Fetch, Incorporated

Review: I have had pet insurance with gopetplan for many years. In April 2014 my dog was injured and his left paw quickly became infected, did not respond to treatment from two local veterinarians and have to be seen by a specialist, requiring the dog to be put under anesthesia for multiple biopsies. All information and receipts, Dr notes etc. has been provided to gopetplan. Per my coverage in the policy I have a 200.00 deductible and 10% co-payment for all related bills to the injury, treatments, medication etc. Gopetplan has made many excuses and has not paid me in full, still owing me hundreds of dollars ( not including an addition claim faxed June 13, 2014). I have requested twice in writing for an audit/ review to be done on my claims and an itemized statement of how much was paid for each receipt submitted. I have also twice asked the gopetplan representative who keeps calling me for the same audit/review, and Itemized statement of payment and she tells me Ok she will send it and I have not received anything in writing.I ahve also continue to ask can I provide anything further information, she has said no.I believe they have no intention of paying me what is owed to me per my policy and would still like the money owed to me and the statement I have requested four times.Desired Settlement: I want the audit review I has requested four times,and money owed to me per my policy agreement.(In addition to the new receipts/Dr notes submitted/faxed on June 13, 2014)

Business

Response:

07/01/2014We would like to thank [redacted] for her communication regarding her recent customer service and claims processing experience via the Revdex.com (Revdex.com).[redacted] has requested a complete explanation and breakdown of all claims for her pet, [redacted], regarding claims from as early as April 19, 2014 to the present. We sincerely apologize that this had not been provided previously, as requested by [redacted].During our review of claims associated with the veterinary services performed on April 19, 2014 it was determined that there was an error in the allocation of split charges. However, this error resulted in a more favorable reimbursement for [redacted] than would otherwise have been the case, so the error has not been remedied. For claims submitted for multiple conditions (in this case : vomiting/ weight loss ([redacted]), limping/ injured paw ([redacted] and [redacted]), lump ([redacted]) and preventative care ([redacted])) where invoice items can apply to more than one condition, the invoice item amount is divided between all related conditions. In the case of services provided on April 19, 2014 the examination fee should have been divided by four conditions, applying $12 per condition. As this did not occur, [redacted] actually received a better reimbursement on future claims related to these conditions.We have provided below a breakdown of services for all of [redacted]’s claims as they have been historically processed.Records indicated that [redacted] was afflicted with several ailments; therefore, the claim was divided into four conditions/ claims according to the medical records:Invoice Date 4/19/2014 Invoice Total $528.63$528.63 The chosen policy has 10% co-pay and a $200 deductible. As displayed in the table above, none of the eligible charges for the aforementioned conditions meet or exceed the chosen $200 deductible so, for this invoice, no reimbursement is due. However, future eligible charges for the same condition in the same policy period will be applied to the $200 deductible (see below).Petplan also received a claim on May 5, 2014 for veterinary exams on April 28, May 1 and May 3, 2014, follow up treatment for [redacted]’s limping/ injured paw (claim [redacted]).The claim referred to in your Revdex.com complaint ([redacted]) for veterinary fees on June 5 and June 11, 2014 was received on June 16, 2014 and processed on June 17, 2014; a reimbursement check in the amount of $203.22 was sent on June 18, 2014. This claim was processed at a 90% reimbursement rate (10% co- pay) and there were no excluded invoice items. If this check has not been received we encourage [redacted] to reach out to us directly to have this rectified.Regarding [redacted]’s request to cancel her policy, we will gladly oblige to her request, if she wishes to proceed with this process. We would like to take the opportunity to remind [redacted] that all future coverage for [redacted]’s coverable conditions after the date of cancellation will be ineligible for reimbursement, including any future, unforeseen illnesses or injuries.We apologize again for any inconvenience caused to [redacted], and hope this communication answers any outstanding questions.Many thanks,Elyse DClaims Manager

Consumer

Response:

[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] Review: [redacted]I am rejecting this response because: The insurance is trying to separate the lab work and other claims and medications from being directly related to the foot injury. On the very first claim, the veterinarian recommended lab work should be done due to the dogs age, in anticipation of having to put the dog under anesthesia to do numerous biopsies,( which was done within 2-3 weeks due to the foot not responding to medication). Also, the antibiotics caused diarrhea and all three veterinarians who treated the dog said he should be on probiotics while on antibiotics, to help with the diarrhea, which it did. The insurance did not pay for either box which was purchased at the vet office. Lastly, they have left out much of the claims information and have very selective in what was sent to you.

After all this time, 6 or more requests, I still have not been provided with a complete itemized list of each visit and what they paid.

Per our agreement the insurance company has revived a payment every month, on time because they deduct it form my credit card. I provided every receipt from the vet, current records, Dr notes, and two years of vet records as they requested. However when it came time to pay a claim, they have cheated me out of hundreds of dollars of reimbursement money that was directly related to the foot injury and infection.

Regards,[redacted]

Consumer

Response:

[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]

Review: [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.

Review: I received a letter of claim denial and the explanation does not apply to us. We applied for coverage on 12/27/13. The coverage inception date on our policy is 12/28/13. There is a 24 hour waiting period for injuries, and the injury occurred on 12/29/13 around 6pm which was more than 48 hours from the application time as well as over 24 hours from policy inception date, therefore the exclusions you pointed out do not apply to this injury. Please update this claim and process. I understand that this was a freak accident considering that we had just purchased the policy and we were definitely not expecting this. We had just moved into a new house that has a doggie door on the back door leading down from the second story. My wife stated that our dog was going to get hurt the way he was running up and down the stairs. I opted to buy insurance at that time. I understand your not wanting to pay the claim however I plan on keeping this insurance for years to come so please follow the policy provisions and process the claim.

Thank you,

[redacted]Desired Settlement: I wish for them to honor the contract and pay the claim.

Business

Response:

Thank you for the recent communication via the Revdex.com (Revdex.com). We appreciate feedback regarding the recently submitted claims regarding [redacted]’s fractured right foreleg.

Review: I received a mail advertising about a pet insurance program that said they will insure your animal with any pre-existing condition. I contacted the company by phone and their representative said that for a few pre-existing conditions is a waiting period of 6 months and she listed all the conditions that we have to wait for that period in order to get full coverage with the pet insurance plan. After that 6 months period, everything will be cover. I decide to enroll my 2 dogs in December of 2010. I did not presented any claims during the 2 + years that my pets were insured under pet plan, even if my dogs visit the vets for their periodical vet checks. One of my dogs had a ear infection (on his right ear, the same ear that got infected before I was insured with petplan) and I paid for all the vets bill and the dog was cure with in a few weeks. That same dog about 8 months later encounter another ear infection (this time on his left ear). We treat the infection and this time was a bit more severe than the first one because we did not realized about the infection earlier enough and his ear infection was more infected than his previous infection.

I contacted the pet insurance and ask how to submit a claim. They explained to me and after a couple of month and his treatments been all finalized, I submitted the claim. Now Petplan is saying that they are not going to pay my claim because my dog had a pre-existing condition. I contacted my vet and they said that is absurd on an ear infection because they mentioned a pre-existing condition. The vet said with any infection, if the pet is not completely cure, he will lose his hear and if we do not treat he will have an internal infection and will end up dying. So obviously that his previous ear infection were all cured and my dog just contracted a new ear infection. My dog is a bloodhound and ear infections on that type of dogs is very common.

I already have paid to the pet insurance over than $2,500- on premiums and never submitted any claim. On my first claim that I tried to submit, they are giving me the round around to don't pay my vet expenses. I feel like I been scam by this insurance company. Besides on their initial phone conversation, they were very clear that after 6 month of waiting period, everything will be cover. I paid their insurance premium for over than 2 years and they do not pay my claim.Desired Settlement: The pet insurance pay my vet insurance claim

Business

Response:

Thank you for your recent communication regarding the assessment of claim number [redacted] for [redacted].

Review: I currently have three policies with PetPlan for my dogs. Over the last 3 years the percentage increase in the policies has been disproportionate compared to most other forms of insurance (e.g., car, home, life, health, etc.). I spoke with [redacted] on the evening of 20SEPT who explained that premium rates are based on three factors: age, breed, and location. The latter two have not changed, so I'm focusing on age. Unfortunately he was not able to explain how age specifically is used to determine premiums. Are there age brackets or yearly age increase-based? The most troubling part is that I was told PetPlan submits premium rate changes to each state who then makes an assessment. Why are the states being given a say in this? I understand if the state was perhaps helping to pay a percentage of my annual premium, but they have literally no stake or care if a premium increases by 1 or 10%. This year I'm looking at nearly $500 in overall premium increases on top of roughly the same from last year. My concern is there is literally no mechanism of control or actual stop to future increases at the same--or more.Desired Settlement: I would like to understand:

- Are premium increases that are derived by age done in brackets or each year?

- Why are individual states given a say in premiums and not the premium holders (customers)?

- Why do the annual contract forms not specify the increases in more detail (this is not transparent and very poor customer service)?

- What is essentially stopping PetPlan for charging me $500 or more--maybe $1000 more next year, when there is literally no basis for this percentage of an increase?

- What governing bodies regulate the pet insurance industry to ensure a monopolization of sorts are not adversely impacting a free market?

- How many other policy holders have complained about the premium increases?

- Does the PetPlan governing board understand these impacts and condone them?

- Why can't PetPlan alert customers of severe premium increases more than 30 days? While some may not see them as gross in nature, a $500 increase is very large and certainly hurts when it comes to adequately budgeting.

Business

Response:

Thank you for your recent communication regarding your Petplan policies. Pet insurance rates (and rate increases) are based on the relative risk of the pet. As pets age, their relative risk increases, so premiums typically increase yearly. In addition to this, rates may increase due to increases in veterinary spending; often as a result of more advanced treatments and medications, increased availability of specialty and referral medicine, and veterinary fee inflation.

Review: Declined claim [redacted] (due to pre-existing condition) for our insured pet was requested to be reassessed twice - the same condition was diagnosed and covered by previous claim back in 2011 by the same pet insurance company, therefore the claim in question wasn't a pre-existing/not covered condition and should have been honored.

Timeline (all 2014):

2/5 - treatment date

3/15 - claim submitted

4/3 - claim denied via letter - no details other than back pain to be pre-existing and not covered condition were provided

4/18 - requested reassessment via phone with Leah L[redacted] based on 2011 covered claim for the same condition

5/22 - email follow up inquiring about the reassessment status

5/28 - voice mail from Lauren/petplan received to call back, followed with phone call to support and talked to Leah L[redacted] again - promised to resubmit again

6/9 - email confirmation from Leah L[redacted], that the claim has been resubmitted for reassessment

6/17 - email followup with petplan to get the status

6/19 - email response from petplan stating that 'additional information from pet's veterinarian hasn't been received'

6/19 - responded to email inquiring if the 'additional information' was requested from the vet directly and for petplan to state what exact information was missing (no response since then)

8/4 - sent email follow up (I confirmed that no info was requested from the vet and no updates to my claim were made on the web first) inquiring about the reassessment status again, requesting clear communication of what missing information is required, when was it requested and by whom; recapped the latest timeline and advised that if no response is received promptly, I'll open a Revdex.com complaint and may consult a lawyer for further action - no response to this request either to date (8/14).Desired Settlement: I'd like for PetPlan to urgently reassess the claim properly with due diligence of reviewing past claims to determine that the condition in this particular claim is/should be covered. If any info from the vet is missing, in addition to all vet notes they already received, I'd like for them to clearly outline what that is so that I can help getting that from the vet to aid in successful resolution and proper coverage of this claim. Due to excessive time lapse and lack of responsible action, I'd like for the $200 deductible fee to be waived as compensation for the trouble. We have a policy coverage of 80% of claim cost w/$200 deductible.

Business

Response:

We would like to thank [redacted] for bringing her recent customer service experience to our attention via the Revdex.com (Revdex.com). Feedback, like [redacted]’s, allows Petplan to continue to improve our customer service experience for all policyholders, including [redacted].

Review: Petplan is an insurance company provides health insurance for pets.A health insurance policy for my dog was established with Petplan back in May 2013. At the time, my dog did not have any medical issue, and never need to see a vet. Starting in Aug 2013 (4 months after the policy was established), my dog needs to see a vet because of diarrhea. A claim was filed and Petplan processed the claim successfully. No payment was made out to me because the claim amount did not meet the deductible.Unfortunately, the diarrhea continues, and the vet had to perform X-Ray, CT scan, and refer to a vet specialist to determine the root cause of the issue, then the medical bills started adding up to over $4000. Petplan declined all the claims, and the reason was "Pre-existing condition". I was surprised with the reason and contacted Petplan to discuss. Then Petplan indicated that under the terms and conditions, I am required to bring my pet for health check within the last 12 months. Otherwise, any medical issue would be considered as pre-existing condition. If there is a pre-existing requirement: 1. Why would Petplan accept the policy? 2. Why would Petplan process the first claim as well?In Oct 2013, my dog has another medical issue, basically air was leaking out from the lung into his body. The vet has been seeing my dog for the diarrhea issue and never noticed any issue with the lung. This issue is definitely not a pre-existing issue. Once again, I am surprised - Petplan also declined the coverage based on the same reason - "Pre-existing condition". The lung issue and diarrhea issue are totally separated, Petplan has no reason to say this is pre-existing.Desired Settlement: 1. The issue here is Petplan processed the first claim, petplan should continue process the remaining claims2. Under Terms and Conditions - Petplan will decline any claims until the health check is completed.- Petplan should not accept any policy until health check is completed- Or Petplan did not send reminders for health checkIn addition, petplan has collecting fee but provide no coverage.3. Petplan declined the second health (lung) issue after the health check is completed

Business

Response:

Thank you for your recent communication regarding the above

referenced policyholder.

[redacted] purchased a Petplan policy for his pet, [redacted], via the

[redacted] website at 3.21 pm PDT on April 12, 2013. This policy went into

effect at 12.01am PDT on April 13, 2013.

An annual health exam is part of routine pet care,

recommended by all veterinarians, in order to monitor a pet’s health and identify

any medical conditions that may not be evident to the pet owner. Petplan does

not require a health exam in order to underwrite a policy, but, in the event of

a claim, it must be evident that a pet has been receiving regular

veterinary care, and that any veterinary-recommended diagnostics or treatment

have been performed. To this effect, Petplan policies require that a pet has

been examined in the 12 months prior to policy inception. If the pet has not

been examined in the 12 months prior to inception, the first exam will be used

as a baseline for any pre-existing conditions, per the policy Terms and

Conditions:

VII.

General Conditions

7.

CARE FOR YOUR PET

a. 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 within the

first thirty (30) days after the effective date of the policy. The examination

will be used as the basis for determining any preexisting 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.

A copy of the policy Terms and Conditions is available on

the Petplan website (http://www.gopetplan.com/terms-and-conditions-explained), and

were also available to **. [redacted] through his online account immediately after he

purchased his policy.

In reference to **. [redacted]’s confusion regarding the linking of

the gastrointestinal and respiratory conditions, the medical history indicates

that the pleural effusion and ascites were both caused by protein imbalances

caused by the chronic diarrhea. In short, chronic diarrhea (and/or the

conditions that cause it) can result in a condition known as protein-losing

enteropathy (PLE). This is identified in [redacted]’s medical history. PLE results in

protein being lost into the intestinal tract. Maintaining correct fluid volume

and pressure within blood vessels and capillaries depends largely on what is

known as “hydrostatic pressure”, i.e. osmotic compounds within the blood

vessels maintain blood volume by maintaining the balance of fluid between blood

vessels and extra-vascular spaces. When blood protein drops low enough, the

osmotic balance can change, resulting in movement of fluid from blood vessels

into areas like the lungs and the subcutaneous space, as happened with [redacted]

(resulting in pleural effusion and ascites).

In summary, **. [redacted]’s pet, [redacted], had not been seen by a

veterinarian in the twelve months prior to policy. Per the Terms and

Conditions, the first exam with the policy then determines any pre-existing

conditions. In this case, a gastrointestinal condition was identified at the

first exam. This condition progressed to become a chronic protein-losing

enteropathy (PLE), resulting in conditions related to hypoproteinemia (low

blood protein), including pleural effusion and subcutaneous ascites.

Consequently, claims for these conditions were not afforded coverage under the

policy.

Consumer

Response:

[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]

Review: [redacted]

I am rejecting this response because:

Petplan failed to provide a consistent answer in the

response. First, Petplan stated annual health exam is recommended by all

veterinarians, and it is not required in order to underwrite a policy. Later, Petplan

indicated the policies require that a pet has been examined in the 12 months

prior to policy inception.

I really not understanding why Petplan did not

make health exam a pre-requisite to underwrite a policy? What is the hidden

agenda with Petplan?

In addition, Petplan processed the first claim successfully (see attached),

and deductible was applied. Petplan failed to address why the first claim was

processed? And what has changed after the first claim?

Lastly, Petplan indicated that gastrointestinal condition

was identified at the first exam, and it progressed to become a chronic

protein-losing enteropathy (PLE), resulting in conditions related to

hypoproteinemia (low blood protein), including pleural effusion and

subcutaneous ascites. Petplan basically uses the gastrointestinal condition to

decline all subsequent claims. Petplan continues collecting the premium,

however no coverage is provided. Again, Petplan continues to collect premium

with no commitment of rendering any services or goods. This is a violation of

consumer rights.

Petplan can avoid all the confusion by requiring health exam

in order to underwrite a policy, and the current practice is not acceptable.

Regards,

Business

Response:

Thank you for your recent communication regarding this matter. Please find our responses below.

Review: Our dog was signed up for Pet Plan before her doctor checkup. We received confirmation of her coverage and after taking her into the vet they wanted to run further tests. When we filed our paperwork with Pet Plan they denied our coverage due to a pre-existing condition, however to this day she was never diagnosed and they ended up not finding anything...Desired Settlement: We expect them to do the right thing and cover our claim.

Business

Response:

Thank you for your recent communication regarding [redacted]'s policy.

Review: To whom it may concern,

I am disputing any and all past, pending, and future charges on my account for the following reasons:

1. Prior to purchasing a pet insurance policy upon the recommendation of my veterinarian, I did tons of market research. Part of that research was specifically reaching out to customer service reps from several pet insurance companies. I reached out to PetPlan’s reps and asked via online chat and telephone if there were any hidden charges, catches, limitations, etc. involved with this policy.

2. Not only was I was assured that there were no limitations under section 1 above, I was promised that even hereditary conditions were covered and was guaranteed that there was no time limit on filing a claim after purchasing a new policy.

3. When I signed up I was enticed to do so by multiple entry errors due to a poorly programmed website that produced the wrong quote because my dog's name and age were somehow entered wrong even though I triple-checked all of this. The default name for dogs is “[redacted]” and this was initially my dog’s listed name.

4. After calling to address the name and birthdate issues my premium was adjusted due to no fault of my own and my account was charged a second time to make up the difference when I would never have signed up for the policy in the first place but for the mistake.

5. I called again between October 25th and November 25th to make sure that I was filing a claim properly and that I was not wasting my time filing a claim that would not be covered. The customer service rep assured me there would be no problems so called every vet my dog has ever been to, submitted all of his records, and all of his bills as instructed and never heard anything back.

6. Despite my reliance upon multiple promises by agents/reps, I was forced to contact PetPlan today to check the status of my claim and was informed that the claim was denied. My dog has no history of any injuries or illness and I was told by the rep that my dog was diagnosed with “lameness” when in fact he was diagnosed with myopathy.

7. Paragraph 6 above leads me to believe that multiple vets’ notes and records were not reviewed and the claim was denied by default although I was promised that exactly this set of circumstances would not occur.

8. I attempted to cancel my policy via http://gopetplan.com but the “contact form” redirects and fails to send the cancellation request when I click enter on multiple browsers so I emailed a representative back and asked for a full refund and to cancel the policy. I cannot attach a photo of the error but I have records of everything including the bugs at http://gopetplan.com where an error occurs every time I attempt to “contact PetPlan in writing to cancel” by hitting the submit button even when I am logged in. I tried to do this a couple of weeks ago as well because I had a hunch that the representatives I spoke with were wrong.Desired Settlement: Please refund any and all charges made to my account in full, immediately, and halt any and all future charges. A prorated refund is blatant consumer fraud/theft.

Business

Response:

This is in response to the Revdex.com (Revdex.com) complaint presented by [redacted]. We hope that [redacted] and [redacted] are both well. (Complaint# [redacted])

We would like to take the opportunity to address [redacted]’s concerns to clear up any confusion or concern that may exist.

Petplan policies provide comprehensive coverage for all cats and dogs. Coverage limitations of the policy are based on the medical history of each individual pet. Petplan policies provide coverage for accidents, illnesses, and hereditary conditions. Coverage cannot be extended where clinical signs were observed prior to policy or during the applicable waiting period or exclusionary period. Petplan has two waiting periods: 14 day illness and 24 accident waiting periods; and an exclusionary period for the stifles (knees). Petplan is proud to offer coverage for hereditary conditions, coverage is extended so long as clinical signs consistent with the hereditary condition were not observed prior to policy or during the 14 day illness waiting period.

[redacted] indicates that several errors occurred during the purchase of his policy for [redacted]. According to our records and the communication exchanged [redacted] shared during a telephone call on October 25, 2014 it was determined that the policy was erroneously booked with the pet name as “[redacted]” rather than “[redacted]” and that [redacted]’s birthdate was also saved as August 11, 2009, however, [redacted] was actually born in 2008. During the call [redacted] was informed about the cost difference for a pet born in 2008 vs. 2009 and the charge for the difference in premium. At this time, [redacted]’s pet’s name was corrected to “[redacted].” We would like to assure [redacted] that Petplan’s online experience is designed to allow for future policyholders the ability to have a comprehensive understanding of coverage and for ease of use. We apologize that [redacted] did not have this experience and we have provided this feedback to our website team.

Petplan claims are processed based on the medical records provided and the policy Terms and Conditions. During the review of a claim, if clinical signs consistent with the claimed condition were observed prior to policy or during the applicable waiting period (accident or illness), the claimed condition is not eligible for coverage. Petplan assessed the claim submitted based on the information provided. According to the medical records provided [redacted] was presented to [redacted] Veterinary Center on October 23, 2014, prior to policy inception of October 26, 2014, with a history of left front lameness. [redacted] represented to [redacted] Veterinary Center on October 28, 2014 for continued lameness and exercise intolerance. At this time diagnostics were pursued and evaluation by a specialist was recommended. On October 29, 2014 [redacted] was examined at [redacted] Veterinary Group Animal Emergency and Specialty Centers for a four week history of intermittent ataxia and exercise intolerance, panting, lameness, and difficulty rising.

Per the Terms and Conditions of the policy, conditions where clinical signs are observed prior to policy or during the 14 day waiting period for illnesses are ineligible for coverage, as they must be considered pre- existing. Specifically, in [redacted]’s case, clinical signs (left forelimb lameness, ataxia and exercise intolerance) were noted with in the 14 day waiting period as well as prior to the inception date of the policy (policy inception of October 26, 2014).

According to our records, Petplan has provided a full refund to [redacted]. [redacted] was charged a total of $235.18, on December 5, 2014 a full refund in the amount of $235.18 was provided to [redacted].

Consumer

Response:

[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.]

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,

Review: 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?

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. [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 [redacted] 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]. 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.

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 nsured.Desired Settlement: Reimbursement of all expenses for [redacted].

Business

Response:

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:

Review: I ordered pet insurance for my bulldog, Aussiedoodle, and cat. It was $1200. The three had clean bills of health from our vet, [redacted] in [redacted], and they showed me their documentation of proof of medical history was faxed, per contractual agreement, to Petplan. When [redacted] needed a surgery for his cherry eye, I filed a claim and [redacted] faxed documentation. The claim was denied for lack of medical documentation. When he had to get surgery in both eyes for cherry eyes through [redacted]'s [redacted], Petplan rejected my claim again saying medical documentation was not received. [redacted] faxed all of their medical exam records on [redacted], and then sent me a copy of their notes, fax transmittal, and claim form, so I re-submitted my claim to Petplan. Today I received a letter from Petplan saying that they have withdrawn the claim (#[redacted]) due to lack of documentation, and, as a consumer, I am hopping mad. I want my full payment returned for these pet policies (~$1200). Petplan is using fraudulent business practices and using the USPS to give a legitimate consumer the runaround. I want the full amount refunded and I wish to never to do business with this underhanded, shady "insurance" company again. That is a pretty malicious and malodorous scam you are running on the American pet-owning public. Shame on you! Do you know how many consumer review boards there are for me to write about my negative experience with you? I am about to start using them.Desired Settlement: Cancel my affiliation with Fetch, refund my three policies in full, and issue a corporate apology.

Business

Response:

Thank you for your communication regarding claim processing for [redacted] (policy number [redacted]) and for the opportunity provide additional clarification regarding the submitted claims for [redacted].

Review: I filed an insurance claim for my pet, a Doberman Pinscher who had surgery to remove a cyst, on April 25th, 2014. Since that filing I've received nothing but conflicting requests for additional information of no relevance to the claim, and I believe it is an attempt to delay indefinitely paying the claim. The requirement was for the last 2 years of veterinary records. I had vets submitted those, but the requirement keeps changing when I talk to them via phone - first they said only 1 year is required, then 2 years, then 2 years prior to the time I obtained insurance for my pet 1.5 years ago through PetPlan. My dog had 3 vets and one of the vets had seen my dog 1 time for an ear infection 3 years ago. The vet is not responding to requests for 2 years prior history, because my dog DID NOT have any services in the 2 years prior to now or to the claim for service. They continue to delay processing my claim, and they let it sit indefinitely without follow-up, again, I believe in an attempt to avoid claim processing and payout. This business should be put out of business for it's changing requirements, for requirements not specified in the insurance agreement and coverage/declarations, and for fraud for changing it's requirements outside of the agreement for service. We have a "Silver" plan but it is more like a lump of coal given that they do not process claims which means that I'm paying $702.28 per year for insurance that does not insure my pet.Desired Settlement: Provide the service/claim processing per the insurance agreement and declarations, stop changing requirements for claim processing, stop wasting my time and delaying the processing of my claims by creating arbitrary, unwritten requirements and not following up on the claim for processing.

Business

Response:

We would like to thank [redacted] for her communication regarding her recent customer service and claims processing experience via the Revdex.com (Revdex.com).

Review: I have filed claim with Pet Plan and I have

sent all the necessary documents.

I have made several calls to customer service

The representatives tell me they need medical

records.

I have mailed the medical records

Still, no solution to my claimsDesired Settlement: I just want the refund according to my

policy

Business

Response:

We sincerely apologize for any inconvenience. Securing medical records from all previous pat care providers can be a laborious process. In this case, we had requested medical records from [redacted] Animal League, who did not have the required records to hand. Upon further requests, we have received the required records and all claims have been processed. Again, we apologize for any delay in processing caused by waiting for medical records.

Consumer

Response:

[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.]

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,

Review: I had a insurance policy #[redacted] on my dog [redacted]. Prior to signing up for the policy I specifically aked if they covered soft palet surgery for English Bulldogs and they assured me that they did. I purchased the policy approx 2 weeks after getting my puppy from the breeder. In September of 2012 my dog [redacted] had to have surgery to shorten his soft palet because he couldn't breathe very well. After the surgery I submitted all the paperwork to Petplan for reimbursment. The claim was denied because they said that the condition was preexisting. I spoke with a representative and they said that I could have the claim reviewed. So I then had the vet that perform the surgery write a letter stating that kennel cough which [redacted] had when I first got him from the breeder had nothing to do with an elongated soft palate so therefore it couldn't be a preexisting condition. It took Petplan 3 months to review it again only to deny again.Desired Settlement: I feel that Petplan owes me for this claim. It seems that no matter what type of claim you would submit they would say it was preexisting. I'm just very disappointed in the outcome when the representive that signed my up assured me this wasn't the case with there insurance company. I also feel that they should reimburse me that additional premium that was charged to my credit card while I waited the 3 months for them to deny the claim again.

Business

Response:

Please find our response attached, many thanks.

Review: I purchased a pet health policy for my puppy. Petplan promises to cover all care provided by licensed veterinarians after a short 14 day waiting period for an illness and much sooner for an accident. This coverage includes hereditary and congenital conditions. According to my veterinarian, my dog was healthy when I purchased the plan; she had no known pre-existing health conditions. Again, let me emphasize the fact that none of the veterinarians who examined my dog prior to purchasing the Petplan policy said she was ill or suspected anything serious was wrong with her. I bought the plan in good faith, believing that if my dog were to get injured or become sick, there would be coverage for her.

A few months after buying my policy the dog became ill. It then became apparent that whatever was causing the illness was serious and at the same time the root of the illness would be difficult to diagnose. In short order, I ran up $2,500 in vet bills in order to pinpoint the source of her illness, never reaching any definitive diagnosis. Petplan encouraged me to move ahead with treatment without seeking pre-approval for coverage and submit the claims as they came in. Petplan agents assured me over the phone that licensed veterinary care was covered. I continued to seek treatment for my dog until the veterinary specialist she saw determined that exploratory surgery would be the next step to solving the puzzle of her illness. At this point I sent in a pre-approval form because the cost of the surgery was going to range between $5,000 and $7,000. Petplan denied the pre-approval, and later denied my appeal to overturn that original decision. In the meantime, the other $2,500 in claims have been left "in process" and I have not been reimbursed. The reason given for the denying the pre-approval for surgery, that her illness was a "preexisting condition," lacks evidence, so much so any reasonable person would conclude that Petplan is trying to avoid paying such a costly claim. A prime example is my veterinarian, who wrote a letter in support of my appeal; she disagreed sharply with their assessment that my dog's condition was preexisting.Desired Settlement: I want Petplan to agree to pay promptly the claims for the $2,500 of veterinary care I've accrued up to this point according to the plan level I chose, and I want Petpan to agree to cover the surgery that might save her young life.

Business

Response:

08/19/2014We would like to take the opportunity to thank [redacted]

for providing his feedback via the Revdex.com (Revdex.com) regarding his

recent claims submission and customer service experience. Opportunities, like the one presented by Mr.

Plescia, allow Petplan the opportunity to improve our processes and procedures

to benefit all policyholders, including [redacted].We would like to take the opportunity to address Mr.

Plescia’s concerns present in his Revdex.com feedback in a hope to provide clarity to

how Petplan policies are structured and benefit our policyholders.Concern #1: “I purchased a pet

health policy for my puppy. Petplan promises to cover all care provided by

licensed veterinarians after a short 14 day waiting period for an illness and

much sooner for an accident. This coverage includes hereditary and congenital

conditions. According to my veterinarian, my dog was healthy when I purchased

the plan; she had no known pre-existing health conditions. Again, let me

emphasize the fact that none of the veterinarians who examined my dog prior to

purchasing the Petplan policy said she was ill or suspected anything serious

was wrong with her.”Response: Yes, Petplan policies provide coverage for

all illnesses and injuries for cats and dogs.

We also provide coverage for hereditary and congenital conditions. Conditions that are not covered by Petplan

include pre-existing conditions and routine/preventative care. Pre-existing conditions are conditions were

clinical signs are observed prior to the purchase of a Petplan policy or during

the waiting periods of the policy.

Petplan has two waiting periods, a 14 day illness waiting period and a

24 hour accident waiting period. [redacted] indicates in his

complaint that his dog ([redacted]) had “no known pre-existing health

conditions.” Additionally, [redacted]

futher indicates that none of [redacted]’s veterinarians “said she was ill or

suspected anything serious was wrong with her”.

Please understand that we are required to follow the medical records

provided to us. During review of [redacted]’s

medical records the following clinical signs were found prior to policy:09/16/2013:

[redacted] Animal Hospital“Owner

called, patient not eating, owner has switched multiple times what he is

feeding pet…eats treats that are offered…”09/24/2013:

[redacted] Animal Hospital“Patient

is not eating well. Picky eater. Owner can only get patient to eat ¾ cup of

kibble on a good day…slightly under weight… if still underweight at the time of

spay (or getting worse at any time) we will investigate more diagnostics to

ensure there is not a congenital issue…”09/30/2013:

[redacted] Animal Hospital“Patient

refuses to eat the same food for more than 2 days… owner is concerned that

patient is underweight and not gaining weight… if owner gets more concerned

about her being underweight, recheck, as if she is failing to grow and gain

weight, then the appetite becomes a bigger concern.”10/28/2013:

[redacted] Animal Hospital“Constant

peeing in crate… and will eventually go on the carpet. Drinking a lot more water. May have a urinary infection…”01/05/2014:

[redacted] Animal Hospital“[redacted] is

doing fine- a little more finicky with food… recheck Chem 10, Lytes…”01/06/2014:

[redacted] Animal Hospital“Recheck

bloodwork: elevated ALT 240… recommend recheck pre- OHE…”02/12/2014:

[redacted] Animal Hospital“Increased

frequency [urination], increased thirst… having accidents in house with

urinating. Drinking a lot of water,

peeing more frequently outside.

Accidents in crate overnight… low USG 1.014, no bacteria… elevated ALT

107…”03/20/2014:

Petplan Policy Inception05/07/2014:

[redacted] Animal Hospital“Won’t

eat food for about 5 weeks. Vomits bile

and H2O, will eat treats…PU/PD…elevated AST 320, elevated ALT 254, elevated

ALKP 197…”Based on the medical records

provided to us from [redacted] Animal Hospital it appears that [redacted] has been

afflicted with clinical signs of decreased appetite, increased urination,

increased thirst, increased liver enzyme (ALT), low urine specific gravity

(USG), and weight loss; prior to policy. Clinical signs relating to or resulting from

an underlying condition are ineligible for coverage. Additionally, the after policy inception,

during the 14 day illness waiting period, [redacted] was observed to not eat for “5

weeks” and was vomiting bile and water.

As these clinical signs were observed during the 14 day illness waiting

period, conditions related to resulting from [redacted]’s vomiting, increase liver

enzymes and weight loss are ineligible for coverage.Concern #2: “A

few months after buying my policy the dog became ill. It then became apparent

that whatever was causing the illness was serious and at the same time the root

of the illness would be difficult to diagnose. In short order, I ran up $2,500

in vet bills in order to pinpoint the source of her illness, never reaching any

definitive diagnosis. Petplan encouraged me to move ahead with treatment

without seeking pre-approval for coverage and submit the claims as they came

in. Petplan agents assured me over the phone that licensed veterinary care was

covered. I continued to seek treatment for my dog until the veterinary

specialist she saw determined that exploratory surgery would be the next step

to solving the puzzle of her illness. At this point I sent in a pre-approval

form because the cost of the surgery was going to range between $5,000 and

$7,000. Petplan denied the pre-approval, and later denied my appeal to overturn

that original decision. In the meantime, the other $2,500 in claims have been

left "in process" and I have not been reimbursed. The reason given

for the denying the pre-approval for surgery, that her illness was a

"preexisting condition," lacks evidence, so much so any reasonable

person would conclude that Petplan is trying to avoid paying such a costly

claim.”Response: The pre-authorization presented to Petplan

indicated the recommended procedure was for the clinical signs of “vomiting,

diarrhea, weight loss and organomegally.”

As the clinical signs of vomiting, diarrhea, and weight loss were noted

prior to policy and are of direct concern for further investigation, procedures

and treatments related to these clinical signs are ineligible for

coverage. Therefore, the recommended

procedures/ treatments including, but not limited to: possible multi- organ

biopsy, intrahepatic shunt attenuation, feeding tube placement, hospitalization

and portography, as indicated in the pre- authorization submitted to Petplan,

are ineligible for coverage. Should [redacted] have additional

information or new information is available regarding [redacted]’s medical history,

we would be happy to review in adjunct to the information currently on

file. Regarding the pending claims for

[redacted], these claims are related to the previously discussed pre-

authorization. As these claims were

being processed at the time [redacted] submitted for an appeal of his pre-

authorization, the claims were put on hold until the appealed pre-

authorization was completed. These

claims have now been completed based on the information provided. All claims, including [redacted]’s are based on the legal medical records and the Terms and Conditions

of the policy. In order to safeguard all

policyholder, including [redacted], we must apply the Terms and Conditions

equally to all. Concern #3: “A prime example is my

veterinarian, who wrote a letter in support of my appeal; she disagreed sharply

with their assessment that my dog's condition was preexisting.”Response: We take all information

provided into account when processing claims or claims that have been

appealed. The information provided by

[redacted]’s veterinarian indicted that [redacted] “was always a somewhat ‘picky’

eater. This continued as she has grown.” We certainly appreciate Dr. [redacted]’

opinion regarding the case, however, [redacted]’s persistent and progressive

decreased appetite, and other clinical signs (increased urination, increased

thirst, increased liver enzyme (ALT), low USG) [redacted] was afflicted with prior to

policy, as well as, within the 14 day illness waiting period make the claimed

condition ineligible for coverage.

Petplan policies do not provide coverage for conditions that are related

to or result from clinical signs observed prior to policy or during the 14 day

waiting period for illnesses. In summary, [redacted] observed clinical signs

consistent with the claimed conditions, procedures and treatments that occurred

prior to policy and during the 14 day waiting period for illnesses. Petplan policies do not provide coverage

for conditions where clinical signs are observed prior to policy or during the

14 day illness waiting period, therefore, coverage cannot be extended.We can certainly appreciate [redacted]’s frustration and we do hope that this clarifies coverage provided by

Petplan. Many thanks,Elyse DClaims Manager

Consumer

Response:

[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]

Review: [redacted]

I am rejecting this response because:

This is a follow-up of a previous complaint(ID # [redacted]) that was closed because I was unable to respond within the 10 days. I would like to reopen that complaint if possible, but if not, then I will proceed with a new complaint. What follows is my response to Fetch, Inc. (Pet Plan's) response to my complaint: I do not accept Petplan's response to my complaint as a satisfactory resolution. Petplan offers two responses, both involving the issue of pre-existing medical conditions, which by their definition need not be confirmed with a veterinarian's diagnosis, but by a much lower standard of "clinical signs" or "symptoms" observed by anyone. The first reason they give for denying coverage is that signs and symptoms were observed in the fourteen day waiting period. This is easy to resolve: Petplan didn't count correctly. If one counts back the "five week history" going back from the veterinary visit including that very day of the visit May 7, 2015, then the five weeks reaches back to April 3, 2014, which is in fact the 15th day of the policy, the first day outside of the waiting period and the first day she was eligible for coverage. The second reason they give for drying coverage is that the clinical signs were present before the inception of the policy. It is here where the issue of false or deceptive advertising becomes relevant. The expression itself "clinical signs" implies treatment in a professional setting such as a veterinary clinic in which veterinary doctors diagnose and treat specific illnesses. This is not what Petplan means by clinical signs and it has huge implications for how they determine pre-existing conditions. I was completely shocked when coverage was denied for my dog based on these criteria. Again, nobody–including our veterinarians–new she was sick until after I had purchased the plan and began treating her with the false comfort of having pet insurance. I operated under the assumption that she was covered for everything except known illnesses or diseases my veterinary doctors had diagnosed. The false comfort of knowing one's pet is insured against any illness or accident-including congenital conditions is the heart of the sales pitch on PetPlans's website, print media, and over-the-phone-marketing. The agent who sold me the policy did not take any time to warn me about how the company determines pre-existing conditions nor did I find any information on that topic redly available on the Petplan website. I felt like a fool when I found out I had been fooled by their marketing campaign. I looked at other pet insurance companies to see how they handled pre-existing conditions. It turns out they all define them the same way. But here's the difference, the other large companies including [redacted], [redacted], and [redacted] are open and up front about the issue of pre-existing conditions on their websites. A number of them have information on pre-existing conditions on their home page. Others have major pages of their website that go into detail to define in plain language what exactly they mean when they employ terms like "pre-existing conditions" and "clinical signs." This up-front approach is completely lacking in PetPlan's website and in their approach to selling customers policies over the phone. Had I purchased a plan from one of the other companies, I would have made better choices when going about treating my dog's illness. Since I first wrote to complain about Petplan, my dog has died of her illness. I can no longer ask PetPlan to pay for the surgery that might have saved her life. I now ask that PetPlan pay the veterinary bills that led up to the plan to do surgery, approximately $2,500. PetPlan's deceptive advertising campaign let me down a path of serious spending that I would have otherwise avoided. I believe they should pay the claims I've submitted for real veterinary services.

Review: I purchased pet insurance from this company on both of my dogs last May. I spoke to a representative of Pet Plan at the time who told me that in order for any claims to be paid for hip or joint issues, my dogs would have to be seen by a vet during the first 30 days of the policy. I am completely clear about exactly what was said. I do not make mistakes about something that serious. I have paid this insurance on both dogs in good faith & have never attempted to file a claim until today. Now I'm told that the insurance will not pay because I did not take the dog to the vet within the first 30 days even though the claim is NOT related to a joint or hip problem. I don't work in the insurance industry & don't understand the fine print. But they have refused to pay this claim or---as it turns out---ANY claim EVER on either of my dogs.

So, if they have known since the first 30 days of the policy period that they were NEVER going to pay a claim, why have they continued to accept my money for coverage they knew I would never get?

This is shoddy business practices to say the least. It's underhanded & dishonest. I paid the premiums in good faith & they accepted my money knowing I was paying for absolutely NOTHING. I feel sure that's illegal. I'm elderly & on a fixed income. I couldn't really afford the pet insurance but did without other things to pay it, thinking I was doing the right thing for my pets. I wouldn't have gone on giving them my money for nothing all this time. I want to stress that when I called and took out these policies I was NEVER told---at no time during the conversation---that if I didn't take my dogs to the vet during the first 30 days the insurance would never pay a dime on anything, which is what they told me today when I called to find out how to file a claim for my little dog that probably has a brain tumor. I could have fulfilled that requirement had I known about it or been paying on other insurance that really would have paid claims. Now I am not going to be able to provide the best care for my dog. So, Pet Plan's trickery doesn't just hurt me, it hurts my little dog too & no telling how many other pets & owners.Desired Settlement: I want a full refund of the premiums I have paid on both of the policies for my pets. Here are the policy numbers: [redacted]-** and [redacted]-**. I have called Pet Plan & canceled the policies & stopped the automatic payments through my bank. They owe me the premium for both policies since last May.

Business

Response:

Our Customer Service Supervisor ([redacted]) is working with **. [redacted] to have the claims in question submitted so that our claims team can analyze the existing medical records and properly assess the claim. We hope to be able to resolve this satisfactorily for **. [redacted].

Consumer

Response:

[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]

Review: [redacted]

I am rejecting this response because: Nothing has been resolved. I have submitted the claim & all bills as they requested. Saying that they "hope" to resolve it satisfactorily for me means absolutely nothing. [redacted] assured me that he would try to get the claim paid & if he couldn't, he would see to it that all of my premiums were refunded. I prefer for the company to pay the claim & any ongoing claims for this incident. That's why I took the insurance & according to what they tell me now, it was completely misrepresented to me when I purchased it over the phone. I bought this insurance & paid the premiums in good faith. They should pay the claim. Barring that, a full refund for any premiums paid is expected.

Review: I bought an insurance plan with PetPlan and cancelled the plan days later. The company did not cancel my plan. They also did not charge me any monthly fees for the following three months. The declaration page for my plan states I am to be billed monthly. Seeing no fees from the company on my credit card billing statement, I was under the impression the plan had been cancelled. Three months later, fees appeared on my credit card statement from the company. I called again to cancel and was told to follow a totally different process from the first time I called to cancel. The representative, [redacted], informed me there is no record of my calling to cancel the first time and there was nothing she could do for me about the prior charges and the initial insurance charge. She walked me through the cancellation procedure and reimbursed me $1.76. I currently have a dispute pending with my credit card company to be reimbursed of the charges. Also, shortly after contacting the company for the second time to cancel, I started receiving newsletters via email and magazines to my home address from the company. I NEVER received any magazines or monthly newsletters from the company prior to all this, when I apparently still had an insurance plan with them. I find this VERY odd. It seems the initial representative I spoke with went through the wrong cancellation procedure. I am being told there is no recorded phone calls or notes from the first time I called to cancel. I never received any literature from this company until AFTER the second cancellation and there were no fees assessed for a period of time, having me believe the policy had already been cancelled. What kind of company charges you monthly fees for February and March, all in the month of May? And why did the company decide to assess me TWO MONTHLY CHARGES FOR ONE MONTH, February (which is also the shortest month of the year)? I would think fees for February and March would be assessed in February and March respectively. Why am I NOW receiving literature from this company only after my final cancellation?Desired Settlement: I want my initial payment back and my monthly charges which were assessed in May, (two for February and one for March of $17.17, $17.17, and $17.09). I would also appreciate an apology to myself and to my credit card company for all this confusion and disillusion.

Business

Response:

We would like to extend our most sincere apologies to **. [redacted] and her credit card provider for any inconvenience. For an unknown reason, our system does not have a record of her Aug/Sept 2013 cancellation request. The several-month delay in payments being collected on the policy appears to be due to the designated card being declined by our payment provider until February 2013, at which point, all due payments were collected. At this time, it is our understanding that all payments have been credited to **. [redacted]'s credit card (sums of $1.76 on 5/10/13, then $34.54, $17.09, $17.19 and $15.33 on 9/4/13).