hedge hunter 1984 Posted April 14, 2014 Report Share Posted April 14, 2014 My 20 month old springer over the last few weeks has slowly started to drink more water to the point I will fill the bowl full of water and she will almost drink it all of it at once (other than that she is fine and still as mad has a hatter) So I took her to the vets. After tests and ultra sound the vet has told me she has most likely got a shunt (liver problem). So if this is the case she will need a scan to see if the shunt is internal or external at a cost of £800 then depending on which shunt it s the operation is from £3000 to £5000. The vet did say that my dog has had this from birth and will of formed when she was inside her mum!! Insurance So I got on the phone to the insurance explained what was going on to which couple of phone calls later I got told that its classed as a "pre existing condition" there for my dog isn't covered for the treatment! So really what is the point of having insurance! Its not the 1st time I have heard of insurances getting out of paying. If the last lot of test come back saying it is 100% a shunt then im going to have to make the hardest decision of my life as I cant possibly afford that can of money! Quote Link to comment Share on other sites More sharing options...
wj939 Posted April 14, 2014 Report Share Posted April 14, 2014 Might be worth speaking with the PDSA not sure they will help but you may find a reduced cost if it's a life threatening Condition and they look at your situation. I'd speak with BASC legal team, they may advise you if the insurance company are unfairly rejecting a claim. Quote Link to comment Share on other sites More sharing options...
kent Posted April 14, 2014 Report Share Posted April 14, 2014 insurance work fuels raised prices in all types of work and the insurers will wriggle out of paying out on many claims, working animals are hardly ever fully covered if working Quote Link to comment Share on other sites More sharing options...
Fal Posted April 14, 2014 Report Share Posted April 14, 2014 (edited) How can something you've never claimed for in the past be a pre-existing condition? If it was something you knew about and told the insurance company when getting a quote or taking out the policy surely then it would be? I can't see how somehting that hasn't been claimed for in the past can be a pre-existing condition? Edited April 14, 2014 by Fal Quote Link to comment Share on other sites More sharing options...
Fatcatsplat Posted April 14, 2014 Report Share Posted April 14, 2014 Poppycock - A pre existing condition is one that you were aware of and either did or did not disclose. This is the first diagnosis - It's covered. When did you buy the policy first? When did the problem first manifest itself as a problem? Don't bother with BASC yet - Ask the broker/insurer on what grounds they are denying the claim utilising as pre-existing conditions exclusion clause. How is the pre ex worded in the policy? Quote Link to comment Share on other sites More sharing options...
hedge hunter 1984 Posted April 14, 2014 Author Report Share Posted April 14, 2014 (edited) How can something you've never claimed for in the past be a pre-existing condition? If it was something you knew about and told the insurance company when getting a quote or taking out the policy surely then it would be? I can't see how somehting that hasn't been claimed for in the past can be a pre-existing condition? Hi That's just what I asked them pal to which the reply was "the dog has had this illness since birth so that is classes it as pre existing illness! The insurer must of got this information from might vet as I didn't tell them Poppycock - A pre existing condition is one that you were aware of and either did or did not disclose. This is the first diagnosis - It's covered. When did you buy the policy first? When did the problem first manifest itself as a problem? Don't bother with BASC yet - Ask the broker/insurer on what grounds they are denying the claim utilising as pre-existing conditions exclusion clause. How is the pre ex worded in the policy? Hi I have had the policy since she was a pup pal she came with for week free insurance then when that ended I changed insurers.It only really became a problem about a month ago or so. I have asked the insurer to which the reply was (as above) The thing is I don't think I have the time to go down the road of a legal battle to get the insurer to pay and unfortunately I don't have the money to pay for the op then take the insurer to court. Looking on the internet I am not the only one who has had this problem. Edited April 14, 2014 by hedge hunter 1984 Quote Link to comment Share on other sites More sharing options...
Medic1281 Posted April 14, 2014 Report Share Posted April 14, 2014 Who is she insured with? I've just dropped my dog off at the vets for a cruciate ligament repair, looking at the thick end of £1800 for that. Insurance with more than pet insurance and they have agreed it, so I guess I'm lucky. On a side note, it's bloody horrible leaving her at the vets!! Quote Link to comment Share on other sites More sharing options...
timd999 Posted April 14, 2014 Report Share Posted April 14, 2014 Poppycock - A pre existing condition is one that you were aware of and either did or did not disclose. This is the first diagnosis - It's covered. When did you buy the policy first? When did the problem first manifest itself as a problem? Don't bother with BASC yet - Ask the broker/insurer on what grounds they are denying the claim utilising as pre-existing conditions exclusion clause. How is the pre ex worded in the policy? I completely agree with Fatcatsplat. Was the advice given over the phone? If so, you may be being fobbed off by a call handler with little or no knowledge of veterinary issues. I would: Read your policy very carefully; Conduct internet research to establish how similar cases have been successfully challenged - knowledge is power! Contact your insurer and make make it abundantly clear that this is a newly diagnosed condition and the policy was taken out in good faith aeons ago, and critically before the vet diagnosed a shunt; Seek advice from your vet. He/she may be able to support your stance; Challenge your insurer's original opinion and ask for clarification on their formal appeal procedure. Appeal; If this fails, seek legal advice and ask the Financial Ombudsman Service if it will arbitrate over your case (contact details on internet); I really do wish you the very best of luck. Quote Link to comment Share on other sites More sharing options...
dougall Posted April 14, 2014 Report Share Posted April 14, 2014 escalate to claims manager,a pre-existing condition is one where there has been previous diagnosis or claim,such a clause is fairly standard insurance clause but is not a basis for avoiding a perfectly valid claim..for an insurer to take that line is a joke,which insurer is it? Quote Link to comment Share on other sites More sharing options...
Fatcatsplat Posted April 14, 2014 Report Share Posted April 14, 2014 Can you name the Insurer please (or at least their trading name) - I'd love to take a look at their wording. Quote Link to comment Share on other sites More sharing options...
wj939 Posted April 14, 2014 Report Share Posted April 14, 2014 Can you name the Insurer please (or at least their trading name) - I'd love to take a look at their wording. I'd be interested to read their terms. Pre existing conditions will need a definition in your contract of insurance, that will decide the legality of their rejection. Your vet may have mistakenly informed them it was not an initial diagnosis. If your BASC member the advice will be free, a legal letter from them supporting you might sway your insurers mind. Quote Link to comment Share on other sites More sharing options...
stuart21 Posted April 14, 2014 Report Share Posted April 14, 2014 Both elbow and hip dysplasia are genetic, but insurers do pay out for this, so I do not see how they cam claim it is a pre existing condition. From my understanding a pre existing condition would be if you took your dog to the vet a year a go and it was suspected, but it has only been confirmed now. I find that my vet is very helpful in helping me argue with the insurer, but do check with your insurer as I stupidly only took an annual illness policy and not a lifetime one. Quote Link to comment Share on other sites More sharing options...
Cookie69 Posted April 18, 2014 Report Share Posted April 18, 2014 Don't mean to hijack this thread But on the subject of insurance ,, If you bought a fully trained dog for example £1800,,, you can I imagine insure him for that amount? If you bought a dog for £450 and then spent £1200 on training after, can you insure The dog for £1650?? Apologies if this is a silly question Quote Link to comment Share on other sites More sharing options...
Medic1281 Posted April 18, 2014 Report Share Posted April 18, 2014 I'm sure you can pick a policy to cover your needs. My dog is a pet so I've got no financial investment in her as such. But after a £2000 vet bill this week, I've found the insurance is worth every penny! Without insurance I would have had the hardest decision ever to make. Quote Link to comment Share on other sites More sharing options...
Radar_uk Posted April 18, 2014 Report Share Posted April 18, 2014 I would certainly go back to the insurer and ask for it to be escalated - my understanding is a pre-existing condition is something you are aware of when taking out the insurance Quote Link to comment Share on other sites More sharing options...
wj939 Posted April 18, 2014 Report Share Posted April 18, 2014 Don't mean to hijack this thread But on the subject of insurance ,, If you bought a fully trained dog for example £1800,,, you can I imagine insure him for that amount? If you bought a dog for £450 and then spent £1200 on training after, can you insure The dog for £1650?? Apologies if this is a silly question Yes you can. You insure the value of the dog, should mine be stolen, fatally injured or die of illness before age 9 I receive the full amount I paid for her. Quote Link to comment Share on other sites More sharing options...
Sprocket Posted April 18, 2014 Report Share Posted April 18, 2014 My 20 month old springer over the last few weeks has slowly started to drink more water to the point I will fill the bowl full of water and she will almost drink it all of it at once (other than that she is fine and still as mad has a hatter) So I took her to the vets. After tests and ultra sound the vet has told me she has most likely got a shunt (liver problem). So if this is the case she will need a scan to see if the shunt is internal or external at a cost of £800 then depending on which shunt it s the operation is from £3000 to £5000. The vet did say that my dog has had this from birth and will of formed when she was inside her mum!! Insurance So I got on the phone to the insurance explained what was going on to which couple of phone calls later I got told that its classed as a "pre existing condition" there for my dog isn't covered for the treatment! So really what is the point of having insurance! Its not the 1st time I have heard of insurances getting out of paying. If the last lot of test come back saying it is 100% a shunt then im going to have to make the hardest decision of my life as I cant possibly afford that can of money! Can you please let us know which insurance company you have used. If nothing else, it may help others on here wasting their money by using the same robbing so and sos that you have. Quote Link to comment Share on other sites More sharing options...
Fal Posted May 1, 2014 Report Share Posted May 1, 2014 Any news on this lads, very interested to know what has happened since? Quote Link to comment Share on other sites More sharing options...
Berettacocker Posted May 7, 2014 Report Share Posted May 7, 2014 I've heard lots of stories about pet insurance not being payed out, mainly to anyone with working dogs. What I do is open an account and put £50 a month in,if you need a vet the cash is there, if not it's still there!. Remember pet insurance is not a legal requirement and you don't get a rebate for not claiming!! Atb Darren Quote Link to comment Share on other sites More sharing options...
Glenshooter Posted May 7, 2014 Report Share Posted May 7, 2014 I've heard lots of stories about pet insurance not being payed out, mainly to anyone with working dogs. What I do is open an account and put £50 a month in,if you need a vet the cash is there, if not it's still there!. Remember pet insurance is not a legal requirement and you don't get a rebate for not claiming!! Atb Darren Yep. I do the same and it's worked well over the years. Quote Link to comment Share on other sites More sharing options...
Vipa Posted May 7, 2014 Report Share Posted May 7, 2014 (edited) That is utter *******... for it to be classed as a pre existing condition there has to be some knowledge of said condition.. there was none therefore they cannot pull that one on you.. As an example, if I sold someone a life insurance policy who, unbeknown to them had say an aortic annurysm (usually symptomless) and then 5 years later it bursts and they die... the insurance company could not wriggle out of it based on the fact it was pre-existing! If it is worst case and they wont budge take them to the Ombudsman the chances of them finding against you are slim and it wont cost you a penny! the problem you have is that with all the PPI claims and claims companies clogging the system up, it could take the FOS 6 months to a year or more to look at your case! Edited May 7, 2014 by Vipa Quote Link to comment Share on other sites More sharing options...
Bogwoppit Posted May 8, 2014 Report Share Posted May 8, 2014 (edited) I work in the insurance industry myself and I have to say, on face value, what they are saying is uttter bo*****cks. However, you can't just go back to them and say 'bo***cks'. You need to escalate the claim within the insurance company, call them back and if they still say they are rejecting it straight away then escalate it within tthe company. Your vet should be able to help you out here too. Don't be tooo quick to accept their forst or second offer (especially if it's nothing). Bw Edited May 8, 2014 by Bogwoppit Quote Link to comment Share on other sites More sharing options...
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