, that there hasn’t been no sign of a heart murmur picked up since 2016. They will ask why you declared it in 2019 if you were aware it wasn’t an issue. 


You do need to be reading your specific insurance though and any recorded exclusions when you get the renewal each year, for exactly this reason. It’s easier to get it changed before you need to claim. 

Mine had an exclusion for all foot conditions due to repeated cysts. I queried it because I said if he got a cut foot that was in no way related to the skin issues. They did then change the condition to tighten it up. 

Another  had sarcoptic mange when I got her so again they put an exclusion on. When I queried how long the exclusion would stay on for they agreed to remove it if she’d been clear of any other skin issues for two years and that was confirmed by a vet.

Both of those were before I needed to claim and that may well be the difference.

FlorayG

Nope. Insurance clearly says no heart conditions covered; it's irrelevant whether the cat HAS a heart condition or not or was ever diagnosed with one. Pet insurance will always put as many exclusions as they can get away with

elsien

FlorayG said:

Nope. Insurance clearly says no heart conditions covered; it's irrelevant whether the cat HAS a heart condition or not or was ever diagnosed with one. Pet insurance will always put as many exclusions as they can get away with

I do think that depends which insurer you with, as some are more amenable to discussion than others. 

PoGee

Thanks for reply. Re 2024 follow up visits with regular vet, I'd questioned why they jumped to possible heart issues whilst he was still fighting off the infection. It was a bad one as his left side of face was distorted and v puffy. I'd asked that he be given a repeat antibiotic injection, as advised by the emergency vet, monitor, and then recheck heart once he'd fought off the infection. 
If I took my niece to the GP with a high temperature, and said - I want cardiology tests as her heart was racing, the GP would think i was nuts.
(the vet wanted to do a referral to cardiology but I said no as chest cavity x-ray normal...no enlargement of heart + he still hadn't fought off the infection.)
The regular vet last year was an older vet but with the abscess, a newly qualified one.

PoGee

It's Petplan

PoGee

FlorayG said:

Nope. Insurance clearly says no heart conditions covered; it's irrelevant whether the cat HAS a heart condition or not or was ever diagnosed with one. Pet insurance will always put as many exclusions as they can get away with

They only put the exclusion on due to my documenting the murmur, which according to most recent vets, was a misdiagnosis.

elsien

PoGee said:

It's Petplan

They are one of the better ones. I would try but more in hope than expectation. And also ask what you would need to do to get the condition changed in future, if they would agree to reconsider?

KxMx

PetPlan will sometimes remove exclusions if there hasn't been a problem for 2 years.

I had success in asking for this with regards to my late cat (dental).

I wrote to them stating:

When I took out the policy I made you aware a Vet mentioned she would need teeth cleaning. You excluded all dental.
Cat has recently been under GA, I asked Vet specifically to examine teeth and they said all okay no work needed.
No work has ever taken place on her teeth. 
As it's been over two years please could the exclusion be removed.

I don't know if they checked with Vet but soon after they sent a new policy with the exclusion removed. 

PoGee

Thanks for replies. The heart murmur is sometimes there, but not noted most yearly visits. It was noted in 2016. Present vet looked at previous vets notes - last noted 2020 but I wasn't told about that. I usually ask vet to note anything they pick up, on the immunisation card, like it was noted in 2016.
My question is why they would disclude ANY heart related issue on the basis of an intermittent murmur. These can also be caused if the cat is stressed eg due to vet visit or being in cat carrier on journey to vet.
If a human has health insurance and has glaucoma as a pre-existing condition (understandably not covered by the policy) but then goes onto develop a retinal detachment or conjunctivitis (after policy commences), one would expect the retinal detachment or conjunctivitis to be covered. I doubt the eye as a whole would be removed from being covered, on the basis of the pre-existing glaucoma.
I know I should've questioned this when I took out policy. The 'fast heartbeat' noted alongside the abscess (2024), complicates things so not sure if worth contacting Petplan now.

sheramber

Blanket exclusion is because that is easier than investigating  whether a new condition is related in any way to the original diagnosis.

e.g would the vet have done an xray if the cat hadn't the previous diagnosis of a heart murmur?