Advice - Petplan - Refusing Claim

[Ycryan]

Hi

I need some sound advice from fellow dibbers as I'm so angry and upset not to mention emotional about my experience with Petplan. (I'll apologise now as this may turn into a long post).

I've got a Bernese Mountain Dog puppy and took the 4 week free insurance with Petplan through my vet when her 5 week free Kennel Club Insurance expired. On the 3rd week of the free insurance policy she was admitted to the Vet School in Glasgow and had to spend the night. Long story short she had been swallowing balls of fur from my other Bernese which completely blocked her up and as a result she was screaming trying to poo. This caused an ≈≈≈≈ pro lapse because she had been straining to go to the toilet. The bill was just over £700.

4 weeks after the claim was submitted to Petplan I still hadn't received a refund (I had to pay part of the treatment up front) and called them to be told they weren't paying the claim because they were classing it as a pre existing condition (she was 15 weeks when it happened).

When she was 9 weeks I had to take her to the vet as she had a tiny lump on her bottom which was causing discomfort when she was doing a poo. The vet had never seen this before, particularly in this location. She gave me an antibiotic steroid cream and by the time I went back to my usual vet the following week he confirmed that it was completely gone.

Petplan are saying that this lump she had was an ≈≈≈≈ pro lapse and therefore this was a pre existing condition that she had before I took out the policy with them and they are not paying out the claim and also have applied exclusions to my policy for this.

I raised a dispute and a complaint as the wording from my vet about the original condition (little lump) in no way stated it was an ≈≈≈≈ pro lapse and it is absolutely nothing to do with her eating a bunch of hair and needing a clear out and stitches to repair the ≈≈≈≈ pro lapse. My vet sent an e-mail with additional information to support the dispute.

This was the week before I went to Florida! All I received from Petplan before I left was an acknowledgement e-mail to my complaint.

I just got back from Florida yesterday and there was 3 letters from Petplan waiting for me, all declining my claim. I've also received another e-mail from the complaints team a few days ago saying they are still investigating my complaint and it could be 14th October before I receive a response from them.

I feel absolutely sick, angry and frustrated and I just can't believe that such a well known, well thought of Insurance company such as Petplan who charge exceptionally high premiums are behaving in this way.

I am going to call them tomorrow to clarify why they still think the two issues are the same condition but get the feeling I will be banging my head off the wall. Also I don't know the wording of the e-mail my vet sent to support my dispute.

I renewed the 4 weeks free cover onto the annual policy while I was waiting for them to process my claim as I was worried that this may be an ongoing thing and I wanted to make sure I was covered. Petplan are charging me £84 per month for the premiums and this is only for the £4000 lifetime cover. I just feel like I'm being robbed and I'm paying significantly higher premiums compared to other insurers and I'm not even covered for this condition!

I'm not prepared to let this go despite the amount of stress this is causing because I believe Petplan are being dishonest by linking a completely unrelated issue with this claim to save them from paying out. If I need to I will take them to the Financial Ombudsman.

Also if they had processed my claim in a timely manner I would have been able to cancel the annual policy within the 14 days and receive a refund of any premiums paid. As it stands I have currently paid 3 monthly payments of £84.00 in the time it has taken them to review my claim and review my dispute.

I'm also annoyed with them that 2.5 weeks after the claim was submitted they contacted me to say they didn't have the full clinical history for Lily. When I queried this they said that my vet had only provided details from the 29th May, nothing prior to this. I explained this was because she was a PUPPY who was only 7.5 weeks old and I only got her 2 days before I took her to the Vets on the 29th May for a full check up and her 1st vaccination. This just struck me as delay tactics and it hasn't got any better as time has gone on.

Apologies for the long post, I just need some advice because I'm getting myself into such a state about it and feel physically sick every time I think about it and I'm dreading contacting them tomorrow, mainly because I feel so emotional about it.

I've already had an e-mail a few weeks ago from the Vet School looking for payment as they were advised by Petplan they had refused the claim. I did e-mail them back and explained I was in dispute as I didn't want them to think I was delaying their payment.

Any advice desperately appreciated.

Thank you for reading. x

[arielrocks]

write a clear timeline of events and keep it updated. Go back to Petplan saying their response thing frame is unsatisfactory and you can’t financially afford to be out of pocket for something they need to resolve.

Then complain to the ombudsman.

Do not use Petplan!

Try healthypets, they have always been fantastic.

[bernard301]

To be honest you have done the right thing, your vet has sent information to support your claim and yet they have still disputed it and refused the claim your only recourse will be to go to the Financial Ombudsman Service once the disputes procedure is complete.

I would also settle up with the vet ASAP. while they may be sympathetic with your situation they may still chase you for the full amount and apply other fees for late payment that you may not be able to recover. (I always make sure vets bills go on one of our loyalty/air miles card to ensure that we get maxiumum points, last year my springer hit our sign up bonus in one go with one of his little indiscretions)

With regards your current cover, you can still cancel the policy at any time so long as you've not claimed on it, you wont get your first 3 payments back, but you will at least be able to go to another insurance company ASAP (although don't forget many have 2-4 week cooling off periods where they do not provide cover)

[ziggyzag]

I would pay the vet school, and get Petplan to pay you back. I was in dispute with an Insurance company with a horse that had to go to a vet school. They said they were willing to wait (lol) but slapped on interest which topped up the orginal bill by £800 (the insuarance company eventually paid half of the interest as a good will gesture)

[Mackenzies03]

My dad has just had a lot of issues with Petplan and thankfully caught then out in their emails as they had contradicted themselves. Read everything very carefully and try to deal with different people as then they are more likely to slip up. Hope puppy is feeling much better x

[WhereIBelong]

I would also remember that if you go elsewhere for cover you will still not be covered for any recurrence as this will now be a pre-existing condition.

As previous posters say... best bet is ombudsman after all avenues have been explored with PetPlan.

[borntoshop]

Would the vets be able to confirm to petplan that they are wrong. If need be I'd go to the ombudsman.

[skalexander]

I would ask the treating vet to address whether it linked to the previous issue, and if not I would complain. If that gets you nowhere, go to the Ombudsman.

More Than refused a claim for radiotherapy for our Cocker Spaniel as it was in France, even though the treatment was better for his cancer, not available in the UK and cheaper than the inferior treatment available in the UK. The Ombudsman told them to pay out in full.

[RickT]

£84 a month for a puppy ? and that's before the next renewal ? something is not right there.

[Guest]

Originally Posted by RickT

£84 a month for a puppy ? and that's before the next renewal ? something is not right there.

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I used to work for a pet insurer (not this one). Puppies are expensive to insure, it is when they are most likely to have health issues uncovered. Pedigree dogs are more expensive to insure than cross breeds or mongrels. £84 is quite high, but I would not say that something is not right.