Fetch, Incorporated

We would like to thank *** *** for her recent
communication to our attention via the Revdex.com (Revdex.com).
*** ***'s experience with claims
processing was not of our high standard, and we would like to
express our sincere apologies
regarding the customer service *** *** received. We appreciate *** *** providing us the
opportunity to make the situation right and provide an additional review of her
claim. After further review of the
submitted claim (***) we have determined that the claim is eligible for
coverage and a reimbursement check will be sent in the amount of $This
represents the invoices of $and $less the $deductible, charges
for food ($+ $13.50), and charges for diagnostics associated with a condition
that first occurred during the waiting period (Anaplasma test for $91.18)).
Again, we would like to apologize for the customer service *** *** received, and thank you her for allowing us the opportunity
to further investigate coverage of her claim for ***. We hope that she and *** are doing well!

We thank *** *** for bringing her concerns to our attention
via the Revdex.com (Revdex.com). We
appreciate the opportunity to provide an additional review to the claims discussed
in *** ***’ complaint and we would like to take the opportunity to clarify
coverage provided by her
pet insurance policy.After review of *** ***’ claim for her dog *** we have
determined that medical records from *** *** Animal Hospital on July
27, indicate clinical signs (repeatable pain on hyper extension of the
left stifle consistent with cranial cruciate rupture and moderately and
consistently weight bearing lameness on left hind limb) consistent with a left
hind partial or complete cranial cruciate ligament tear. The medical records from The *** ***
Hospital further indicate that the initial onset of left hind non- weight
bearing lameness on January 14, 2016. On
July 13, medical records form *** *** Animal Hospital indicate
“limping intermittently x months” at which point x- rays were ordered and
results indicated a likely left hind cranial cruciate ligament tear. *** ***’ policy for *** incepted on January 4,
2016. Petplan policies exclude coverage
for damage to rupture of the cruciate ligaments where clinical signs occur
during the first six months the policy is in effect. Except coverage is given if a veterinary
examination occurs within the first thirty day of the policy and the medical
records specifically note health knees with no known pre- existing
conditions related to the knees.Specifically, in ***’s case, the first available medical
records after January 4, (policy inception date) was January 14, 2016,
which *** was noted to have left hind weight- bearing lameness. This lameness, according to the medical
records was intermittent for months until it was fully investigated and as a
result determined to be consistent with a partial for completed cranial
cruciate rupture of the left hind limb.
As the clinical signs first started within the first six months of the
policy, cranial cruciate ligament is excluded from coverage. The pertinent part of the Terms and Conditions are referenced
below:IDefinitions Used Throughout This PolicySome
words or phrases in the policy have been defined belowDefined words or
phrases are printed in bold type and have the following meanings, unless a
different meaning is described in a particular coverage or endorsement.Clinical Signs
Changes in your pet’s healthy
state, its bodily functions or behavior (as observed by any individual, or recorded in your pet’s medical
record).Pre-existing Condition(s) A medical
condition which first occurred or showed clinical sign(s) before the effective date of this policy or which
occurred or showed clinical sign(s) during the policy waiting period.Treatment(s) Any
veterinary care and prescribed medications administered by a vet in treating your pet’s injury or illness.VGeneral ExclusionsThe
following exclusions apply to your policy and coverage partsWe will NOT pay costs you incur for your pet in the
following categories:g Any treatment associated with
damage or rupture of cruciate ligaments, luxation of the patellas or other soft
tissue disorders of the knee where clinical sign(s) occur during
the first six (6) months that the policy is in effectExcept coverage is given
if your pet is examined by a vet within the first thirty (30) days of
the policy and the medical record specifically notes your pet does not have any pre-existing conditions relating to the knees.h. If your pet has received treatment for a cruciate or soft tissue injury to
one knee during the first six (6) months of the policy (where no certification
of knee health has been provided as described in Section V.g.) then the other
knee is automatically excluded from coverage for a period of twelve (12) months
from the date of last treatment to the affected knee.i. If your pet has received treatment for a cruciate or soft tissue injury to
one knee prior to policy inception then the other knee is automatically
excluded from coverage for the longer period ofitwelve (12) months from the date of last treatment to the affected kneeiithe first six (6) months that the policy is in
effect, as per Section V.g.j If your pet has shown clinical signs of a cruciate or soft tissue injury to one knee prior to the
effective date of this policy or during the first six (6) months of the policy
(where no certification of knee health has been provided as described in
Section V.g.) and appropriate treatment has not been performed, then the other knee is automatically excluded from
coverageOnce appropriate treatment has been performed, the other leg is excluded from coverage for a period of
twelve (12) months from the date of last treatment to the affected leg.We hope that this better clarifies *** ***’ concerns
surrounding coverage provided by her pet insurance policy and we hope this
finds *** *** and *** doing well

Complaint: ***
Thank you for the response, and the clarification, explanation, etcbut
it doesn't address the issue of the premium cap Per your last
response, *** ***’s policies were previously affected by a renewal
premium cap factor At the time of our most recent filing, this factor
was removed; therefore, *** ***’s policies are also increasing as this
renewal cap is no longer in effect."My dog turned in June
2015, BEFORE your most recent filing, yet his March premium under
the previous underwriter was not capped, the premium increased $239.08, I
was overcharged for his March policy renewal.Regards,
*** *l***

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,
*** ***

I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
The claim has been processed and PAID
Regards,
*** ***

We would like to thank *** *** for communicating her concerns via the Revdex.com (Revdex.com). We had an opportunity to speak with *** *** and discuss her concerns surrounding her Petplan policy. We were able to work with *** *** to determine a policy structure that makes
sense for her. If *** *** has any additional questions or would like to discuss further we are always available (###-###-####)

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I
have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me.
Regards,
*** ***

We have received *** ***’s concerns surrounding her
recent claim. We would like to thank *** *** for presenting her concerns and allowing Petplan provide additional
insight into our policy coverage*** *** indicates concern surrounding Petplan’s
congenital
coverage. Petplan does
provide coverage for congenital conditions, except when clinical signs that are
related to, resulting from, and/or caused by the condition were first observed
prior to the policy inception.
Specifically, in *** ***’s case her dog *** presented to the
vet for “strong urine odor” and was treated for a urinary tract infection on
March 16, prior to policy inception (policy inception April 7, 2015). ***’s condition continued and she was again
treated for a urinary tract infection on May 20, 2015. On May 20, during ***’s appointment
for another urinary tract infection additional diagnostics were performed to
determine the underlying cause of ***’s persistent and recurrent urinary
tract infections. According to the
medical records, at this appointment corrective surgery for a left ectopic
ureter with mal- development of bladder sphincters was discussed to treat
***’s persistent and recurrent urinary tract infections.The pertinent part of the Terms and Conditions are below:
IDefinitions Used Throughout This Policy
Some words or phrases in the policy have been defined below
Defined words or phrases are printed in bold type and have the following
meanings, unless a different meaning is described in a particular coverage or
endorsementClinical Sign(s)
Changes in your pet’s healthy state, its bodily functions or behavior
(as observed by any individual, or recorded in your pet’s medical record)Congenital Defects or
Abnormalities Any condition(s) or
disorder(s) present at and existing from the birth of your petVGeneral Exclusions The following general exclusions apply to your policy and coverage partsWe will NOT pay costs you incur for your pet in the following categories:
fCongenital defects or abnormalities where clinical sign(s) were apparent prior to the effective date of the
policy or that became apparent during the first fourteen (14) days beginning on
the effective date of your policyRegarding *** ***’s concerns surrounding the customer
experience she received. We have
reviewed the calls referenced in the complaint and have determined that at no
time did we indicate that congenital conditions were coverable in cases where
clinical signs of the condition were present prior to policy inception.
We sincerely appreciate *** *** providing her
feedback and apologize for any perceived miscommunication. We would like to refund the remaining portion
of *** ***’s premium. *** *** will be receiving an additional $

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is somewhat satisfactory to me. Regardless that you didn't admit, you as the business, practiced deceptive policiesYour systems also did not process a change to my payment information in May 2016, even though I have a screen shot of the acceptance Based on both of these, I accept the payment, but have cancelled my policy effective 7/25/I refuse to deal with a deceptive company who can't see the mistake they made, but blame the customer.
Regards,
*** ***

We reached out to *** *** and we were able to speak with him on November 4th, 2016. We have provided the attached to supplement our conversation with *** ***

[A default letter is provided here which indicates your acceptance of the business's
response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me, BUT ONLY AFTER THE Revdex.com WAS INVOLVED!
Regards,
*** ***

We would like to take this opportunity to thank *** *** for bringing her concerns regarding her policy to our attention via the Revdex.com (Revdex.com)We are sorry to hear about *** ***’s experienceWe appreciate *** *** advising Petplan of her address changeWe were previously unaware
of this change, but we are now able to confirm we have the correct addressWe have made *** ***’s address change effective her past renewal of December 23, As a result, we have reassessed *** ***’s March 25, and April 1, claims and they are now subject to a single $deductible*** *** will be receiving a claim check for $On May 10, we have attempted to reach out to *** *** via phone to discuss her concernsWe have not heard back from *** *** at the time of our responseWe encourage her to contact us if she has any additional questions and we would be happy to assistWe are available 24/at ***

This response is in reference to the Revdex.com (Revdex.com) concern submitted by *** ***We would like to take the opportunity to address and reassure *** *** regarding his concerns
We would like to assure *** *** that the issue he experienced was an isolated technical issue that
was immediately rectified and continues to be closely monitoredAdditionally, we have attempted to contact the other policyholder, however, the information was no longer validWe would like to take the opportunity to thank *** *** for bringing his concern to our attention; for it is with feedback, like *** ***’s, that allows us to ensure a positive customer service experience
We sincerely apologize for *** *** recent customer service experience and we assure him that the matter has been rectified and will continue to be monitoredIn addition to the original $gift card offered to *** ***, we would like to offer an additional $gift card, for a total of $Again, we would like to thank *** *** for taking the time to bring this concern to our attention so that we can improve our customer experience based on his valuable feedback

Be careful pet lovers when you get insurance for your beloved 4-legged babyAll of them will claim they give the best coverage, convenience in payment etc,etcBe very careful and diligent when you have the monthly payment scheduled for them to collect thru your bankBeen with GOPETPLAN for years only been paid back for measly claim, but found out I've been charged times for a particular monthNow I'm trying to check all my bank statements going back as far as I can getTheir excuse, computer glitchUNACCEPTABLE !!!!
They have the guts to tell you, if you cancel now, you wont be able to re instate ...w/o condition this, condition that

[To assist us in bringing this matter to a close, you must
give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed as Answered]
Complaint: ***
I am rejecting this response because:***'s reported "GI Issues Since Obtained" was purely a non-medical observation on the behavior of a month old kitten who was scared out of her mind when first acquired by myself. Having losing cats only months before, I was paranoid that something may have been wrong with ***, and I was unaware of the behavior patterns of a month old kittenInterpretation of these few words has definitely divided the opinions of Petplan and myself.It is very unlikely that a month old kitten who had received a clean bill of health days before my acquisition developed a GI issueIt still amazes me that Petplan has made no attempt to contact my vet, Dr***, to discuss ***'s initial medical examinationDr*** had also submitted a letter to Petplan indicating that *** had no GI issue what so ever, she received a clean bill of healthMy paranoid observations had no correlation to a suspected GI issue.I am requesting a third party, professional, non-biased individual(s) to become involved and make a ruling on this caseI would also request that my vet become contacted so she may give her professional medical opinion as to ***'s medical conditional upon my acquisition
Regards,
*** ***

Because I did respond to the compliant stating that I believe they should refund my original charge due to the fact there was nowhere online stating that I needed to get a physical in days After receiving $for the year never once did they say I am suppose to get a physical Only until a year later when I submitted bill did they say I needed a physical in days They had no problem taking my money at the start and there was no where it was stated I had to get a physical, until a year later when they saw I submitted a $bill then told me they cannot honor the bill So I really never had pet insurance This is a senior pet insurance site and should make it very clear to seniors in writing that they need a physical in days. I want my original amount spent refunded since I never really had pet insurance to begin with They had no problem taking my money. Thank you for your help! *** *** *** ***

We would like to thank *** *** for bringing her concerns via the Revdex.com (Revdex.com) to our attention.
*** ***’s claims have been reassessed after review of the appeal submitted to Petplan. It was determined that *** ***’s claims were eligible for reimbursement based on the updated statements provided by her veterinarian. We are pleased that we were able to come to a favorable resolution
*** *** also discusses concern surround the calculation of her claim. We would like to take the opportunity to provide some additional clarity regarding claims processing. Per the Terms and Conditions of *** ***’s chosen policy the co-pay will be applied to the total eligible costs (after removal of any invoice items not covered by the policy [i.efood, routine/ preventative care, etc.]) charge(s) submitted for reimbursement. After the copay is applied the deductible will be subtracted. Please refer to the pertinent part of the Terms and Conditions below (IVCo-pay and Deductibles):
IDefinitions Used Throughout This Policy
Some words or phrases in the policy have been defined belowDefined words or phrases are printed in bold type and have the following meanings, unless a different meaning is described in a particular coverage or endorsement
Co-pay(s) The percentage of your claim for which you are liable before any applicable deductible is applied
Deductible(s) The fixed amount per illness or injury per policy period that will be deducted from any benefit
payment made to you, after any co-pay amount has been deducted, for which you are liable prior
to receiving any claims settlement
IVCo-pay and Deductibles
For each illness or injury that is treated during the policy period and that is not related to any other illness or injury during the same policy year, you will pay an amount of co-pay and a deductible as stated on
your declarations page
The co-pay percentage will be deducted from the total of all costs for a covered illness or injuryOnce the co-pay has been applied, the deductible will be applied to the remaining amountThe deductible will be applied separately to each separate medical conditionWhen the treatment dates of an illness or injury fall into two or more policy periods you will be required to pay a deductible for each policy period
As an example, if you have a covered claim of $1,to which a ten (10) percent co-pay and $deductible apply, first the ten (10) percent co-pay is applied and $is deducted from the covered amountThen the $deductible is applied and taken off the covered amountThis means that out of the original $1,000, we will reimburse you a
total amount of $
In addition to the application of the deductible and co-pay, there are total limits on our insurance per policy period as set forth on the declarations page as maximum annual benefits(See also Section VI.)
In the event that your pet receives specialized treatment or treatment from a specialist vet, a twenty (20) percent co-pay (or thirty (30) percent if you have elected a thirty (30) percent co-pay), as stated on your declarations page, will automatically apply to covered claims, except if treated for an immediate life-saving emergency consultation
Please note italicized portion for emphasis
If *** *** has any additional questions we would be happy to assist her. Our Happiness Managers are available hours a day days a week at ###-###-####

On December 13, we called Mr*** to discuss his concerns and discuss the outcome of his claims assessment. We will continue to be working with Mr*** for future claim submissions. If Mr*** has any further questions or concerns we are available 24/at ###-###-####

---------- Forwarded message ----------From:
"">Revdex.com of Metro Washington DC Date: Wed, May 7, at 12:PMSubject: Fwd: You have a new message from the Revdex.com of Metro Washington DC & Eastern Pennsylvania in regards to your complaint #[redacted].To: [redacted]
---------- Forwarded message ----------
From: [redacted]
Date: Wed, May 7, at 10:AM
Subject: RE: You have a new message from the Revdex.com of Metro Washington DC & Eastern Pennsylvania in regards to your complaint #[redacted]
To: "[email protected]"
I received a response from the company on 04/29/14, in which they completed their review of my pre-auth requestI am satisfied with the completion of the requestThe ticket can be closed on my end

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
 Complaint: [redacted]
I am rejecting this response because:
Regards,
[redacted]