After acquiring additional information from the *** *** Hospital, and speaking with the Dr, it was determined the incident from *** is not related to the current treatment. Payment will be processed in the next days
%
Upon review of the adoption papers and the Vet notes from *** Pet hospital, PetFirst has reconsidered and will process the claim for the Upper Respiratory infection. Payment will be made in the next business days
** *** *** ** *** *** *** *** *** *** ** *** *** *** ** *** *** *** *** *** ** *** *** ***
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved
Regards,
*** ***
Our system linked the policies together and when it did everything was then put in the husband's name. PetFirst has been in touch with Ms*** to explain what has happened and we will get her name back on her policy after the refund has been processed for her husband's part of the
policy. We are awaiting a cancellation form stating his dog has passed away from Mr***
Ms*** *** has had a basic plan with PetFirst from until Feb In the Basic plan cruciate ligament damage is listed as an exclusion in the policy packet that is sent to the customer each year after they renew their plan. This exclusion has been in her policy packet
since 2012. There have not been any changes to this exclusion that is listed belowExclusion # Diagnosis, medical management, or surgical correction of cruciate ligament damage or rupture to include treatment for the anterior cruciate ligament (ACL), medial cruciate ligament (MCL), posterior cruciate ligament (PCL), and cranial cruciate ligament (CCL).This member was presented the opportunity to change to our Lifetime plan, that does cover cruciate ligament treatment, in September of but unfortunately chose not to change plans because of cost. Due to Department of Insurance regulations we are obligate to follow the terms and conditions of the policy packet that she chose. PetFirst regrets that MS *** has canceled her policies and hopes that *** recovers from his current injury and lives a long and happy life
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
Regards,
*** ***
After the Claims Manager reviewed the complaint submitted by *** *** it has been determined payment should be made. PetFirst will reimburse according to the policy with a deductible and percentage of copayment.Payment will be mailed out by 8/12/16.Sorry for any confusion or
inconvenience this may have caused the Policyholder
It is our goal at PetFirst to provide coverage that is valuable to pet parents and also to provide a positive customer experience. Upon first review by the claims team of the original claim filed by the insured there was a determination that the symptoms exhibited by the covered pet existed
prior to the effective date of the policy. However, after a further review and receiving information from the veterinarian, a determination was made that this claim should have been paid. A check has since been issued and mailed to the insured. We apologize for any inconvenience our policyholder experienced due to this delay in payment. It is our belief that this issue has been resolved
It is our goal to provide every policyholder with prompt and fair claims service. Upon review of this complaint it was determined that the policyholder should have received payment for the claim submitted. The claim is currently being processed based on the policy provisions. The
policyholder will receive a check within the next few days. We apologize for any inconvenience experienced caused by this delay
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved
Regards,
*** ***
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.The reason I reject this response is that the sales rep informed me that they would cover the visit for the urinary tract infection immediately as well as the customer service rep informed me as well. I informed both of these individuals that my dog had an appointment with the vet due to a possible urinary tract infection, they both reported that it would be covered, even touted that this is one of the reasons why PetFirst is one of the best insurance companies that are out there. It is the main reason I bought into this insurance other than that I wouldn't have because I had called other insurance companies and knew they wouldn't cover it, however the company's sales rep said they would. So either the sales rep is blatantly lying to get people to sign up for the insurance, the company is having their sales rep use inaccurate information to boost their sales thereby making the company a fraud and using advertisement. Either way you misinformed me, the customer and I got cheated out of what I was told to expect to happen. And that to me is blatant dishonesty. I have and will continue to discourage my co-workers who were interested in signing up with this insurance to not do so due to the tactics used by their sales rep and if they have already signed up to be very cautious about what they do with the insurance when they have to take their pets to the vet. Very disappointed in how this all turned out. In the end it is about honesty and treating the customer with respect. I bought into this plan in good faith and believing that services would be rendered. I gave complete information about what I was doing with my dog and the vet and the possible problems that existed, the company said they would cover it and now they are citing something other than what they told me. I am just plain disgusted with this.
Regards,
*** ***
Based on the submission of this (and additional) information, we are re-evaluating the claim settlement for Mr***. Please contact us directly if you have any questions.Sincerely,*** ***
***
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Although I am glad they took the time to review the claim and accepted their mistake in denying it in the first place, I still find it deceptive that they tricked me into getting a supposedly better policy more expensive and with more coverage but omitting to explain that it will make all previously covered illnesses a pre-existence. I will accept the response but will take my business elsewhere.
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.
I don't accept the response from the company because they have not addressed how they are going to stop their sales reps from giving misinformation. I just had another co-worker who signed up with them have the same thing told to her. I advised her of what happened to me so that she would not be under the misgivings that her pet appointment would be covered this time as her dog had the same situation as mine. She has since then cancelled her account as well, fortunately for her she did it before she went to her vet and realized it would not be covered. Quoting the New York State Law is great, I understand why you didn't pay the bill, having your sales reps misrepresent is entirely different and that is the problem here. Train your reps appropriately so others don't fall into the same trap. The good thing is that you are not the only animal insurance that is available and the others have made it a point to inform me and the others of what can and cannot be done within certain time frames. Your company failed in this regards, making this a less than desirable company to work with. And if word of mouth is good advertisement, I'll do my best to inform my community of this episode so that they can make better informed decisions than solely going on what the reps say. Thank you
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the...
business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.
[redacted]i am not approving this until the check or refund is in hand. We have received nothing so far
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]
All Lifetime policies contain a "Waiting Period" applicable to new illnesses. There is both a definition of "Waiting Period" in the policy form and the "Waiting Period" application rule is covered in the EFFECTIVE DATE section of the policy form."Waiting Period" shall refer to an initial period of days from the inception date of this policy shown on the declaration page for illness claims.EFFECTIVE DATE"Your" coverage begins as of the effective date and time shown on the "documents of insurance" (including the Declarations, which forms part of this policy as issued) provided to "you" upon enrollment int the Plan. "We" will not reimburse "you" for illness expenses arising from any incident pertaining to "your pet" occurring within the initial "waiting period" commencing at policy inception shown on the declaration page. This "waiting period" shown on the declaration page will not apply to accident expenses or any subsequent "policy period" representing a renewal of this policy, if continuous coverage is maintained. The effective date of the policy in question ([redacted]) is 9/24/2016. The effective date for illness coverage is 10/8/016. Treatment was received for the claim (Incident number [redacted]) in question on 9/24/2016, the same day as the policy effective date. Per policy terms and conditions (the insurance contract), the claim was denied. We believe this claim was denied in good faith and in accordance to clear policy language filed and approved by the state of New York.
After acquiring additional information from the *** *** Hospital, and speaking with the Dr, it was determined the incident from *** is not related to the current treatment. Payment will be processed in the next days
%
Upon review of the adoption papers and the Vet notes from *** Pet hospital, PetFirst has reconsidered and will process the claim for the Upper Respiratory infection. Payment will be made in the next business days
We regret that we'll be unable to pa* *** pet insurance claim. We will fully refund all pet insurance premium paid ** *** ***
** *** *** ** *** *** *** *** *** *** ** *** *** *** ** *** *** *** *** *** ** *** *** ***
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved
Regards,
*** ***
Our system linked the policies together and when it did everything was then put in the husband's name. PetFirst has been in touch with Ms*** to explain what has happened and we will get her name back on her policy after the refund has been processed for her husband's part of the
policy. We are awaiting a cancellation form stating his dog has passed away from Mr***
Ms*** *** has had a basic plan with PetFirst from until Feb In the Basic plan cruciate ligament damage is listed as an exclusion in the policy packet that is sent to the customer each year after they renew their plan. This exclusion has been in her policy packet
since 2012. There have not been any changes to this exclusion that is listed belowExclusion # Diagnosis, medical management, or surgical correction of cruciate ligament damage or rupture to include treatment for the anterior cruciate ligament (ACL), medial cruciate ligament (MCL), posterior cruciate ligament (PCL), and cranial cruciate ligament (CCL).This member was presented the opportunity to change to our Lifetime plan, that does cover cruciate ligament treatment, in September of but unfortunately chose not to change plans because of cost. Due to Department of Insurance regulations we are obligate to follow the terms and conditions of the policy packet that she chose. PetFirst regrets that MS *** has canceled her policies and hopes that *** recovers from his current injury and lives a long and happy life
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below
Regards,
*** ***
After the Claims Manager reviewed the complaint submitted by *** *** it has been determined payment should be made. PetFirst will reimburse according to the policy with a deductible and percentage of copayment.Payment will be mailed out by 8/12/16.Sorry for any confusion or
inconvenience this may have caused the Policyholder
It is our goal at PetFirst to provide coverage that is valuable to pet parents and also to provide a positive customer experience. Upon first review by the claims team of the original claim filed by the insured there was a determination that the symptoms exhibited by the covered pet existed
prior to the effective date of the policy. However, after a further review and receiving information from the veterinarian, a determination was made that this claim should have been paid. A check has since been issued and mailed to the insured. We apologize for any inconvenience our policyholder experienced due to this delay in payment. It is our belief that this issue has been resolved
It is our goal to provide every policyholder with prompt and fair claims service. Upon review of this complaint it was determined that the policyholder should have received payment for the claim submitted. The claim is currently being processed based on the policy provisions. The
policyholder will receive a check within the next few days. We apologize for any inconvenience experienced caused by this delay
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved
Regards,
*** ***
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.The reason I reject this response is that the sales rep informed me that they would cover the visit for the urinary tract infection immediately as well as the customer service rep informed me as well. I informed both of these individuals that my dog had an appointment with the vet due to a possible urinary tract infection, they both reported that it would be covered, even touted that this is one of the reasons why PetFirst is one of the best insurance companies that are out there. It is the main reason I bought into this insurance other than that I wouldn't have because I had called other insurance companies and knew they wouldn't cover it, however the company's sales rep said they would. So either the sales rep is blatantly lying to get people to sign up for the insurance, the company is having their sales rep use inaccurate information to boost their sales thereby making the company a fraud and using advertisement. Either way you misinformed me, the customer and I got cheated out of what I was told to expect to happen. And that to me is blatant dishonesty. I have and will continue to discourage my co-workers who were interested in signing up with this insurance to not do so due to the tactics used by their sales rep and if they have already signed up to be very cautious about what they do with the insurance when they have to take their pets to the vet. Very disappointed in how this all turned out. In the end it is about honesty and treating the customer with respect. I bought into this plan in good faith and believing that services would be rendered. I gave complete information about what I was doing with my dog and the vet and the possible problems that existed, the company said they would cover it and now they are citing something other than what they told me. I am just plain disgusted with this.
Regards,
*** ***
Based on the submission of this (and additional) information, we are re-evaluating the claim settlement for Mr***. Please contact us directly if you have any questions.Sincerely,*** ***
***
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Although I am glad they took the time to review the claim and accepted their mistake in denying it in the first place, I still find it deceptive that they tricked me into getting a supposedly better policy more expensive and with more coverage but omitting to explain that it will make all previously covered illnesses a pre-existence. I will accept the response but will take my business elsewhere.
Regards,
[redacted]
 %3
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.
I don't accept the response from the company because they have not addressed how they are going to stop their sales reps from giving misinformation. I just had another co-worker who signed up with them have the same thing told to her. I advised her of what happened to me so that she would not be under the misgivings that her pet appointment would be covered this time as her dog had the same situation as mine. She has since then cancelled her account as well, fortunately for her she did it before she went to her vet and realized it would not be covered. Quoting the New York State Law is great, I understand why you didn't pay the bill, having your sales reps misrepresent is entirely different and that is the problem here. Train your reps appropriately so others don't fall into the same trap. The good thing is that you are not the only animal insurance that is available and the others have made it a point to inform me and the others of what can and cannot be done within certain time frames. Your company failed in this regards, making this a less than desirable company to work with. And if word of mouth is good advertisement, I'll do my best to inform my community of this episode so that they can make better informed decisions than solely going on what the reps say. Thank you
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the...
business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.
[redacted]i am not approving this until the check or refund is in hand. We have received nothing so far
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
Regards,
[redacted]
All Lifetime policies contain a "Waiting Period" applicable to new illnesses. There is both a definition of "Waiting Period" in the policy form and the "Waiting Period" application rule is covered in the EFFECTIVE DATE section of the policy form."Waiting Period" shall refer to an initial period of days from the inception date of this policy shown on the declaration page for illness claims.EFFECTIVE DATE"Your" coverage begins as of the effective date and time shown on the "documents of insurance" (including the Declarations, which forms part of this policy as issued) provided to "you" upon enrollment int the Plan. "We" will not reimburse "you" for illness expenses arising from any incident pertaining to "your pet" occurring within the initial "waiting period" commencing at policy inception shown on the declaration page. This "waiting period" shown on the declaration page will not apply to accident expenses or any subsequent "policy period" representing a renewal of this policy, if continuous coverage is maintained. The effective date of the policy in question ([redacted]) is 9/24/2016. The effective date for illness coverage is 10/8/016. Treatment was received for the claim (Incident number [redacted]) in question on 9/24/2016, the same day as the policy effective date. Per policy terms and conditions (the insurance contract), the claim was denied. We believe this claim was denied in good faith and in accordance to clear policy language filed and approved by the state of New York.