Healthy Paws Pet Insurance LLC

Complaint: ***
I am rejecting this response because:I am unsatisfied with the response received, I would like a full refund for services NOT RENDERED!
Sincerely,
*** ***

Complaint: ***I am rejecting this response because:
This is pure white wash and baloney It's obvious that this is a scam and your business model is to snare a client with a low rate and find ANY EXCUSE, even not RISK related to increase their premium Many will be so incensed that they cancel Great news for you as you keep the completely unused paid premium to date This is a scam and I've filed a complaint with the US and CT *** *** There are NO RISK or increase in expense (except your premium) associated with my relocation I use same vet No adverse environmental issues in this new location vs the previous location.Sincerely,*** ***

Complaint: ***
I am rejecting this response because:We were clearly informed that the surgery would be covered in a written reply by customer service We were deceived into enrolling with Healthy Paws, under the presumption that cancer would be covered (in a written statement), which was later denied
Sincerely,
*** ***

We welcome the opportunity to take a closer look into your account and the recent claims processed for your furry family members.Two claims were uploaded via your online customer center on May 2nd, Upon initial processing of these claims, an exam fee in the amount of $was excluded from
coverage in each claim, for a total of $This is the cost of the examination fee set forth by your veterinary clinic prior to the discount being applied by your clinic’s wellness planThe exam fee was discounted and as such, not included in the final charges on your invoiceThese fees were excluded from coverage, but should not have been reflected in the processing of your claims.You contacted us on May 13th, to discuss the processing of both claims, and the error in excluding the examination feeThe mistake was corrected and the claims were appealed on May 14th, We reached out to you after correcting the claims to make you aware of the additional reimbursement you would be receiving.We appreciate your patience as we corrected your claims as quickly as possibleWe strive to provide outstanding customer service by processing claims accurately and quickly, and will continue to do our best to ensure claims are processed correctly for your furry family membersPlease don’t hesitate to contact us, should you need any assistance in the future

Your Healthy Paws policy covers the treatment of any new accident, illness, or injuryPlease be aware that we are unable to provide coverage for any conditions showing clinical signs or symptoms prior to enrollment or during the 15-day waiting periodThe medical history noted that your sweet girl
was showing symptoms of an illness during the waiting period, which is why we were unable to provide coverageHere’s the timeline of the medical visits and policy benchmarks: 2/21/Exam for vomiting 3/07/X-rays taken to rule out causes for vomiting 3/07/Enrolled with Healthy Paws 3/13/Recheck and additional diagnostics for on-going vomitingUltrasound revealed masses on spleen and abdomen3/15/SplenectomyBiopsies from spleen and kidneys sent to laboratory3/22/Healthy Paws Waiting Period Ends As noted in our policy: IIEXCLUSIONS & LIMITATIONS 1) GENERAL EXCLUSIONS We do not cover: cIllness that occurs or recurs within the first fifteen (15) days following the pet policy effective dateWe’re disappointed when we are unable to provide coverage, especially the continued supportive care for an illness that presented during the waiting periodYou and your family are in our thoughtsIn regard to your premium payments, we only collected months of premium for one dogThe third payment was for adding a new pet to your accountWhen you canceled your policy, we refunded you the full premium for the new pet and a prorated refund for the first dog that was enrolled

Complaint: ***
I am rejecting this response because: I understand that! The issue is the unforeseen stuffed that happened while she was covered that you's will not coverWhich is fine whateverI just want all my money back period and of storyOr maybe you would like me to contact a lawyer and hold you's responsible for the unforeseen matters that she was covered underWhat is a pre existing infection? Also what is a pre existing cardiac arrest? I really like to know? I never heard of it and can't find any information on either Which would prove your statement on non coverageSo please define
Sincerely,
*** ***

Complaint: ***I am rejecting this response because:Sincerely,*** ***
I want the $immediately back on my Master CardHealthy Paws does the same thing over and over againThey don't pay for anything because they are crooks who should not be in business, all they do is take their customers moneyI strongly advise not to do business with Healthy PawsEvery negative feedback I find is also being forwarded to Bob Ferguson the Attorney General for Washington StateI purchased a truthful and meaningful honest Pet Insurance Policy from ASPCA everything is detailed very clear as to what they cover

I’m sorry to hear that your dog was not feeling wellI hope that she’s better now that she’s received medical treatment
In regard to your complaint, we work really hard to provide full transparency about how our claims are processed, which is why we provide several examples on our websiteDuring
the quoting process, we have a link to our FAQ’s, which includes messaging about the annual deductible, reimbursement calculation, and provide a sample copy of our policy that includes the definition of how the deductible works.
As stated in the policy, on page 5:
VDEFINITIONS
9) DeductibleThe amount you must first pay with respect to the cost of insured veterinary treatment for your pet after your pet’s coinsurance portion has been applied
We also provide examples of how the annual deductible and reimbursement calculations workYou can find reimbursement examples on our website:
https://www.healthypawspetinsurance.com/claim-examples
We have processed your claims as outlined in our policyWe hope that your dog continues to feel better

I understand that you are trying to find a way to get the dental cleanings covered for your kittyYou may think that we can make an exception, but our hands our tied when it comes to coverage and changing our policyThere are many rules and regulations we must follow in the insurance industry and we would be discriminating against our other pet parents if we didn’t follow the policy provisionsWe process our claims under the same guidelines for all of our pet parentsIt’s written in our policy that we do not cover dental health care, which includes the dental cleaning, or prophylaxisI listed the provisions in your previous complaint and any pet parent can find this information in our policy and in our FAQ’s on the websiteFrom a management perspective, we have looked at adding dental health care to our policyIf we added these treatments to our coverage, it would increase the monthly premiumMany pet parents are sensitive to premium increases, which is why we have not pursued adding the coverage of new treatments to our policy

Healthy Paws Pet Insurance
We strive for complete transparency so that our pet parents
understand how the policy works including messaging about premium increasesIf
you were to speak with one of our team members or review the FAQ’s on the
website, we state that our premiums may increase annuallyThis premium adjustment allows you and your dog
continued access to the best veterinarian care.https://www.healthypawspetinsurance.com/frequent-questions
If there are premium increases,
they are adjusted on the anniversary of your enrollment each year, as the cost
of veterinary care generally increases over timeIt 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 budget
Though most premiums
increase over time as the cost of veterinary care increases, rates in your area decreased which was why we were able to lower your monthly premium for your
dog in January
We’re happy to hear your sweet boy is happy and healthy!

Healthy Paws Pet Insurance
We strive for complete transparency so that our pet parents
understand how the policy works including messaging about premium increasesIf
you were to speak with one of our team members or review the FAQ’s on the
website, we state that our premiums may increase annuallyThis premium adjustment allows you and your dog
continued access to the best veterinarian care.https://www.healthypawspetinsurance.com/frequent-questions
If there are premium increases,
they are adjusted on the anniversary of your enrollment each year, as the cost
of veterinary care generally increases over timeIt 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 budget
Though most premiums
increase over time as the cost of veterinary care increases, rates in your area decreased which was why we were able to lower your monthly premium for your
dog in January
We’re happy to hear your sweet boy is happy and healthy!

Complaint: ***
I am rejecting this response because:The histopathology report for my dog's current cancer shows that it is unrelated to the cancer she suffered from in Letters to Healthy Paws from the surgeon and radiation oncologist who treated both her cancer in and her current disease reiterate what is clearly shown in the histopathology reportThe radiation oncologist's letter specifically states that my dog's current, cancer is a "new disease process." Therefore, by definition it cannot be "preexisting." There is also no information in my pet's medical record and indeed no scientific data showing that her previous, cured cancer placed her at higher risk for a second, unrelated cancerTherefore, Healthy Paws' argument that her current cancer is "preexisting" is specious. I'm not sure why Healthy Paws is bringing up the $14,000+ claim they paid for my dog's mass on her spinal cord last year, as it has little to no relevance to the current issueIt seems to demonstrate that the company feels it has paid "enough" in claims for my dogThat is not the way insurance works. Regardless of what the third-party review (paid for by Healthy Paws) finds, I will take whatever steps necessary to make sure Healthy Paws fulfills its contractual obligations and acts in good faith so that my dog may receive the treatment she is entitled to.
Sincerely,
*** ***

Dear ***,You stated in your earlier complaint #*** that you didn’t agree with our definition of pre-existingPlease understand that no pet insurance company will cover a pre-existing conditionIf we did, the pet premiums would look more like insurance premiums for people.You can find information about a pre-existing condition in our policy that is posted on our website and in our FAQ’s:https://www.healthypawspetinsurance.com/frequent-questionsFAQ:What is a pre-existing condition?A pre-existing condition means that the condition first occurred or showed clinical signs or symptoms (there doesn't need to be a diagnosis) before your pet's coverage started (including waiting periods)Our pet insurance protects you against future conditions, and unfortunately no pet insurance company can cover pre-existing conditions.At Healthy Paws, identifying a pre-existing condition is simple! If it's an accident, illness or injury and the symptoms didn't occur before enrollment, you're covered.Here are some of examples of how pre-existing conditions work:Example 1: Your dog has been itchy ever since you adopted her from the shelterOver the past month she's been in several times to see her veterinarian for her itchy skin, loss of fur, hot spots and ear infectionsYour veterinarian is treating the symptoms, but has not diagnosed the condition yet.The cost of the treatment is becoming more expensive, so you decide to enroll her in pet insuranceA couple of months later your dog has another flaof itchy skin and you take her to see her veterinarian, who diagnoses her condition as allergies and prescribes additional medication.Allergies would be considered pre-existing, since the clinical signs and symptoms of the condition were noted before enrollment.Example 2: Your cat was seen for a urinary tract infection (UTI) one year agoThe urinalysis showed bacteria and crystalsYour veterinarian treated the condition with antibiotics and placed him on a special diet.Your cat is back to and you decide to enroll in pet insuranceDuring the 15-day waiting period, your cat begins showing signs of a UTI and you take him to see your veterinarian.A UTI would be considered pre-existing because your cat was treated for the same condition one year ago, and the clinical signs and symptoms of this condition started during the 15-day waiting period.You can see that we work very hard to be transparent with how our policy worksWe want our policyholders to understand how the policy works so that we meet expectations and there is no disappointment.Based upon the notes in your kitties’ medical records, we are unable to provide coverage for his claimOn the claim date 2/15/it was 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.” The notation that he had a cough since taking over ownership is why we were unable to provide coverage for the treatment including the x-rays.Additionally prior to his enrollment, when he had a dental cleaning on 3/11/2016, it was noted that body x-rays were recommendedThere was a “differential diagnosis of whole body disease.” I hope this helps you better understand why we were unable to cover the x-rays to check for coughing.Please reread our Revdex.com responsesI did not state in any of our communications that we would be offering a full refundAlso, filing multiple Revdex.com complaints is not a strategy to get a full refund of premiumsIf the claim condition presented after enrollment and the 15-day waiting period, the claim would have been covered and we wouldn’t be having this discussionWe have handled the processing of the claim in good faith and accordance with all policy language and applicable laws and regulations.With your permission, if the Revdex.com would like to review our policy and *** medical records, we would be happy to share this information with themWe wish you and *** all the best.Sincerely,Jen

We understand that any premium increase may cause a hardshipOver the life of a pet, all pet insurance companies will raise rates to keep up with the rapidly rising costs of veterinary care, which includes the cost of the best medical and diagnostic options available todayMy background is in
veterinary medicine and we increased the rates for services such as surgery, diagnostic tests and hospitalization annuallyA 10% increase in the veterinary industry was not unusualAdditionally the cost of the medications would change based upon our costs from our distributorsOther things to consider are new diagnostics, procedures and treatments that are available
Our premium increases are reviewed on an annual basis and the increase percentage was the same for all policyholders in your zip codeYour rates are never increased due to filing claimsPlease let me know if you have additional questions

We addressed your concern in our original response, but it sounds like you need further explanation, which we are happy to provide.Your monthly premium is currently $based on your chosen coverage levelA quote for a new customer enrolling a new policy with the same age and breed, as well as zip code location as your furry kiddo is reflecting $This premium is higher than your current monthly premium.The annual increase for your policy takes effect on the anniversary of enrollment each yearAs we notify you days in advance, this increase has not yet taken effectThe new premium on the anniversary of your enrollment will be increasingThough this is slightly higher than they quote you are currently seeing for new enrollments, new quotes also vary or increase over timeIf you were to generate a new quote after your policy anniversary in June, you would likely see a quoted premium higher than your new premium rate. We strive to keep our premiums as low as possible while still providing comprehensive coverage so we can be here for your furry family members when they are ill or injuredIn order to provide coverage for all the pets enrolled with us, our premiums are subject to change over time for both enrolled customers and pet parents who are not yet part of the Healthy Paws family.We hope that this clarifies our original response

Complaint: ***
I am rejecting this response because: I called the business a few days after setting up the policy and requested the policy be cancelled prior to the policy going in effectI was told that I had not been charged yet and it was still time to cancelThe lady I spoke with name with Shelby Shelby went in and told me she would process the cancellation and I shouldn’t have a problem at that time when I initially set this policy up I provided the company my American Express card this is not a cart that I constantly watch that’s how this hundred dollars was able to slip through the cracks I make multiple charges throughout the year on this cart and it wasn’t until I call them to update them a year later thinking that they were my insurance company which is Pet premier that’s how old this end up getting caughtAt that Time I immediately requested to speak to a supervisor to get this whole thing handled and process with Li I was told at that time that they didn’t go in and cancel the policy the policy was still in a fact I told them at that point I already had insurance and was happy to provide their insurance to them so that they can see that coverage was already in place and they can do the refund I was told at that time that they couldn’t do anything and that they were keeping all my money it wasn’t until I called and let them know that I was filing a complaint on them and ask for the address of the company which they refuse to give and I have to end up calling the state business office to get their information at that point I went on to Revdex.com and I filed the complaint against the companyI get a call back from a young lady who was another supervisor who is in a previous email telling me that she will be more than happy to go in and process a closure, and she told me as a courtesy the Father’s Day can go back was me she then asked at that time that I provide her with a email saying that the policy would be canceled in May and I greed to the cancellation I told her I did not agree to canceling this policy in May and I want it all of my money back I had health to all of my money back the whole time now this young lady Shelby calls meet up when I was filing a complaint again because I did not receive the money back that the company told me that they will be sending back for the May process I was still holding out for the Revdex.com to Stepien and give me some type a result on this while I dealt with the business getting back at least the money they were going to give me for me I have sense call my credit card company Company and explain to them what happened right now everything is on the standstill until we figure this thing out on the company in I’m not filing the complaint with the credit card company for fraud yet I’m waiting to see what’s going to happen with this outcome if you look at the email she sent that I agreed to canceling the policy in May if I agreed to cancel the policy in May why would I be filing a complaint I already had insurance in place I didn’t need a secondary insurance policy on my pics which was explain to them I explain to them that I was in the military and I was overseas at the time and somebody else was keeping my pants at the time like I said I could not catch this because it’s such a small amount of something dollars that this was able to slip through the cracks I have since called both credit card companies and have them block this company so that no more fraud could occur on my count I also have went on to several websites to write out exactly what happened so other people would not fall victim of this company when they see that other insurance was in place at that time as long as they could’ve verified it they should’ve went in and immediately issued a refund on my account what they’re doing is they asked me to go hit one is the meet all the claims which is what I was explaining to them that I do need double coverage because somebody else was already covering the Pats so I submitted all the claims to show them that these were in fact being covered and I still have not got any form of payment based on those claims what I was told was they were going to process the claims as a secondary like they are the secondary insurance Pet insurance does not allow you to have a first and a second it’s not like regular insurance therefore they should have went in and issue a full refund I don’t agree to what they’re saying and I want all of my money backThis company is nothing more than I A fraud and other consumers should in fact be warned about this company immediatelyI originally went with the other company based on the fact that they had a better reputation and they offer more of your money back with your pets that’s the reason why this company was canceled originally at the shopping around that week I found a better deal and a better offer I called back spoke to them they said they would cancel it immediately over the phone they said nothing about it had to be put in writing if they have the word records of everything let them produce itI Have attached the pets previous insurance to this policy so that you can verify for yourself the coverage was in fact in place just as I let them knowAlso I have sent them all of the claims for the time that this current insurance was in place so that they can see in fact that my pants were in fact being seen and if the insurance was in fact being paid if you asked him to provide you claims that I filed they can’t do it all the claims that they were sent I have a record of him and I’ll fax confirmation showing that every claim that they have was just recently sent to them in December other than that as I stated this Company is nothing more than a fraud look into ripped consumers off When I was on the phone with one of the representatives the other day before being transferred to Shelby she told me that months have not been paid out at $I would like all of my money back in fUllAfter speaking to Shelby and confronting her why my package on my policy was not cancel she immediately got defensive and then put a note on my count that all transactions with me or to be done via email which is fine I don’t have a problem with that I don’t want any contact with this company I just want my money back
Sincerely,
*** ***

I’m sorry to hear that *** developed in illness a couple of days after he was enrolled with usI hope he’s feeling better now that he’s received medical treatmentAll pet insurance companies have some type of waiting period before coverage goes into effectWe have a 15-day waiting period before
we provide coverage for any injury or illness and months for an illness related to hip dysplasiaYou can find this information on your Healthy Paws Mobile App, Customer Center and Website
The specific messaging states:
“Waiting Periods:days from the Pet Policy Effective Date for accidents and illness and months from the Pet Policy Effective Date for illness related to hip dysplasia”
On our FAQ:
Is there a waiting period?
There is a waiting period of days after your policy effective date for accidents and illnessesYour policy is effective 12:a.mof the day following the date you enroll your pet with Healthy Paws Pet Insurance
Hip dysplasia coverage is provided at no extra cost and is subject to a month waiting period for pets younger than sixAt this time, we are unable to cover hip dysplasia if your pet is six years of age or older at the time of enrollment
In regard to your concerns regarding the phone conversation with one of our Customer Care Representatives, we will review the call, as this is not a typical interaction with our Pet ParentsWe take a lot of pride in our customer service and I’m saddened to hear this feedbackWe will have our Excellence Team, which is our Performance and Auditing Team, review this call immediately
I understand that you spoke to one of our managers on June 1st, which was the same day we processed your claim. The timeline that was communicated to you if you wanted to speak with the VP of Customer Care and Claims was because I was out of the office on vacationI apologize that we were not clearer about why this timeline was communicated with youI would be happy to speak with you about your policy, claim and waiting periods if you have any additional questionsI will send you a separate email to you to schedule a good time to speak

Complaint: ***
I am rejecting this response because my understanding for regarding about the refund on my premiums up to date is ten months; not just one month I can definitely say that Healthy Paw Insurance is not a reputable one at all What is the point of receiving only one month of refund back on my premium by going through Revdex.com and making a complaint? If the refund is for only one month, the previous e-mail should have said that they will only refund me one month only Why did healthy paws insurance use this kind of sentence structure "we will refund your premiums to the date"? Now, I can say Healthy Paw Insurance is a very shady one in terms of handling complaints and claims
*** ***

Healthy Paws Pet Insurance
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 care
Just like the cost of
veterinary care and treatment, premium increases may fluctuate over timeIn
your area we did not increase premiums in or During the past couple
of years there was an overall increase in the frequency of high-value
treatments such as cruciate ligament surgeries, cancer treatments including
chemotherapy, and foreign body exploratory surgeries performed by veterinarians
(most of which can range anywhere from $3,000-$14,000)These rate increases,
which were lower than stated in the compliant, ensure that we can continue to
provide nose-to-tail coverage for the life of your petWe never increase your
rates based on your personal claims history
We hope this helps
clarify the necessity of premium increases for pet insurance companies in
general as well as your personal increase this year

While they have in the end processed my claim, their inadequate customer service, customer badgering and accusations make their business model unpalatableIf I had not called them out on their errors they would have done nothing Buyer beware!
Sincerely,
*** ***