Fetch, Incorporated

We thank [redacted] for providing additional feedback
regarding her concerns surrounding her Petplan policy.  We would like to take the opportunity to
review each of [redacted]’s concerns.[redacted]’s Concern:“The
plan also rejected reimbursement for vet claims due to diarrhea in said animal.
 When asked about this, policy representative said that the paperwork was
not submitted by veterinarian ([redacted] Animal Hospital).  When consulted
about claim issuance, veterinarian office said they had submitted claim.
 When speaking to another representative, they said submission was
insufficient.  I requested a copy of what was sent to PetPlan and
resubmitted veterinary claims with information obtained from veterinarian which
had a complete list of diagnoses and medications.  PetPlan still rejected
this information and said it was insufficient and then requested an additional
2 years of vet history from April 2015.”Petplan Response:[redacted] submitted a claim on March
10, 2015 for an incident date of February 23, 2015 for veterinary fees related
to diarrhea.  To date Petplan has
received medical records from University of [redacted] for an examination on
April 11, 2015 and medical records from [redacted]’s primary veterinarian from
May 26, 2011- April 16, 2014.  Petplan
requested medical records and laboratory results from April 2014 through April
2015 in order to complete the processing of [redacted]’s claim for [redacted];
please note this request includes the medical records for the date of service
claimed.  Once Petplan receives the requested
medical records and laboratory results we will be able to complete the
assessment of [redacted]’s claim for [redacted] and determine coverage.  At this time we have not rejected or approved
[redacted]’s claim submitted for veterinary fees related to diarrhea.    “For
premium adjustments, at no point was it made clear that yearly assessment would
significantly increase the premium.”  Petplan Response:Petplan premiums do not increase based on claims
activity.  Petplan insurance, as with all insurance, can have premium
increases.  Preimums are determined by three standard factors:
breed, age and area and three factors 
the policyholder influences: deductible, copay and annual limit.  The combination of breed, age, area, and
policyholder selected dedutible, copay and annual limit determine the annual
premium.  Petplan policies are
customizable with regards to copay, deductible and annual limit.  Policyholders have the ability to influence
their preimum by adjusting the copay, deductible and annual limit, effectively
increasing or decreasing the overall preimum. 
If [redacted] is interested in receiving additional quotes to determine a
preimum that is more acceptable to her, we would be happy to assist.

[redacted] [redacted] [redacted]
 Complaint: [redacted]
I am rejecting this response because:
I do not feel they are working with me and my vet to resolve this issue. My vet waited since Thursday to get a call from their vet. She finally reached out to them to no avail. According to their vet they don't consider clinical signs to be the same as the medical field do.  They make up their own interpretations and don't believe anything my vet tries to get across to them. When my puppy was first bought she put a note in the chart to monitor her development as she was small and she has Maltese in her. This type dog can have a condition called liver shunt so my vet put this note in the chart so any other vet at her hospital that might see my dog monitored her weight. She does this with a lot of small dogs mainly yorkies and Maltese.  PetPlan is trying to say because she was small and a finicky eater she showed clinical signs of a shunt. My puppy's food had just been changed when I bought her a few weeks before   My puppy gained weight exactly like she was suppose to and my vet would put that she is doing great in the chart.  Eight months later when it was time to spay her my vet did blood work.  It's hospital policy to do this on any dog less than five pounds. My dog had elevated bile salts indicative of a liver shunt. My puppy saw a specialist that also charted she had no other signs other than lab work. She will now go to university of Tennessee ion November 1st for more test and possibly surgery.  PetPlan is refusing to pay for anything related to any liver disorder. If my puppy had signs of this in December 2015 why would we wait this long to treat her?  I had no idea the note was even in her chart until I got copies of my vet notes for this claim.  PetPlan has a reputation according to all the online complaints to deny claims siting préexisting disorders. They take anything the vet might put in a chart and turn it around to fit their purpose. They took out around $85 from my bank account then two days later knowing they were going to reject all the claims submitted that I had appealed.  My vet and I are both disgusted with their tactics and clear disregard for the pets they insure   They keep calling saying the claims are denied but maybe they can work something out with me but never do anything.  This company should not be allowed to continue to exploit people's pets that they love and consider family.  I'm heartbroken and trying all I can to get the money together to help my puppy. I have already spent about $1000 as she is now on numerous medications and special food. This behavior should not be allowed to continue and it's hard to believe they have an A rating yet the Internet had nothing but negative posts about the way they take people's money and leave their pets with no protection. I always felt my little dog was protected in case she got hurt or sick but I now see that Peyplan had no intention of protecting her.
Regards,
[redacted]

We had an opportunity to reach out to [redacted] directly and assist her with the concerns she addressed in her Revdex.com complaint.  At this time her concerns presented in her Revdex.com complaint have been resolved.  We look forward to continuing to work with [redacted].

We would like to thank [redacted] for bringing his concerns
regarding his policy to our attention via the Revdex.com (Revdex.com) and
would like to take the opportunity to provide some clarity.
Petplan requires all pets to have an examination within 12
months prior to policy...

inception.  If an
exam has not been documented within 12 months prior to policy the first
available documented examination after the effective date of the policy will be
used as the basis for determining any pre- existing conditions.  Any conditions or clinical signs found during
this examination will not be eligible for coverage.  Please refer to the pertinent part of the
Terms and Conditions below (VVI. General
Conditions, 7, b.)VII. General Conditions7. CARE FOR YOUR PETa.
In order for your policy to remain valid you must take care of your
pet and arrange and pay for your pet to have the following:i. An annual health check.ii. An annual dental exam.iii. Any treatment normally suggested
by a vet to prevent illness or injury.b. If your pet has not been examined by a vet within the twelve (12) months prior to the effective date of the policy you must arrange to have your pet examined at your own
expense after the effective date of the policy. The first documented
examination after the effective date of the policy will be used as the basis
for determining any pre-existing
conditions. This section applies to both new policies and continuous policy
years where your pet has not received the care described
in Section VII.7.a. For the avoidance of doubt; if your pet does not
receive its annual health check during a period of continuous coverage, the
next examination will be used as the basis for determining any pre-existing conditions.Specifically, in [redacted]’s case, after review of the
information provided, the last available examination for his dog Marley
occurred on July 25, 2014 greater than 12 months prior to the policy inception
of October 22, 2015.  Medical records on
November 24, 2015 (first documented medical record after the effective date of
the policy) note a diagnosis of diabetes; as such, per the Terms and Conditions
diabetes and conditions caused by, related to, or resulting from diabetes are
not eligible for coverage.  The claims
submitted for “diagnosis of diabetes” are not eligible for coverage.[redacted] also indicates concern regarding the information available
online prior to the purchase of a policy. 
To ensure everyone who visits our website can be fully informed we have
the Terms and Conditions available for review: (http://www.gopetplan.com/terms-and-conditions-explained)
The website further explains the Terms and Conditions to
ensure a comprehensive understanding of the policy.  Specific to [redacted]’s concerns examination
requirements are explained:
We took the opportunity to reach out to [redacted] regarding
his concerns in an effort to discuss [redacted]’s desired outcome (request of a
full refund) as outlined in the Revdex.com complaint. 
[redacted] indicated that he would consider it; however, at this time he
did not accept our offer of a full refund.

I received phone  message along with email  from Heather in regards to my full adjustment which I emailed to advise ok. 
Regards,
[redacted]

We would like to take this opportunity to thank [redacted] for bringing his concerns to our attention via the Revdex.com (Revdex.com). We are sorry to hear about [redacted]’s experience.   We can appreciate [redacted]’s concern with the timeframe of his claim completion. When a policyholder...

files their first claim with Petplan, we typically ask for two years of medical records prior to having a policy with Petplan. We absolutely understand that would not be reasonable if a pet is now nine months old. We would simply ask for all medical records available from the first exam to present.   We have reached out to [redacted]’s veterinarian and received all his pet’s medical records. [redacted]’s claim [redacted] has been assessed and a letter will be mailed today, June 22, 2017. His claim did not meet his chosen $300 annual deductible, but with his 90% reimbursement rate, $160.20 has been applied toward his annual deductible.   [redacted] has chosen to cancel his Petplan policy and a pro-rated refund of $374.73 has been issued back to his credit card on file. Due to [redacted]’s frustration with his claim, we will allow him to reinstate his policy for continuous coverage as long as the refunded premium is collected by June 28, 2017.   On June 21, 2017, we have attempted to reach out to [redacted] via phone to discuss his concerns. We have not heard back from [redacted] at the time of our response. We encourage him to contact us if he has any additional questions and we would be happy to assist. We are available 24/7 at [redacted].

We thank [redacted] for bringing her concerns to our attention via the Revdex.com (Revdex.com).  We have reached out to [redacted] to discuss her concerns and discuss her pet insurance policy coverage.  We are in the process of working with, and will continue to work with [redacted]...

[redacted] to resolve her concerns. 
We invite [redacted] to continue to work with us directly.  Our Happiness Managers are available 24 hours a day 7 days a week and can be reached at [redacted]

This is in reference to the Revdex.com (Revdex.com)
complaint submitted by [redacted].  We
would like to take the opportunity to thank [redacted] for bringing her
concerns to our attention.  [redacted]’s Concern #1:“In purchasing
[redacted] supplement for my pet advertised...

on box was free trial for pet
insurance.  In signing up for this it
states by upgrading would be given [redacted] for $25 in 30 day of signed up which I
signed up 12/10.  Never received this
gift card.”Response:After receipt of the Revdex.com complaint we researched [redacted]’s policy for [redacted].  We found
that [redacted] set up a free policy using the [redacted] promotion; and also,
purchased a full policy using the [redacted] promotion.  These policies were incepted on the same day
and each have a separate and distinct promotion.  Our third party vendor regarding the [redacted]
promotion previously sent [redacted] an email to verify her address.  According to our records, her address has not
been confirmed.  We have requested the
company provide the promised promotion to [redacted] at the address provided at
the time of policy purchase. Regarding the [redacted] promotion, our systems did not
recognize an upgraded policy as the full policy was purchased with the [redacted]
promotional code.  We have sent [redacted] a $25 [redacted] gift card as promised in the [redacted] offer.[redacted]’s Concern #2:“…also in submitting
claims was told no reimbursement since there is a 14 day wait yet upon
purchasing you are required to pay 1st month and last month ahead of
time.  My feelings on this matter then
the insurance should be in affect immediately.”Response:Petplan policies have a 14 day illness waiting period and a
24 hour accident waiting period. 
Conditions where clinical signs are first observed during the aforementioned
and respective waiting periods are not eligible for coverage.  Additionally, Petplan policies do not provide
coverage for pre- existing conditions, or conditions where clinical signs were
first observed prior to policy inception or during the aforementioned waiting
periods.  Specifically, in the case of
[redacted], we received two claims (periodontal disease and hepatopathy).  After review of claim [redacted] for periodontal disease the
medical records provided indicate that [redacted] was found to be afflicted with
dental disease in July of 2014.  As
clinical signs consistent with periodontal disease were present prior to policy
(policy inception November 30, 2014), and [redacted]’s policy does not provide
coverage for pre- existing conditions coverage could not be extended for claim
[redacted] for periodontal disease.After review of claim[redacted] for hepatopathy the medical
records provided indicate that [redacted] was found to be afflicted with elevated
liver enzymes on December 11, 2014 (Day 12 of the 14 day illness waiting
period).  As clinical signs were first
observed during the 14 day waiting period for illnesses, and conditions consistent
with clinical signs found during the waiting period are not eligible for
coverage, reimbursement cannot be extended for hepatopathy.[redacted]’s Concern #3:“Upon recently
cancelling was told reimbursement would be pro rated and received adj of
roughly $90 recently.”Reponse:[redacted] requested cancellation of her policy on March 5,
2015.  Per the Terms and Conditions of her
policy any cancellation request 30 days after policy inception is subject to a
pro- rata refund.  Specifically, in [redacted]’s case this entitled her to $90.09, which was refunded on March 10, 2015
to the credit card on file.

This communication is in response to the complaint presented by [redacted] via the Revdex.com (Revdex.com).  We would like to take the opportunity to thank [redacted] for the concern presented in her inquiry. Since receiving this message we have contacted [redacted] via a voice message...

offering our additional assistance and to review our findings on the audit of the renewal email.

We appreciate Mr. [redacted]’ continued communication with us. While we understand Ms. [redacted]’ concerns regarding her denied claim, all our claims are assessed using pet’s medical records from their veterinarian. The records we’ve received from [redacted] dated September 30, 2017 (within the first fifteen days beginning on the effective date of your policy, as well as the first examination of record), indicate Ms. [redacted]’ pet was seen for coughing and diagnosed with a suspected upper respiratory infection. He was treated [redacted]. The coughing persisted and her pet continued to visit both [redacted] and [redacted] for a respiratory infection   While we cannot reimburse Ms. [redacted]’ claim per the terms and conditions of her policy she may cancel her policy anytime. Our service manager called her 12/27/17 and again today 12/28/17 leaving a voice message to provide direct assistance.  To date we have not heard back. We encourage her to contact us if she has any further questions or concerns. We are available 24/7 at [redacted]

9/4/2014
We would like to thank [redacted] for his recent feedback provided via the Revdex.com (Revdex.com). After review of [redacted]’s complaint, we woul like to take the opportunity to address his concerns and provide clarity surrouding coverage provided by the...

policy for [redacted].Customer Concern #1: “Ref. [redacted], Pet plan, I bought a health insurance # [redacted] for my daughter’s dog [redacted] but Pet plan denied all claims. Any claim put by my daughter for [redacted] was denied on the base of preexisting condition. Our dog had diarrhea that started 24 hours after the effective date, it is preexisting condition. The diarrhea was from eating food she was allergic to. Explain to me how Diarrhea a common symptom of many diseases is a preexisting condition?”Response #1: Petplan policies have two waiting periods; a 24 hour waiting period for accidents and a 14 day waiting period for illnesses. During these waiting periods, if clinical signs (e.g. diarrhea) are observed during the applicable waiting periods, future coverage (for conditions that are consistent with the clinical sign that occurred during the waiting period) cannot be extended. Specifically, in the case of [redacted]’s claim, [redacted] exhibited diarrhea during the 14 day illness waiting period, subsequent exam dates for [redacted] indicated progression and chronicity, indicative of an underlying cause to [redacted]’s recurrent diarrhea. Per the policy Terms and Conditions any condition (medical illness or accident) that first shows clinical signs during the applicable waiting period is considered pre- existing and not eligible for coverage.
Customer Concern #2: “I would like you to listen to the conversation I had with the seller while purchasing the insurance for [redacted] to show you pet plan used this as a strategy not to reimburse clients. I authorize access to this communication with the seller by the Revdex.com.”
Response #2: Our licensed sales agents are required to discuss waiting periods and provide answers to any questions our clients may have during every call. Additionally, access to the Policy Terms and Conditions which describe the definition of pre-existing conditions are available through our website prior to purchase (http://www.gopetplan.com/terms-and-conditions-explained), and the full range of policy documents is available after purchase through the online account portal (https://account.gopetplan.com/). To offer as much clarity as possible, the subjects of waiting periods and pre-existing conditions are also specifically addressed in at least two places on the website; http://www.gopetplan.com/terms-and- conditions-explained and http://www.gopetplan.com/faq/petplan-policies Customer Concern #3: “[redacted] was suspected having IBS in July or August, months after the effective date. They say IBS is a preexisting condition, they do not want to reimburse. [redacted] was a healthy dog (see all previous consultation at [redacted] Animal Hospital). Unfortunately Pet Plan refused all reimbursement, denied all claims and kept taking money from my bank account for services not provided. I appeal the decision and one of their employees (Lauren) requested more information. I authorized F airport animal hospital to provide [redacted]’s file to them. Here is what happen: On august the vet ordered some lab work and [redacted] cannot tolerate her regular diet. She thinks [redacted] may have IBS, we spent our money to treat the dog and submitted our claim which was denied. The years 2013 and 2014 have been a disappointed time for [redacted].
Response #3: Petplan policies cannot provide coverage for illnesses that first show clinical signs during the first 14 days after the effective date of a policy. The Petplan policy for [redacted] started on April 28, 2013. The medical records provided by [redacted] Animal Hospital indicate that [redacted] presented to the vet on April 29, 2013 with a presentation of “diarrhea for about three week”. [redacted]’s diarrhea continued through the policy waiting period, and on June 22, 2013 [redacted] again presented for “still having diarrhea.” These clinical signs continued to progress and diagnostics indicate inflammatory bowel disease (IBD). As the current condition is consistent with clinical signs of chronic diarrhea, and this was noted during the 14 day waiting period for illnesses (and, indeed, the records indicate this had been present for up to three weeks prior to the policy starting), this conditions is not eligible for coverage as it is considered pre- existing per the policy Terms and Conditions.Customer Concern #4: “I spoke to Meagan about double payment in April 2014. She said at each renewal time or anniversary date they take one month extra which I was not aware of.”
Response #4: During the initial purchase of a policy 18% of the annual premium is charged. The 18% ultimately reflects the first and last payments of the policy, therefore, [redacted] was not charged the month prior to policy renewal.Customer Concern #5: “To resolve the problem, I would appreciate the Revdex.com mediate for me to have my check or all my contribution back because there is no point to have insurance if the dog is not insured.”Response #5: Petplan has provided insurance coverage to **. [redacted] per the Terms and Conditions of the policy. Our liability extends to any illness or injury covered under the policy for the insured period. Unfortunately, the claimed condition is not a coverable condition because it falls under the definition of a pre-existing condition. This does not negate the fact that coverage has been provided as contracted. However, since no claims have been submitted for the policy year starting April 28, 2014, we are happy to refund the premiums paid in this policy year thus far, as follows:Date Paid Premium 04/28/2014 $ 94.77 05/28/2014 $ 44.88 06/28/2014 $ 44.80 07/28/2014 $ 44.80 08/28/2014 $ 44.80 $ 274.05Please find below excerpts from [redacted]’s medical history which were used in the determination of the submitted claims:

RE: Revdex.com Complaint [redacted]
We would like to take the opportunity to thank Ms. [redacted] for bringing her concerns surrounding policy changes to our attention. We would like to take the opportunity to address Ms. [redacted]’ concerns. 
Recently, Petplan underwent a change in underwriters and with...

this some changes to our policies occurred.  Our previous underwriter decided they no longer wanted to underwrite for pet insurance.  As a result, we needed to find a new underwriter that was willing to take on our risk.  Our risk is ongoing (chronic disease coverage), we wanted to make sure that our new underwriter would assume coverage for all of the currently covered medical conditions for all of our policyholders.  Unfortunately, finding an underwriter that was willing to assume this required us to make some policy changes and an increase in premium price. 
We can certainly appreciate how this would be a shock and we are dedicated to working with our policyholders to find a policy that will work for everyone’s individual needs; the new policies we created are completely customizable for this reason. 
We have attempted to reach out to Ms. [redacted] multiple times via phone and also via email.  We have not had success in discussing her policy with her.  We encourage her to reach out and speak with one of our Happiness Managers at ###-###-####, so that we can better assist Ms. [redacted] with her needs.

[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 Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because:While I understand your position, but I still feel I deserve a refund. I suppose we are just going to have to agree to disagree. 
Regards,
[redacted]

We would like to thank [redacted] for bringing his concerns regarding his policy cancellation to our attention via the Revdex.com (Revdex.com) and appreciate the opportunity to address his concerns. We would like to apologize for any confusion regarding Petplan’s cancellation process. We are...

able to provide a full refund if a policy is cancelled within 30 days of the policy effective date. As [redacted]’ policy renewed on April 14, 2017, the 30 day cancellation would need to have been made by May 14, 2017. I can certainly understand the confusion as [redacted]’ policy cancelled effective May 1, 2017 since we were unable to collect his annual payment at the time of his renewal. [redacted]’s then chose to reinstate his policy and pay his annual premium on May 30, 2017. At that time, his pet’s policy was then reinstated and active. We did not hear back from [redacted] until June 28, 2017 when he decided to cancel. Since [redacted] has had conversations with multiple Petplan representatives and there was misunderstanding regarding our cancellation process, we have issued a full refund of his recently renewed policy. His policy has been cancelled effective his renewal date of April 14, 2017. On June 30, 2017, and July 6, 2017, we have attempted to reach out to [redacted] via phone and email to discuss his concerns. We have not heard back from [redacted] at the time of our response. We encourage him to contact us if he has any additional questions and we would be happy to assist. We are available 24/7 at [redacted].

[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 [redacted], and find that this resolution is satisfactory to me. 
Regards,
[redacted]

[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 [redacted], and find that this resolution is satisfactory to me. 
Regards,
[redacted]

[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 Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because: the insurance is twisting facts and making up senerios  that did not happen. They have several years of [redacted]'s records and it's easy to seen he has been nearly the same weight and is still the same weight. I never told the vet he was vomiting or had weight loss. I don't know where that came from. He was taken to the vet for his foot the first time and nearly a dozen more visits all related to the foot injury. 
I took my dog to the vet for a foot injury PERIOD. While I was there they gave him vaccinations that were due that I did not expect the insurance co to pay for. The vet drew labs because they said they had to have them before they would put him under anesthesia for biopsies of his foot. Because they were drawing blood already I asked them to do a heart worm check to save the dog from another blood draw at a later visit, again, I did not expect the insurance to pay for the heart worm test.
If Pet Plan has decided not to pay me per our insurance coverage agreement, then I feel I have the right to have a complaint filed  against them. 
I paid for a policy for coverage that they have decided not to reimburse me for. I have been cheated out of several hundred dollars. 
[redacted]

Revdex.com:Thank you so much for assisting me with this complaint (ID [redacted]) and facilitating a resolution in such a timely manner.  According to the response from PetPlan (Fetch, Inc.), they've done exactly as I asked and I'm satisfied with the result.   [redacted]

[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 Administratively Resolved]
 Complaint: [redacted]
I am rejecting this response because:
Regards,
[redacted]
They never called me multiple times, I can send a call history from my phone service to confirm that. I've called them after they made excuses on how 'they never received the fax' or nothing was time sensitive when it was. They are making false stories just to save their hides. & [redacted]'s condition was not pre-existing when the fee was for testing to see what was going on. I wouldn't reccomend PetPlan on my worst enemy's pet & would have no problem letting the media know of their scam of a company.

This is in response to the Revdex.com (Revdex.com) complaint presented by [redacted]. We appreciate [redacted]’s concerns and would like to provide him and explanation regarding his claims assessment and reimbursement.
[redacted] has expressed frustration regarding his policy coverage. We...

would like to assure [redacted] that all of his claims have been reimbursed at his chosen coverage: 100% reimbursement and a $50 deductible. We would like to remind [redacted] that deductibles are applied per condition, per policy term. Additionally, any invoice items that are not covered via the policy have been excluded during claims processing (e.g. food, routine anal gland expressions, etc.).
We would like to take the opportunity to provide a detailed explanation of [redacted]’s claims outlined in the Revdex.com complaint:
• Claim [redacted]: Includes invoices from September 18, 2014 related to vomiting and diarrhea. These fees came to a total of $697.64; after $35.09 was removed for food and applicable tax and application of the chosen co-pay (0%) the total amount eligible for reimbursement is $662.55. Payment in the amount of $330.04 was authorized on December 1, 2014. Additionally, payment in the amount of $200.00 was authorized on March 26, 2015. We have determined that an additional $132.51 is owed to [redacted] and have authorized payment in the aforementioned amount.
• Claim [redacted]: Includes invoices from October 11, 2014 relating to vomiting and diarrhea. These fees came to a total of $220.40; after $34.55 was removed for food and applicable tax and application of the chosen co-pay (0%) the total amount eligible for reimbursement is $185.85. Payment in the amount of $185.85 was authorized on March 26, 2015.
We would like to apologize to [redacted] regarding his customer service experience and thank him for bringing his concerns to our attention. We appreciate his feedback, for it is for feedback like his that allows us to improve our customer service experience going forward.