Pet Insurance Won't Pay

Sprite1100 · 13 November 2018 at 5:53PM

Hi,

Thank you for checking out this post.

We recently added a small french bulldog puppy named Peanut to our family. When we purchased the puppy, we received 35 days free pet insurance from the date of purchase (28 August 2018) with a private company.

I received a call from the private insurance company 1 week prior to expiration of the cover to ask if i wanted to carry on with the policy. As the cover was £120 per month i decided not to proceed and look elsewhere.

The day the cover expired (01 October) i was away on a business trip and my partner was looking after Peanut. She called me to tell me that Peanut had caught her leg whilst jumping through the conservatory door and that she couldn't put any weight on her foot. My partner then phoned the vets and scheduled an emergency appointment that day.

The vet examined peanuts leg and said to bed rest her for the night and if it hadn't improved by the next afternoon, to bring her back in for an x-ray.

I returned home the next day and the problem had not improved so i took Peanut back to the vets where they carried out an x-ray at a cost of £430 (02 October).

I phoned the private insurance company to discuss the situation and the customer service advisor explained that because Peanut was taken to the Vets on 01 October and they had a record of this, then she WOULD be covered for any treatment related to that injury.

I have since submitted a claim to the insurance company but they have declined the claim due to the following reasons.

"Cover is available for 35 days form the start of your policy on 28 August 2018. As your policy has lapsed, there is no cover available for the treatment 02 Oct 2018 for Peanut's lameness."

I have checked the terms & conditions for the policy which states. 'We will not pay any treatment received after the 35 days covered by this policy.'

Does anyone have any advice on how i should contest this claim? I don't have any legal background so not sure what the next move should be.

Thank you for reading.

Kindest regards,
Sprite

tacpot12 · 13 November 2018 at 6:55PM

If the policy says that it will not cover any treatment provided after 35 days, then it really was a very limited policy - even if Peanut had had an accident on 29th August, the policy still might not have covered all the costs of the treatment (if treatment needed to continue after 1st Oct.). So legally, the insurance company is allowed to refuse the claim.

So I don't think you have a very stong legal case. But you might be able to find a moral case on which to argue the issue. I think that had you known this was how the policy was worded, you might have arranged your own cover more urgently. I would suggest that you write to insurance company saying that you wish to complain about their decision and that the relevant wording was buried deep in the policy. You can work the advisor's mistake into the complaint; you can suggest that you might have acted differently if the advisor had given you the correct information. You could make the case that if even the insurance company's advisors are confused what chance does a consumer have.

I would suggest that you offer to settle your complaint if the insurance company shares the cost of the claim with you. (50/50 seems fair to me as you did have time to sort out a replacement policy, and this policy was free).

Hopefully they will see the opportunity to close the complaint promptly and cough up something.

Hope this helps and that Peanut makes a full recovery.

sheramber · 13 November 2018 at 10:27PM

This is free cover supplied when you get a new puppy. It is for a limited time to cover anything that arises immediately after purchase and saves arguments with the breeder as to who is liable for something that happens in the first few days.

Of course, the insurance hope that you will then continue the policy.

The benefit is that any condition that has arisen during the free period will be covered by the ongoing policy. whereas if you take out a policy with someone else that condition will be classed as a pre existing condition and excluded .

You should be aware there is also an exclusion period ( often 14 days) when you take out a new policy for any new illness arising during that time..

Any treatment on the 1 October is covered by the free policy but to have cover for any further treatment at a later date you would need to have renewed the policy so that you had continuing cover.

You cannot claim for a period when you do not have cover.

If you had taken out a new policy with a different company then any further treatment would be excluded as it is now a pre existing condition, having occurred initially before you took out the policy.

Pet Insurance Won't Pay

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