Pet Insurance Not Paying Out

Chrispy90 · 30 July 2019 at 11:28AM

Hi there,

My name is Chris and my dog's name is Roxi. Her insurer is Direct Line and they are refusing to pay for her lump removal for 2 reasons.
- There was a previous condition that she had tartar on her teeth and vet recommended dental cleaning. The lump was under a tooth.
- The diagnosis was in Poland and even though the procedure in the UK, they said they don't cover anything outside of the UK.

I can't afford this honestly and I don't know what to do. I think it's unfair that they're not paying out and would like advise on how to fight it, or if there is no point.

Thanks and Kind Regards,
Chris

sp1920 · 30 July 2019 at 4:31PM

Hi Chris, if the vet recommended tarter removal and you had this procedure carried out, I can’t see that they have any grounds to refuse. If you didn’t, they probably do - every pet insurance policy I’ve had requires an annual dental check to be carried out and acted on. If no luck you could try the PDSA though I think they means test before they help you these days. Good luck.

KxMx · 30 July 2019 at 6:55PM

I'm guessing because of the previous dental advice, oral and mouth are now excluded? And that is why the lump claim has been rejected?

I was with Pet Plan for my Cat and had similar. Because of previous dental advice an exclusion was placed. However after she had been treatment free for 2 years with annual check ups, I successfully got the exclusion removed.

Direct Line may consider this if the timing is right. Worth a try.

Might there be a

Chrispy90 · 30 July 2019 at 7:04PM

Thanks,

I carried out the dental cleaning (not asking that to be covered) and during the cleaning is when the vet found there to be a lump. We then returned to the vet in the UK to have the lump removed. Reviewing the history, the lump was caused by a gingivitis, discovered by biopsy. So there was no way of knowing before the procedure.

Is there any chance of fighting this? Should I suck it up and pay? How would you move forward?

Kind regards,
Chris

sheramber · 30 July 2019 at 7:24PM

Can you explain why the first treatment was done in Poland?

Was this before you took out the insurance with Direct Line?

Claddagh_Noir · 30 July 2019 at 7:25PM

Hi Chris,

You can try and fight it but any time you go to the vet, they note everything, no matter how trivial. I realised that when I asked for my pet's notes. My vet a couple of years ago wrote that my dog was aggressive and needed to be muzzled when he was being looked over in the vet's office. He was actually a bit aloof because the vet was a stranger, he wasn't a threat.

See if you can request the complete notes for your pet.

All the best.

Chrispy90 · 30 July 2019 at 7:48PM

The teeth clean was done in Poland because it was cheaper and wasn't going to be covered by insurance anyway. I have full notes from the vet now. She was insured before the teeth cleaning- after the initial health check when we rescued her.

sheramber · 31 July 2019 at 9:54AM

When you are not happy with your insurances decision you should follow the complaint procedure.

https://www.directline.com/complaints

I would recommend you complain in writing stating it is a complaint. Keep a copy.

Pet Insurance Not Paying Out

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