Pet's Best Insurance Services

Hi ***, thank you for your review. The claim was denied accordingly as you disclosed upon online self-enrollment that your pet suffered from Asthma prior to the policy effective date. We still requested medical records from your vet to check whether the claimed condition was related or not. Medical records from your vet indicate in fact the claimed condition was Asthma, which per your information, your pet suffered from prior to coverage. If you disagree with the claim decision, you are welcome to file an appeal with supporting documents. We wish you the best.

Hi ***, thank you for your review of our company. We see you self-enrolled in the policy on our website where we list our waiting periods on the quote form as well as detailed in the policy documents that were provided after enrollment for your careful review. A cruciate ligament injury typically carries a one year waiting period and we have reduced that with PetsBest to only six months. We wish Jackson the best.

Hi ***, thank you for your review of our company. We see you self-enrolled in the policy on our website where we list our waiting periods on the quote form as well as detailed in the policy documents that were provided after enrollment for your careful review. A cruciate ligament injury typically carries a one year waiting period and we have reduced that with PetsBest to only six months. We wish Jackson the best.

Hi ***, thank you for your review of our company. We see you self-enrolled in the policy on our website where we list our waiting periods on the quote form as well as detailed in the policy documents that were provided after enrollment for your careful review. A cruciate ligament injury typically carries a one year waiting period and we have reduced that with PetsBest to only six months. We wish Jackson the best.

Hi ***, thank you for your review of our company. We see you self-enrolled in the policy on our website where we list our waiting periods on the quote form as well as detailed in the policy documents that were provided after enrollment for your careful review. A cruciate ligament injury typically carries a one year waiting period and we have reduced that with PetsBest to only six months. We wish Jackson the best.

Mr. complaint seemingly takes issue with the terms of the policy. This policy states: “OPTIONAL WELLNESS BENEFIT. We will pay the actual costs incurred for the following Wellness Benefits your Pet(s) receives from a licensed veterinarian during the Policy Term up to the Maximum Limit shown in the Wellness Benefit Schedule.” (emphasis added)

The only covered item in Mr. claim was the examination fee itself totaling $45.00. As Mr. readily notes, “The discount allows a vet who participates to give me 25% off a bill.” Thus, each line item on the invoice, including the covered exam, had the discounts applied. Mr. of $45.00 was discounted to $33.35 since this was the out of pocket expense for the covered item.

What Mr. seemingly takes issue with is not being able to profit off the discount. The Pet Assure discount is something Mr. purchased on his own volition and is not something offered through Pets Best. The discount offered through this program is a wholly separate arrangement not involving Pets Best. Mr. is not entitled to reimbursement at a higher amount than what he expended for the covered item. Since Mr. only expended $33.45 for the covered item, this amount is all his policy reimburses.

An illustration may help understand. Say a person incurred $10,000 of medical care charges at a hospital. Without insurance, they would have to pay this amount out of pocket. However, the hospital charges the insurance company a discounted rate of $6,000 for this exact care. Would the insurance company be expected to pay the hospital $6,000 and remit the $4,000 to the policyholder? Clearly not. Mr. is essentially asking for the $4,000 amount to be directed to him in this scenario.

Mr. complaint seemingly takes issue with the terms of the policy. This policy states: “OPTIONAL WELLNESS BENEFIT. We will pay the actual costs incurred for the following Wellness Benefits your Pet(s) receives from a licensed veterinarian during the Policy Term up to the Maximum Limit shown in the Wellness Benefit Schedule.” (emphasis added)

The only covered item in Mr. claim was the examination fee itself totaling $45.00. As Mr. readily notes, “The discount allows a vet who participates to give me 25% off a bill.” Thus, each line item on the invoice, including the covered exam, had the discounts applied. Mr. of $45.00 was discounted to $33.35 since this was the out of pocket expense for the covered item.

What Mr. seemingly takes issue with is not being able to profit off the discount. The Pet Assure discount is something Mr. purchased on his own volition and is not something offered through Pets Best. The discount offered through this program is a wholly separate arrangement not involving Pets Best. Mr. is not entitled to reimbursement at a higher amount than what he expended for the covered item. Since Mr. only expended $33.45 for the covered item, this amount is all his policy reimburses.

An illustration may help understand. Say a person incurred $10,000 of medical care charges at a hospital. Without insurance, they would have to pay this amount out of pocket. However, the hospital charges the insurance company a discounted rate of $6,000 for this exact care. Would the insurance company be expected to pay the hospital $6,000 and remit the $4,000 to the policyholder? Clearly not. Mr. is essentially asking for the $4,000 amount to be directed to him in this scenario.

Mr. complaint seemingly takes issue with the terms of the policy. This policy states: “OPTIONAL WELLNESS BENEFIT. We will pay the actual costs incurred for the following Wellness Benefits your Pet(s) receives from a licensed veterinarian during the Policy Term up to the Maximum Limit shown in the Wellness Benefit Schedule.” (emphasis added)

The only covered item in Mr. claim was the examination fee itself totaling $45.00. As Mr. readily notes, “The discount allows a vet who participates to give me 25% off a bill.” Thus, each line item on the invoice, including the covered exam, had the discounts applied. Mr. of $45.00 was discounted to $33.35 since this was the out of pocket expense for the covered item.

What Mr. seemingly takes issue with is not being able to profit off the discount. The Pet Assure discount is something Mr. purchased on his own volition and is not something offered through Pets Best. The discount offered through this program is a wholly separate arrangement not involving Pets Best. Mr. is not entitled to reimbursement at a higher amount than what he expended for the covered item. Since Mr. only expended $33.45 for the covered item, this amount is all his policy reimburses.

An illustration may help understand. Say a person incurred $10,000 of medical care charges at a hospital. Without insurance, they would have to pay this amount out of pocket. However, the hospital charges the insurance company a discounted rate of $6,000 for this exact care. Would the insurance company be expected to pay the hospital $6,000 and remit the $4,000 to the policyholder? Clearly not. Mr. is essentially asking for the $4,000 amount to be directed to him in this scenario.

Mr. complaint seemingly takes issue with the terms of the policy. This policy states: “OPTIONAL WELLNESS BENEFIT. We will pay the actual costs incurred for the following Wellness Benefits your Pet(s) receives from a licensed veterinarian during the Policy Term up to the Maximum Limit shown in the Wellness Benefit Schedule.” (emphasis added)

The only covered item in Mr. claim was the examination fee itself totaling $45.00. As Mr. readily notes, “The discount allows a vet who participates to give me 25% off a bill.” Thus, each line item on the invoice, including the covered exam, had the discounts applied. Mr. of $45.00 was discounted to $33.35 since this was the out of pocket expense for the covered item.

What Mr. seemingly takes issue with is not being able to profit off the discount. The Pet Assure discount is something Mr. purchased on his own volition and is not something offered through Pets Best. The discount offered through this program is a wholly separate arrangement not involving Pets Best. Mr. is not entitled to reimbursement at a higher amount than what he expended for the covered item. Since Mr. only expended $33.45 for the covered item, this amount is all his policy reimburses.

An illustration may help understand. Say a person incurred $10,000 of medical care charges at a hospital. Without insurance, they would have to pay this amount out of pocket. However, the hospital charges the insurance company a discounted rate of $6,000 for this exact care. Would the insurance company be expected to pay the hospital $6,000 and remit the $4,000 to the policyholder? Clearly not. Mr. is essentially asking for the $4,000 amount to be directed to him in this scenario.

Explanation of Ms. Claim Processing Complaint.
Ms. purchased an Accident & Illness policy, with a $250.00 deductible and 90% reimbursement, with an added Wellness rider, on March 11, 2019. On June 28, 2019, she brought her pet to her veterinarian for a Wellness exam. The pet was noted to have an ear infection at that time as well. Ms. submitted her claim on June 28, 2019.
Because this claim was both for a Wellness exam (covered under the Wellness rider) and an Illness (Otitis/ear infection), the claim was split on July 7, 2019. On July 8, 2019, Pets Best requested 12 months of medical records from *** for review. This review is necessary as the policy contains a Pre-existing Condition exclusion and no reimbursement is available for conditions that displayed signs or symptoms prior to policy inception or during an applicable waiting period. Otitis (ear infections) is a fairly common condition that is related to allergies. As a result, records are generally requested for review of the first claim to determine if the Pre-existing Condition exclusion applies.
Ms. inquired with Pets Best on July 15, 2019 to verify the records were received that day via email. In confirming receipt of records, a Customer Care agent advised the records would be reviewed and if all necessary information had been provided, the claim would be processed accordingly.
Review of these records showed a gap of three years where the pet had not been seen. Often this gap is due to the pet being seen at a different veterinarian whose records have not been submitted or obtained. Due to this gap in time (which is significant for a pet), the processor sent a request on July 16 (the next day) to contact Ms. to determine whether the pet had been seen elsewhere or if any additional records were available. Ms. responded to this email expressing frustration with the delay. Ms. called the next morning (July 17) to advise that she did not have the money for veterinarian visits during the three-year gap and did not take the pet for any examinations. She also noted that she adopted the pet in 2011 from ***. This information was added to her claim and relayed for processing.\
Ms. inquired on July 19 as to the status of her claim and demanded immediate processing. A customer care agent explained in detail why records were needed and how this impacted the processing time. Ms. chose to cancel her policy at that time and received a refund of $29.00. Cancellations do not impact the processing or outcome of any claims and Ms. claim was processed as normal on July 20, 2019. The complete records and information revealed that the claim was covered under the policy.
Ms. was reimbursed $45.00 for vaccinations under the Wellness rider. Under the Accident & Illness policy, as noted, there is a $250.00 deductible and, once satisfied, the policy reimburses 90% of covered expenses. Ms. Illness claim totaled $175.00 of which $76.35 was not covered as it related to vaccines and addressed in the Wellness portion of the claim. Of the remaining $88.79, $9.86 was Ms. co-pay amount and $88.79 was covered under the Policy. The $88.79 was applied toward the $250 deductible.
No Refund of Premiums Available.
Ms. policy was effective from March 12, 2019 through July 20, 2019 paid in monthly increments of $41.55. She received a refund of $29.00 upon cancellation. She requests a $240 refund for her claim. However, even if this full amount were covered under her policy, it would not exceed the $250.00 deductible. Additionally, only 90% of the $240.00 would apply toward the deductible. Unfortunately, no additional refund is available.
Specific Policy Provisions.
The Policy Ms. purchase addresses each of her concerns noted in her complaint:
1. Refunds are returned pro rata: Section 4(H).
2. Claims are Processed as Quickly as Possible: Section 6
3. We may require complete medical records: Section 6(C).
4. Co-insurance & Deductible: Section 7(A)-(B).
We advertise that most claims are processed in 5 days or less, which is true. However, they may be delayed when additional records are needed. As illustrated here, records were requested on July 8 but not obtained until July 15. Once complete records were obtained the claim was processed within five days.

Explanation of Ms. Claim Processing Complaint.
Ms. purchased an Accident & Illness policy, with a $250.00 deductible and 90% reimbursement, with an added Wellness rider, on March 11, 2019. On June 28, 2019, she brought her pet to her veterinarian for a Wellness exam. The pet was noted to have an ear infection at that time as well. Ms. submitted her claim on June 28, 2019.
Because this claim was both for a Wellness exam (covered under the Wellness rider) and an Illness (Otitis/ear infection), the claim was split on July 7, 2019. On July 8, 2019, Pets Best requested 12 months of medical records from *** for review. This review is necessary as the policy contains a Pre-existing Condition exclusion and no reimbursement is available for conditions that displayed signs or symptoms prior to policy inception or during an applicable waiting period. Otitis (ear infections) is a fairly common condition that is related to allergies. As a result, records are generally requested for review of the first claim to determine if the Pre-existing Condition exclusion applies.
Ms. inquired with Pets Best on July 15, 2019 to verify the records were received that day via email. In confirming receipt of records, a Customer Care agent advised the records would be reviewed and if all necessary information had been provided, the claim would be processed accordingly.
Review of these records showed a gap of three years where the pet had not been seen. Often this gap is due to the pet being seen at a different veterinarian whose records have not been submitted or obtained. Due to this gap in time (which is significant for a pet), the processor sent a request on July 16 (the next day) to contact Ms. to determine whether the pet had been seen elsewhere or if any additional records were available. Ms. responded to this email expressing frustration with the delay. Ms. called the next morning (July 17) to advise that she did not have the money for veterinarian visits during the three-year gap and did not take the pet for any examinations. She also noted that she adopted the pet in 2011 from ***. This information was added to her claim and relayed for processing.\
Ms. inquired on July 19 as to the status of her claim and demanded immediate processing. A customer care agent explained in detail why records were needed and how this impacted the processing time. Ms. chose to cancel her policy at that time and received a refund of $29.00. Cancellations do not impact the processing or outcome of any claims and Ms. claim was processed as normal on July 20, 2019. The complete records and information revealed that the claim was covered under the policy.
Ms. was reimbursed $45.00 for vaccinations under the Wellness rider. Under the Accident & Illness policy, as noted, there is a $250.00 deductible and, once satisfied, the policy reimburses 90% of covered expenses. Ms. Illness claim totaled $175.00 of which $76.35 was not covered as it related to vaccines and addressed in the Wellness portion of the claim. Of the remaining $88.79, $9.86 was Ms. co-pay amount and $88.79 was covered under the Policy. The $88.79 was applied toward the $250 deductible.
No Refund of Premiums Available.
Ms. policy was effective from March 12, 2019 through July 20, 2019 paid in monthly increments of $41.55. She received a refund of $29.00 upon cancellation. She requests a $240 refund for her claim. However, even if this full amount were covered under her policy, it would not exceed the $250.00 deductible. Additionally, only 90% of the $240.00 would apply toward the deductible. Unfortunately, no additional refund is available.
Specific Policy Provisions.
The Policy Ms. purchase addresses each of her concerns noted in her complaint:
1. Refunds are returned pro rata: Section 4(H).
2. Claims are Processed as Quickly as Possible: Section 6
3. We may require complete medical records: Section 6(C).
4. Co-insurance & Deductible: Section 7(A)-(B).
We advertise that most claims are processed in 5 days or less, which is true. However, they may be delayed when additional records are needed. As illustrated here, records were requested on July 8 but not obtained until July 15. Once complete records were obtained the claim was processed within five days.

Explanation of Ms. Claim Processing Complaint.
Ms. purchased an Accident & Illness policy, with a $250.00 deductible and 90% reimbursement, with an added Wellness rider, on March 11, 2019. On June 28, 2019, she brought her pet to her veterinarian for a Wellness exam. The pet was noted to have an ear infection at that time as well. Ms. submitted her claim on June 28, 2019.
Because this claim was both for a Wellness exam (covered under the Wellness rider) and an Illness (Otitis/ear infection), the claim was split on July 7, 2019. On July 8, 2019, Pets Best requested 12 months of medical records from *** for review. This review is necessary as the policy contains a Pre-existing Condition exclusion and no reimbursement is available for conditions that displayed signs or symptoms prior to policy inception or during an applicable waiting period. Otitis (ear infections) is a fairly common condition that is related to allergies. As a result, records are generally requested for review of the first claim to determine if the Pre-existing Condition exclusion applies.
Ms. inquired with Pets Best on July 15, 2019 to verify the records were received that day via email. In confirming receipt of records, a Customer Care agent advised the records would be reviewed and if all necessary information had been provided, the claim would be processed accordingly.
Review of these records showed a gap of three years where the pet had not been seen. Often this gap is due to the pet being seen at a different veterinarian whose records have not been submitted or obtained. Due to this gap in time (which is significant for a pet), the processor sent a request on July 16 (the next day) to contact Ms. to determine whether the pet had been seen elsewhere or if any additional records were available. Ms. responded to this email expressing frustration with the delay. Ms. called the next morning (July 17) to advise that she did not have the money for veterinarian visits during the three-year gap and did not take the pet for any examinations. She also noted that she adopted the pet in 2011 from ***. This information was added to her claim and relayed for processing.\
Ms. inquired on July 19 as to the status of her claim and demanded immediate processing. A customer care agent explained in detail why records were needed and how this impacted the processing time. Ms. chose to cancel her policy at that time and received a refund of $29.00. Cancellations do not impact the processing or outcome of any claims and Ms. claim was processed as normal on July 20, 2019. The complete records and information revealed that the claim was covered under the policy.
Ms. was reimbursed $45.00 for vaccinations under the Wellness rider. Under the Accident & Illness policy, as noted, there is a $250.00 deductible and, once satisfied, the policy reimburses 90% of covered expenses. Ms. Illness claim totaled $175.00 of which $76.35 was not covered as it related to vaccines and addressed in the Wellness portion of the claim. Of the remaining $88.79, $9.86 was Ms. co-pay amount and $88.79 was covered under the Policy. The $88.79 was applied toward the $250 deductible.
No Refund of Premiums Available.
Ms. policy was effective from March 12, 2019 through July 20, 2019 paid in monthly increments of $41.55. She received a refund of $29.00 upon cancellation. She requests a $240 refund for her claim. However, even if this full amount were covered under her policy, it would not exceed the $250.00 deductible. Additionally, only 90% of the $240.00 would apply toward the deductible. Unfortunately, no additional refund is available.
Specific Policy Provisions.
The Policy Ms. purchase addresses each of her concerns noted in her complaint:
1. Refunds are returned pro rata: Section 4(H).
2. Claims are Processed as Quickly as Possible: Section 6
3. We may require complete medical records: Section 6(C).
4. Co-insurance & Deductible: Section 7(A)-(B).
We advertise that most claims are processed in 5 days or less, which is true. However, they may be delayed when additional records are needed. As illustrated here, records were requested on July 8 but not obtained until July 15. Once complete records were obtained the claim was processed within five days.

Explanation of Ms. Claim Processing Complaint.
Ms. purchased an Accident & Illness policy, with a $250.00 deductible and 90% reimbursement, with an added Wellness rider, on March 11, 2019. On June 28, 2019, she brought her pet to her veterinarian for a Wellness exam. The pet was noted to have an ear infection at that time as well. Ms. submitted her claim on June 28, 2019.
Because this claim was both for a Wellness exam (covered under the Wellness rider) and an Illness (Otitis/ear infection), the claim was split on July 7, 2019. On July 8, 2019, Pets Best requested 12 months of medical records from *** for review. This review is necessary as the policy contains a Pre-existing Condition exclusion and no reimbursement is available for conditions that displayed signs or symptoms prior to policy inception or during an applicable waiting period. Otitis (ear infections) is a fairly common condition that is related to allergies. As a result, records are generally requested for review of the first claim to determine if the Pre-existing Condition exclusion applies.
Ms. inquired with Pets Best on July 15, 2019 to verify the records were received that day via email. In confirming receipt of records, a Customer Care agent advised the records would be reviewed and if all necessary information had been provided, the claim would be processed accordingly.
Review of these records showed a gap of three years where the pet had not been seen. Often this gap is due to the pet being seen at a different veterinarian whose records have not been submitted or obtained. Due to this gap in time (which is significant for a pet), the processor sent a request on July 16 (the next day) to contact Ms. to determine whether the pet had been seen elsewhere or if any additional records were available. Ms. responded to this email expressing frustration with the delay. Ms. called the next morning (July 17) to advise that she did not have the money for veterinarian visits during the three-year gap and did not take the pet for any examinations. She also noted that she adopted the pet in 2011 from ***. This information was added to her claim and relayed for processing.\
Ms. inquired on July 19 as to the status of her claim and demanded immediate processing. A customer care agent explained in detail why records were needed and how this impacted the processing time. Ms. chose to cancel her policy at that time and received a refund of $29.00. Cancellations do not impact the processing or outcome of any claims and Ms. claim was processed as normal on July 20, 2019. The complete records and information revealed that the claim was covered under the policy.
Ms. was reimbursed $45.00 for vaccinations under the Wellness rider. Under the Accident & Illness policy, as noted, there is a $250.00 deductible and, once satisfied, the policy reimburses 90% of covered expenses. Ms. Illness claim totaled $175.00 of which $76.35 was not covered as it related to vaccines and addressed in the Wellness portion of the claim. Of the remaining $88.79, $9.86 was Ms. co-pay amount and $88.79 was covered under the Policy. The $88.79 was applied toward the $250 deductible.
No Refund of Premiums Available.
Ms. policy was effective from March 12, 2019 through July 20, 2019 paid in monthly increments of $41.55. She received a refund of $29.00 upon cancellation. She requests a $240 refund for her claim. However, even if this full amount were covered under her policy, it would not exceed the $250.00 deductible. Additionally, only 90% of the $240.00 would apply toward the deductible. Unfortunately, no additional refund is available.
Specific Policy Provisions.
The Policy Ms. purchase addresses each of her concerns noted in her complaint:
1. Refunds are returned pro rata: Section 4(H).
2. Claims are Processed as Quickly as Possible: Section 6
3. We may require complete medical records: Section 6(C).
4. Co-insurance & Deductible: Section 7(A)-(B).
We advertise that most claims are processed in 5 days or less, which is true. However, they may be delayed when additional records are needed. As illustrated here, records were requested on July 8 but not obtained until July 15. Once complete records were obtained the claim was processed within five days.

Ms. original policy was cancelled for non-payment on 12/24/18. She purchased a new policy on February 27, 2019. Per the terms of the policy language, there was no continual coverage from the first to second policy. As a result, the Pre-existing Condition exclusion would exclude from coverage any Condition that was Present or had signs or symptoms prior to expiration of the applicable waiting periods of the second policy.

Ms. inquire about her claim on 7/17/19 and used explicit language when informed of this possibility. At her request, the policy was cancelled. Ms. complaint here is one dealing with the contractual terms of her policy and results of her own failure to read the terms and meet her payment responsibilities.

Ms. original policy was cancelled for non-payment on 12/24/18. She purchased a new policy on February 27, 2019. Per the terms of the policy language, there was no continual coverage from the first to second policy. As a result, the Pre-existing Condition exclusion would exclude from coverage any Condition that was Present or had signs or symptoms prior to expiration of the applicable waiting periods of the second policy.

Ms. inquire about her claim on 7/17/19 and used explicit language when informed of this possibility. At her request, the policy was cancelled. Ms. complaint here is one dealing with the contractual terms of her policy and results of her own failure to read the terms and meet her payment responsibilities.

Ms. original policy was cancelled for non-payment on 12/24/18. She purchased a new policy on February 27, 2019. Per the terms of the policy language, there was no continual coverage from the first to second policy. As a result, the Pre-existing Condition exclusion would exclude from coverage any Condition that was Present or had signs or symptoms prior to expiration of the applicable waiting periods of the second policy.

Ms. inquire about her claim on 7/17/19 and used explicit language when informed of this possibility. At her request, the policy was cancelled. Ms. complaint here is one dealing with the contractual terms of her policy and results of her own failure to read the terms and meet her payment responsibilities.

Ms. original policy was cancelled for non-payment on 12/24/18. She purchased a new policy on February 27, 2019. Per the terms of the policy language, there was no continual coverage from the first to second policy. As a result, the Pre-existing Condition exclusion would exclude from coverage any Condition that was Present or had signs or symptoms prior to expiration of the applicable waiting periods of the second policy.

Ms. inquire about her claim on 7/17/19 and used explicit language when informed of this possibility. At her request, the policy was cancelled. Ms. complaint here is one dealing with the contractual terms of her policy and results of her own failure to read the terms and meet her payment responsibilities.

This Policy was purchased on January 15, 2019 with illness coverage beginning January 29, 2019. Under the terms of the policy, “Pre-existing Conditions” are defined as: “Any condition for which a Veterinarian provided medical advice, the Pet received treatment for, or the Pet displayed signs or symptoms consistent with the stated Condition prior to the effective date of a Pet insurance policy (Policy Effective Date) or during any Waiting Period.”
Ms. contends “Nowhere on any vet record does it state that my dog has had this prior. There is no proof and nothing noting this.” However, the records obtained from *** dated April 27, 2019 show the following entry on page 1: “O stated p is uncomfortable when getting picked up O stated she thinks around the stoomach (sic) area. O stated it started around jan when p came back from groomers. P goes down the stairs hesitated but still jumps normal and jumps of (sic) the sofa all the time.” *** was diagnosed with IVDD on this date based in part on this record of ***’s symptoms. These symptoms are consistent with the diagnosed IVDD and the timeline places symptoms before illness coverage began. As a result, this condition was excluded as a “Pre-existing Condition.”
Upon review, January 29, 2019 was the date the coverage for illnesses began. No definitive date was given as to when *** was seen at the groomers. If this visit occurred on January 29, 2019, Ms. may submit a receipt and statement from her financial provider showing the date of this transaction for our additional review.
Ms. has expressed her belief that “This company is just ripping people off” both in the Revdex.com Complaint and similarly, albeit with much more colorful language, when she inquired with our customer care agent and was informed of why her claim was denied. Unfortunately, we are bound to make these determinations based on the medical records provided which, in this case, document symptoms before coverage was available.

Unfortunately, Ms.' rejection of our response simply restates the original complaint. We have already identified the records that reference ***'s symptoms. Ultimately, Ms. is taking issue with the terms of her policy which define and determine "Pre-existing Conditions" based on when the pet displayed signs or symptoms of the condition. This determination is not based on the date of diagnosis. ***'s symptoms are documented to have occurred prior to expiration of the waiting period in January.

*** Attachments Redacted by Revdex.com

This Policy was purchased on January 15, 2019 with illness coverage beginning January 29, 2019. Under the terms of the policy, “Pre-existing Conditions” are defined as: “Any condition for which a Veterinarian provided medical advice, the Pet received treatment for, or the Pet displayed signs or symptoms consistent with the stated Condition prior to the effective date of a Pet insurance policy (Policy Effective Date) or during any Waiting Period.”
Ms. contends “Nowhere on any vet record does it state that my dog has had this prior. There is no proof and nothing noting this.” However, the records obtained from *** dated April 27, 2019 show the following entry on page 1: “O stated p is uncomfortable when getting picked up O stated she thinks around the stoomach (sic) area. O stated it started around jan when p came back from groomers. P goes down the stairs hesitated but still jumps normal and jumps of (sic) the sofa all the time.” *** was diagnosed with IVDD on this date based in part on this record of ***’s symptoms. These symptoms are consistent with the diagnosed IVDD and the timeline places symptoms before illness coverage began. As a result, this condition was excluded as a “Pre-existing Condition.”
Upon review, January 29, 2019 was the date the coverage for illnesses began. No definitive date was given as to when *** was seen at the groomers. If this visit occurred on January 29, 2019, Ms. may submit a receipt and statement from her financial provider showing the date of this transaction for our additional review.
Ms. has expressed her belief that “This company is just ripping people off” both in the Revdex.com Complaint and similarly, albeit with much more colorful language, when she inquired with our customer care agent and was informed of why her claim was denied. Unfortunately, we are bound to make these determinations based on the medical records provided which, in this case, document symptoms before coverage was available.

Unfortunately, Ms.' rejection of our response simply restates the original complaint. We have already identified the records that reference ***'s symptoms. Ultimately, Ms. is taking issue with the terms of her policy which define and determine "Pre-existing Conditions" based on when the pet displayed signs or symptoms of the condition. This determination is not based on the date of diagnosis. ***'s symptoms are documented to have occurred prior to expiration of the waiting period in January.

*** Attachments Redacted by Revdex.com

This Policy was purchased on January 15, 2019 with illness coverage beginning January 29, 2019. Under the terms of the policy, “Pre-existing Conditions” are defined as: “Any condition for which a Veterinarian provided medical advice, the Pet received treatment for, or the Pet displayed signs or symptoms consistent with the stated Condition prior to the effective date of a Pet insurance policy (Policy Effective Date) or during any Waiting Period.”
Ms. contends “Nowhere on any vet record does it state that my dog has had this prior. There is no proof and nothing noting this.” However, the records obtained from *** dated April 27, 2019 show the following entry on page 1: “O stated p is uncomfortable when getting picked up O stated she thinks around the stoomach (sic) area. O stated it started around jan when p came back from groomers. P goes down the stairs hesitated but still jumps normal and jumps of (sic) the sofa all the time.” *** was diagnosed with IVDD on this date based in part on this record of ***’s symptoms. These symptoms are consistent with the diagnosed IVDD and the timeline places symptoms before illness coverage began. As a result, this condition was excluded as a “Pre-existing Condition.”
Upon review, January 29, 2019 was the date the coverage for illnesses began. No definitive date was given as to when *** was seen at the groomers. If this visit occurred on January 29, 2019, Ms. may submit a receipt and statement from her financial provider showing the date of this transaction for our additional review.
Ms. has expressed her belief that “This company is just ripping people off” both in the Revdex.com Complaint and similarly, albeit with much more colorful language, when she inquired with our customer care agent and was informed of why her claim was denied. Unfortunately, we are bound to make these determinations based on the medical records provided which, in this case, document symptoms before coverage was available.

Unfortunately, Ms.' rejection of our response simply restates the original complaint. We have already identified the records that reference ***'s symptoms. Ultimately, Ms. is taking issue with the terms of her policy which define and determine "Pre-existing Conditions" based on when the pet displayed signs or symptoms of the condition. This determination is not based on the date of diagnosis. ***'s symptoms are documented to have occurred prior to expiration of the waiting period in January.

*** Attachments Redacted by Revdex.com