Healthy Paws Pet Insurance LLC

I’m sorry to hear that your kitty has stomatitisI‘m quite familiar with the medical condition, because I have a kitty that has the stomatitis too and my background is in veterinary dentistryAs you described, the primary treatments for stomatitis are partial extractions with routine dental cleanings or full mouth extractionsThe first course of treatments typically starts with partial extractions, a dental cleaning and sealantsIf there are no improvements of the inflammation, a veterinarian will recommend full mouth extractionsWe process claims using the same policy provisions for all of our pet parents, meaning that we are consistent with our coverage from one Pet Parent to anotherAs stated in our policy, we do not cover dental health care, particularly dental cleanings or prophylaxis, which is why we did not cover this line item from your kitty’s claimYou can find this information outlined on our policy, on page of 7: IIEXCLUSIONS & LIMITATIONS 3) PREVENTIVE CARE EXCLUSIONS We do not cover: dDental health care, however if injury to teeth is caused by an accident, we do cover the cost of extraction and/or reconstruction of damaged teeth4) OTHER EXCLUSIONS I Claims in any way arising from the lack of use and/or implementation of preventive healthcare products and/or methods when such products and/or methods would be in accordance with generally accepted veterinary standardsRoutine healthcare includes: vaccinations, flea control, heartworm medication, de-worming, dental care, ear plucking, grooming, and prudent regular care; VDEFINITIONS 10) Dental Health CareThe regular care required to maintain dental hygiene for your petThis includes brushing, scaling, polishing, extractions and reconstructionsFor the claim in question, we covered the treatments as outlined in our policyWe covered the pre-anesthetic blood work, dental x-rays, hospitalization, fluids, anesthesia, surgery, histopathology, pain relievers and prescription medicationsThe two line items that were not covered on this claim were the Exam Fee and the dental cleaningAnyone visiting our website can see this information on our “Benefits, Coverage and Exclusions” pageBy making preventative care (which includes routine dental care) part of the pet parent's financial responsibility, it allows us to offer a complete accident and illness plan at an affordable monthly premiumOur policyholders value comprehensive coverage and unlimited benefits at reasonable ratesI hope this clarifies your concerns and that your kitty is feeling better after his recent treatments

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 meThis company went ABOVE AND BEYOND to make this rightThis is a company of integrity and I am happy to remove the complaintWe have always settled on my last claim and the company was incredibly generousSincerely, [redacted]

Revdex.com:I have reviewed the response made by the business in reference to complaint ID [redacted] but would like to let the VP know that I initially spoke with a Healthy Paws Pet Insurance representative on November 9, at 1:p.mand the female representative stated that I could only cancel through a link and she would email it to me This is how and why I received an email with the automated link; as a result, I emailed customer service to inquire about the cancellation date but no one responded nor did I receive a phone call back from Healthy Paws after leaving a message on November 29, at 9:p.m The attachments are herewith for the VP's review; meanwhile, I look forward to receiving my prorated refund of my pet insurance premiums, as this resolution is satisfactory to meSincerely, [redacted] ***Supporting Documentation Redacted by Revdex.com Staf*

I’m sorry to hear that you’re frustrated with pet insuranceBased upon your feedback, you were upset that our policy did not cover treatments for your pet on 7/5/2016, 7/7/2016, 7/12/and 8/5/Please understand that we are unable to provide coverage for any services rendered prior to your policy effective date of 7/13/No pet insurance company would reimburse treatments before a pet was enrolled for coverage In regard to the claim submitted for services on 8/5/2016, all of the charges on this invoice were related to wellness and preventative care and our policy provides coverage for treatments related to accidents, illnesses or injuriesOur policy provides coverage for diagnostic testing such as blood work, x-rays or CT scans, hospitalization, surgeries and prescription medications for any new signs or symptoms of illness or injury that occur after enrollment and waiting periods As outlined in the policy, we do not cover preventative careThese expected costs such as vaccines, flea control, deworming etcare not covered on the policy and is the pet parent’s responsibilityYou can find this information in our policy and our website Page of the policy: IIEXCLUSIONS & LIMITATIONS 3) PREVENTIVE CARE EXCLUSIONS We do not cover: aSpaying and neutering bPreventive healthcare including vaccinations or titer test, flea control, heartworm medication, de-worming, nail trim, and grooming cParasite control including but not limited to internal and external parasites for which readily available prophylactic treatments are available dDental health care, however if injury to teeth is caused by an accident, we do cover the cost of extraction and/or reconstruction of damaged teeth eAnal gland expression On 8/29/you successfully canceled your policy using the online Customer Center

Healthy Paws offers continuous lifetime coverage for your petOur policy is continuous until canceled and you can increase your coverage as long as you have not submitted a claimOnce you have submitted a claim, you will be able to decrease coverage, but will no longer have the option to increase the planSince you filed claims for your pet, you no longer had the option to increase coverage, which was why we did not approve your request to lower your deductibleYou can find this information in our Policy, on page of 7:IIIGENERAL CONDITIONS 7) You are entitled to increase your pet’s deductible level and/or increase your pet’s coinsurance amount at any timeThis request must be made in writing and will become effective the month following approval by usYou may apply to lower your pet’s deductible level and/or decrease your pet’s coinsurance amount provided that your pet has not previously filed a claim with usThis request must be in writing and will become effective the month following approval by usYou can also find information about changing your deductible on our FAQ:https://www.healthypawspetinsurance.com/frequent-questionsManaging Your PolicyCan I change my deductible or reimbursement level after enrolling?You can increase your coverage as long as you have not submitted a claimOnce you have submitted a claim, you will be able to decrease coverage, but will no longer have the option to increase your plan.You can view your reimbursement and deductible options by clicking Pet Policies in your customer center to change your policy options.Increasing your coverage would include raising your reimbursement and/or lowering your annual deductible, resulting in less out of pocket expenses before receiving reimbursement, and a higher monthly premium.Lowering your coverage would include decreasing your reimbursement and/or raising your annual deductible, resulting in more out of pocket expenses before receiving reimbursement, and a lower monthly premium.In regard to the annual premium adjustment, we understand that premium increases can be a stress financiallyOur goal is to keep our premiums as low as possible while still providing comprehensive coverageYour monthly bill is going up because veterinarian care has grown more expensive over the last few yearsThis premium adjustment allows continued access to the best veterinarian careIt is important to us to keep premium adjustments manageable and we notify you days prior to the premium adjustment to allow time to plan and budgetPremiums for potential customers will increase over time as wellAt the time your premium increase takes effect, you will likely see an overall increase in premiums for other customers as wellIf you were to create a new policy after your policy anniversary date, the premiums will be higher than the current premium for your pet.We strive for complete transparency so our pet parents understand how the policy worksWe outline coverage changes and annual increases in our frequently asked questions and in our sample policy available prior to enrollmentOur team members are always happy to answer any policy questions as well.https://www.healthypawspetinsurance.com/frequent-questions

Revdex.com: I have no choice but to accept because I don’t want to keep going in circlesIt’s a sketchy business practice taking advantage of current customers making them pay higher premiums than other new enrolled customers and trap them into a higher premium simply because they know that if your pet has a condition they know it is hard for you to leave insurance because most insurance do not accept pre-existing conditionThabkfully my pet does not have any pre-existing condition so I have chosen to cancel my policy effective the end of my billing cycle May 12th (give and take a few days) but it is a shame you take advantage of customers and make them pay more moneyi hope this is made public Sincerely, [redacted]

We are hoping that [redacted] asks the Revdex.com to remove this complaint from our company reviews because the information regarding the handling of this claim is inaccurateWhen the Revdex.com complaint regarding the processing of a hiatal hernia claim was posted on July 27, 2016, we hadn’t processed the claimDue the invoice amount and complicated nature of [redacted] sweet boy’s conditions, we requested that the treating veterinary hospital fax us medical records to be reviewedOnce we reviewed the history, we processed the claim on August 5, 2016, which was covered for any new conditions and a reimbursement check was mailedWe processed this claim fairly and within our policy guidelines If this review is not removed from the Revdex.com, for pet parents researching pet insurance, please understand that we work very hard as a claims paying organizationOur hands our tied and are unable to provide coverage for claims when any signs and/or symptoms, not a diagnosis, start prior to the policy effective date (enrollment) or during the waiting periodsNo pet insurance company covers pre-existing conditionsOur claims determinations are based off of the information documented in the medical records and the Healthy Paws Policy We process claims for all pets according to the same standards set within the provisions of the policy

Complaint: [redacted] I am rejecting this response because:Your most recent response is incredibly frustrating and indicative of your company's egregious slight of handYour response has completely erased the fact that I am seeking TREATMENT for my cat, not simple dental cleaningI get my dogs' teeth cleaning regularly, and have accounted for this cost, because it is PREVENTATIVEI understand that your your policy excludes dental cleaning from coverage --but that is because, if you actually look at your policy, you categorize it under preventative careI am not asking you to provide preventative dental cleaning for all pets--I am asking you to provide dental cleaning for animals who need it as treatment when it could cure their disease by eliminating the allergen (plaque) which is the source of inflammationMy ONE YEAR OLD cat's need for dental cleaning every three months does not serve the same function as preventative dental cleaning, and your policy has not accounted for this discrepancyInstead, your responses over the past months have been ad hoc, forcing me to prove that cleaning is treatment and then when I do, then denying that this proof has any impactAGAIN, YOU NEED A POLICY THAT COVERS TREATMENT FOR ANIMALS WITH AN AUTO-IMMUNE DISORDER, WHOSE CAUSE DOES NOT ORIGINATE IN THEIR MOUTH AND WHOSE TREATMENT, THOUGH HAPPENING TO COINCIDE WITH GENERIC PREVENTATIVE CARE, DOES NOT SERVE THE SAME AIM OR FUNCTION Your most recent response, and your inadequately crafted policy, completely ignores these nuances in animal health, which could easily be cleared up by providing coverage for animals with veterinary note of diagnosis and treatmentINSTEAD, YOU ARE BEING DISCRIMINATORY AGAINST ANIMALS WHOSE DISEASE MANIFESTS IN THEIR MOUTH AND YOUR DENIAL OF TREATMENT IS FORCING ME INTO REMOVING ALL MY CAT'S TEETH INSTEAD OF WHAT SHOULD BE A STRAIGHT-FORWARD TREATMENT PLANYour policy, as well as your customer service, public relations, and reading comprehension is downright shamefulYour advertised persona 'all treatment is covered' is a blatant falsification and your denial of treatment is a breach in contractI will continue to fight you publicly and legally, and I currently have a groundswell of support (from vets, rescues, and other Healthy Paws clients) behind me to do soI advise you to find a better defense than the incoherent one you are now peddling, as it will end up costing you legal fees and public goodwill down the line Very angrily yours, [redacted]

Healthy Paws requests your pet’s full medical history at the time of the first claimThis includes medical records since your pet joined your family and through the date of the first claimBy obtaining full medical history through the date of your first claim, we are able to accurately determine the timeline of any illnesses or accidents to ensure we are providing coverage to the fullest extent of the policyWith your first claim, we received medical records of your pet’s veterinary visit prior to enrollmentWe reached out to you and your veterinarian to obtain medical records for any other veterinary visits after this date and through the date of the first claimWhile the invoice submitted outlined the treatment your pet was given on that day, we did not receive medical records from your veterinarian outlining signs, symptoms, condition being treated, or treatment plan.The claim was closed due to the length of time it had been open and awaiting additional informationThough we were unable to determine coverage without receiving additional medical records, we are happy to review updated medical records and review your claim for reprocessing at any time.Our coverage is continuous until canceledYou may cancel your policy at any time and we ask that you notify us in writing days before your next billing dateWhen we received your cancellation request, we provided a refund of the last two charged premiums

We are delighted to hear that your English Bulldog is in excellent health! This is great news, as we like to hear that our pups are happy and healthyWe know that it’s stressful when your pet is sick or injuredWe’re here to protect your pet and give you peace of mind if you ever need us! Based upon your feedback, it sounds like you’re frustrated with the premium increase you received with your recent address changeUnderstandably so, as I wouldn’t be happy with a premium increase, but let me take a moment to explain how premiums are factored to help you better understand the increaseOur premiums are based upon factors: · Pet breed · Age at the time of enrollment · Zip Code When your zip code changed, your premium changed to reflect the rates in your areaPremium base rates are consistent with all pets that are enrolled in that zip codeBased upon insurance regulations and guidelines, we must be fair and consistent with premiums in your areaWith address changes, premiums may increase or decrease based upon cost of veterinary medicine in the areaI hope this clarifies your questions about your premium increase due to address change

Pre-existing conditions can be very frustrating not only to pet parents but for us tooAs a claim paying organization, we’re disappointed when we find notations in the medical records that indicate that conditions occurred prior to enrollment or during the waiting periods Our claims determinations are based off of the information provided by you or your veterinarian and the Healthy Paws Policy including when the signs and or symptoms presented, not when a condition is diagnosedHere’s a timeline of the notes in the medical records and policy events: 11/21/Exam for spot on ear that has been there for a few daysYour veterinarian was ruling out abrasion vs a growth in which they recommended to monitor for inflammation or persistence4/23/You sent an email to Healthy Paws inquiring about coverage and pre-existing, specifically a small bald area, concerns of alopecia and if cancer would be covered in the futureWe informed you that could not provide follow up care to the alopecia that was notedThere were no questions in the email referencing a growth on the inner ear4/24/You enroll with Healthy Paws with a policy effective date of April 25, at midnight5/10/Waiting Period ends for accidents and illnesses 5/12/Claim service date for growth on right inner earMedical records note that the growth has been there for months and is growingClaim was denied due to pre-existingSince the signs and/or symptoms of the growth were present prior to enrollment, we are unable to provide coverageNo pet insurance covers pre-existing conditionsAs noted in our policy page of 7: IIEXCLUSIONS & LIMITATIONS 1) GENERAL EXCLUSIONS We do not cover: 2) PRE-EXISTING CONDITIONS We do not cover pre-existing conditions Pre-existing conditions means: aillness or the recurrence of any illness or condition which first occurred or displayed any signs and/or symptoms consistent with the stated illness or condition prior to the pet policy effective date; ban injury or recurrence of an injury that occurred prior to the pet policy effective date; or cany condition or complication resulting from an illness or injury that occurred prior to the pet policy effective date We hope your sweet boy is recovering well from his surgery

Complaint: [redacted] I will never ever recommend anyone to buy pet insurance from healthy paws since it is definitely not a reputable company Are you a vet to conclude that coughing is a pre-existing condition? Are you a vet to tell me that no cat cough in his/her life time? Since you're not a vet, do not tell me about the pre-existing condition That is why a lot of people that I know, they do not buy pet insurance and now I totally understand the reason What makes you think I bring my cat to the vet after month of having pet insurance? I would have brought the cat to the vet from the day that the enrollment expired; not month of paying the premiums It is a waste of my time to deal with this kind of nonsense.When I submitted my dental record, why did not I get contact from healthy paws about the ultrasound in the beginning? Ultrasound was done to look at one of the extraction of the teeth that was done earlier before I adopted my cat Do not interpret something that is not there If you're not a vet, do not ever try to interpret something that you have no knowledge What..trying to refund me one month for pet insurance? What a joke? If I don't have faith in your policy, it should be started from the beginning thru up to date; not just one month

When there is evidence that a pet parent has/had insurance coverage with another pet insurance company, it’s part of our investigation process to determine coverage; the date coverage started and/or the date it was cancelledThe language in most pet insurance policies state that the first company you enroll with is considered your primary companyWhen filing a claim, when dual coverage is present, we must obtain the Explanation of Benefits (EOB) or Notice of Cancellation from the other insurers before claims can be processed In our policy on page of it states: llExclusions & Limitations 5) Limitations dWe will not make any payments for any claims for which you are entitled to be paid under any other insurance except for any additional sum which is payable over and above such other insuranceIn an attempt to process your claim we requested the Notice of Cancellation from your previous insurance provider to confirm dates of coverageOn 6/26/we received an email with a cancellation attachment from your previous insurer that listed inaccurate cancellation informationOnce the error was identified, the correct documentation was sent on 6/27/and we processed your claim as outlined in the policy We hope your sweet girl is feeling better! Have a safe fourth holiday

Dear Revdex.com, I believe there was a misunderstanding of our cancellation process, which is completely computer automatedHere's how the cancellation process works: As stated in our policy, on Page of 7, “You may cancel your policy by notifying us in writing via regular mail, fax or email at least fourteen (14) days in advance of your next premium payment When a Pet Parent requests to cancel their account, they can cancel by either sending us the request in writing or by completing the process onlineIf the cancellation is completed online, the Pet Parent completes the cancellation request by clicking a link to confirm the cancellation and our automated system cancels the accountNext, an email is sent to the Pet Parent with the Notice of Cancellation and instructions on how to reach us if they need additional help or want to provide feedback In [redacted] ’s situation, the email responses she sent on November 29th requesting to cancel immediately were sent to an automated email systemThis is why she did not receive a response from a Healthy Paws Customer Care RepresentativeOne of our team members would have been happy to help her with her requests I have sent an email directly to [redacted] , explaining these details and we are working on the prorated refundWe have settled this compliant as she requestedPlease consider removing this complaint from our record Thank you, Jen

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. Sincerely, [redacted] ***

Pre-existing conditions can be very frustrating not only to pet parents but for us tooAs a claim paying organization, we’re disappointed when we find notations in the medical records that indicate that conditions occurred prior to enrollment or during the waiting periods Our claims determinations are based solely off of the information provided by you or your veterinarian and the Healthy Paws Policy Our coverage is based upon when the signs and or symptoms presented, not when a condition was diagnosedWe process claims for all pets according to the same standards set within the provisions of the policy We understand that you feel that we should review symptoms by species, but we base all of our claims determinations on the notations written in the medical record for the individual pet In your kitty’s medical records, it’s noted that he “presented for coughingSince taking over ownership he has always had a cough, sounds almost like hacking up a hairball, particularly after he has been on his back.” Since these signs or symptoms were noted to begin prior to his enrollment, we are unable to provide coverage for these conditions No pet insurance company covers pre-existing conditionsAs noted in our policy: IIEXCLUSIONS & LIMITATIONS 1) GENERAL EXCLUSIONS We do not cover: 2) PRE-EXISTING CONDITIONS We do not cover pre-existing conditionsPre-existing conditions means: aillness or the recurrence of any illness or condition which first occurred or displayed any signs and/or symptoms consistent with the stated illness or condition prior to the pet policy effective date; ban injury or recurrence of an injury that occurred prior to the pet policy effective date; or cany condition or complication resulting from an illness or injury that occurred prior to the pet policy effective dateSince you did not find value in our policy, we will refund your premiums to the date after your claim invoice service dateWe hope your kitty is feeling better

Healthy Paws pet insurance requires a full nose to tail physical exam of your pet by a licensed veterinarian in order to be eligible for coverageThis physical exam establishes your pet’s health at the time of enrollmentWe ask that an examination is completed within months prior to enrollment
for pets enrolled under the age of 6, or within days prior to enrollment for pets enrolled over the age of years oldIf your pet has not been examined within this time frame, we accept a physical examination within the first 15-days of the policy effective dateWhen completing the online application, we ask if the physical exam requirement has been met, and if not, that you to acknowledge an examination will be required within the first 15-days for coverageThough we ask you to acknowledge the need for this enrollment examination, we do not request full medical records, including the enrollment exam, until you file your first claimShortly after enrollment, you had contacted us to let us know that the enrollment examination for your pet may be delayed due to an unforeseen trip out of the countryWe discussed that this delayed enrollment examination would be accepted, however coverage might be affected if any clinical symptoms were noted at the time of this examinationIf you had traveled out of the country with your pet, an examination would have been required to obtain an international health certificate for travelWe would also accept this examination and/or the international health certificate as your pet’s enrollment examOur coverage is continuous until canceled where premiums are automatically collected each month until a Pet Parent cancels his/her accountYou may cancel your policy at any time and we ask that you notify us in writing days before your next billing dateWhen we received your cancellation request, we provided a refund of the last charged premium

Complaint: ***
I am rejecting this response because: this isn't what I was told on the phone Healthy Paws customer service ended up stating it was a mistake that my premium is higher than if I signed up today, and have grandfathered me into the old pricing Will see if it takes told in the days as mentioned Please be consistent; I didn't appreciate the canned response here

We’re sorry to lose you as a customerAll cancellations must be in writing or by clicking a “cancel” link we send to you via emailDo you have any records showing that you canceled in July? If so, please send to us and we would be happy to backdate your cancellation effective date.Based on our
records, we do not have any communications in July that you wanted to cancel your policy which is why we kept your policy activeOn 7/29/we received an email and phone call from you requesting to change your pet’s nameThis is a copy of the email we received:7/29/1:PM“Please change my pet's name to *** ***, it looks like it's the human parent's name currentlyTeresa C*** Thank you!”On 12/28/we received communications to cancel your policy

Complaint: ***
I am rejecting this response because:I understand what you just said above but you totally ignored the part where you quoted me for a higher premium as an existing customer vsas someone who is wanting to sign upYou emailed me directly to my personal email first and told me different quote a much higher quote and when I sent you screen shots of it you brushed it of as a glitch. Attached is is a photo of the premium you increased and a screen shot As if I wanted to sign up as a new customerYou take advantage of existing customers because you know that if someone has a pre-existing condition on their pet it is hard to leave and make it hard for customers to leave instead of being fair with each and every individualSo when you do reply please lay everything on the table instead of trying to hide the truth
Sincerely,
*** ***