Pets Best Insurance

I have had different disputes different days with this business they are each seperate but they are trying to tie them into dispute and taking the balance owed of the least expensive owed and using it for all They set up unauthorized reoccuring debits on my stored info and began withdrawing out of my account monthlyMy pymts is and it was already paid up for the month so when I call Noone will admit the money was taken outThat charge was set up July I assumed it would be corrected and didn't check back onto the account to see if it was credited until yesterday July I did call July to cancel and was given a prorated balance of I had not gotten my prorated or my cancel letter yet but I had no doubt it would come but I noticed the charge was nvr put back so I called and was told they were putting on my card tomorrowI asked what that credit was for they said my prorated balance which I was already expecting so I move onto the charges that were taken out extra if they were gonna put it backThey said the u get tomorrow will cover itSo I'm only get fee and it covers the fee and the feeThey go me a document clearly stating the was unauthorized and was scheduled to be put back that next day but was never processedO.kso now I hv proofThen I get a letter saying I cancelled July and I'm getting prorated confirmationSo after leaving a Revdex.com review yesterday they said I was told I was getting and they created a brand new document showing I was right but said they gave me the docs yesterday but it was a completely different doc I'd nvr seen and it even had today's date on it and my phone shows when I received the doc and when Revdex.com got the doc they never sent it to me I see it 1st time online then ask for a copySo now theyre admitting the and have erased the prorated amount of that's owed for cancellingtimes in a row.Alot of apologies and alot of reprimand ingredientsI want a personal phone call from the CEO of this company to contact me so we can discuss the issues I have been having and informing him of problem areas that need attention to implement a better education of the company and your job responsibilitiesProper phone etiquette using a calming voice since ppl who call for insurance are already frustrated and a pleasant tone of voice can set a good tone on how the call will endSaying sir and maam and Mr n Mrs thank you please just politeAnd education in all the areas since so many depts don't take calls the reps cannot answer any questions for those departments and then the client has to do all the work tracing to his account on his own by calling banks when they can pull up ur policy number and guide you thruI have a lot of great ideasI know when my pet had lymphoma it was the staff at the hospital that really showed they cared and that your feelings are valid and you matterO.KI called for info on my pet insuranceOn July during the call I ask if I could just cancel of the pets I then changed my mind and decided to keep them all on the policyThat was thaton July I receive reoccurring automatic withdrawels hv been set up from them under my card I hv on fileI nvr authorized any debit or set up payments or go my card info now was I asked if they could take money or told they were taking moneyI called to ask abt the fees and was told they were supposed to be credits and not debits n to call bankIt was obviously debits but ins said they see them on their screen as credit I was then told it was reinstatement fee since I said I wanted to cancel pets then turned around n said no never mind they charge you fees totalling even though their was no lapse in coverage had I cancelled I'd still be covered til midnight and I didn't even cancel and reinstate I was discussing it out loud and she just clicked buttons for fun so I was a paid in full active client until my next pymtsOn July I decide I am going to cancel so I make a phone call and at no time was any of my previous calls or charges were even mentioned since I was unaware the money had not been put backSo call I cancel get a prorated refund amounts of in to days get a letter yesterday confirming phone call cancel July That was simple enuffBut that day before I got the letter I called abt why the was still on my acctThey said they were reimbursing me next day and I was getting even more money since pc calculations aren't precise and you need to check them manually...hmmm so he found me an extra centsHmmmmmall day long I am telling them you took out of my account and to just tell me what I was paying for nobody ever gave an answer they said you're getting back 2morrow for a prorated from cancellation and if you ask where the is they say it's covered in the your getting 2morrow.So all day this charge of is a prorated amount of and also a reimbursement for and you get free penniesSo I get an email of the document showing the charge and showing the charge so I have proof it's different transactionsSo I show them clearly on the printout they sent me confirms everything so I goto Revdex.com and they have made a new document showing it my way and said it was given to me yesterday but has today's date on itExcept now the covers the unauthorized debit and the now also covers the proratedSo they lost the cents they were just giving me freeI am rejecting this response because: pets best sent documents saying they owed me and I was told it was supposed to be a credit and not a debit They sent me a document stating in handwriting beside the totals that these were supposed to be processed as credits and we're never processedAnd it showed the amounts on their document as debits When I pointed it out and posted the complaint on Revdex.com they responded that they provided me with the attached document And they created an entire new document that it was a credit but it had that days date on it but they say they gave it to me the day beforeI want this money put back in my accountI want the truthI want all these ppl who have verbally and mentally abused for hours at a time today to apologize and all be reprimandedI want the accounting depth held responsible for their lies and manipulation trying to twist words and numbers around to insult my intelligenceThey are not stupid they know they accidentally took money out and don't want to own up to it and have to go abt and do their job that they chose then don't wanna do itYou spent more time and energy on trying to manipulate me that had you used that effort to actually do your job and further yourself you would be putting a lot more money in your pocketYou trying to save 40$ all day took up at least employees hours each of working hours that's a day n half pay you lost your businessDivide that by each of your salaries and the overtimeYour costing business more than ur makingI have earnedI hv date time name recordings and I took notes

Complaint: ***I am rejecting this response becauseSincerely,*** ***

Revdex.com:
I have reviewed the response made by the business in reference to *** ** ***, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below
That is unacceptableYou have all the records everythingIt took Petsbest 1/months to tell me you were not going to payBoth vets said it was chronic kidney failure and that is supposed to be covered according to your policy
Regards,
Shelli Rich

Your policy has very specific exclusions regarding dental treatment, especially anything related to periodontal disease Your pet had nine teeth extracted This is almost always due to periodontal disease, but we wanted to get your pets medical records to try and see if there was another
reason for the extractions Your records took some time to obtain, and once they were received they confirmed that the extractions were due to periodontal disease and were appropriately denied

I am sorry to see that your pet was diagnosed with Parvovirus The insurance policy that you purchased has a 14-day waiting period before benefits go into effect, with an exclusion that excludes any condition that manifests during that period As your policy was purchased on 9/4/2015,
and your first claim for this condition was incurred on 9/17/2015, the condition falls within the waiting period and is excluded from coverage If you would like to file an appeal, please contact customer service at 1-877-738-

There is nothing I can add to my previous response The pre-authorization was not able to be approved due to findings in the medical records that the condition pre-existed coverage, and the company is willing to cancel the policy in question back to December of if it is being asserted that the reinstatement of coverage was not requested The fact that a pre-authorization for coverage under that policy is being disputed appears to negate the idea that the policy should not currently be in force, but if this is the outcome desired it can be achieved

Revdex.com:I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to meSincerely, *** ***

The denial of this claim was due to the diagnosis that you provided on the claim form matching with a condition that you admit your pet was diagnosed with before pet insurance was procured.  All pet insurance companies must deny pre-existing conditions in order to keep the coverage affordable....

 According to your provided summary, your pet was diagnosed with Atopy (a common skin allergy in dogs) in 2014.  On the claim form that you submitted to us you wrote "The vet diagnosed that he is having a skin infection likely secondary to an allergy."
Reinforcing your own narrative of the condition, we gathered your pet's medical records from Red Cedar Animal Hospital and Lake Lansing Road Animal Clinic.  The notes for your visit on 11-4-2014 at Red Cedar Animal Hospital indicate a diagnosis of Atopy.  Your visit of 10/21/2015 at Lake Lansing Road Animal Hospital (the date of service in question) indicate a "suspected allergies" diagnosis.
As you indicate that the condition being claimed is a condition that your pet was diagnosed with prior to purchasing coverage, and your veterinary records support this statement, it appears that this condition was appropriately denied as a pre-existing condition.

Good afternoon,The medical records of the pet in question show that the cat was showing symptoms of kidney failure, including increased kidney blood values, generalized muscle atrophy, poor body condition and hard stool only 9 days after the coverage went into effect.  The policy in question...

clearly excludes any condition that is present either before the policy is taken out. or during the short 2-week waiting period.  The pet's poor condition only 9 days after the coverage went into effect strongly indicate that the condition had been ongoing for quite some time, and the claim was appropriately denied as pre-existing the coverage.Should the policyholder wish to dispute this finding, she can avail herself of the claims appeal process contained within her policy.  This can include an independent veterinary review of her records by an unbiased veterinarian we have employed for this purpose.

Complaint: [redacted]
I am rejecting this response because their statement ignores the fact, that on their own website, pre-existing conditions are defined as, "Any illness or injury that begins before your policy is effective, or during your waiting period, will be considered “pre-existing”. Some conditions, like broken legs or kennel cough, heal or are curable and require no further treatment. Once healed or cured, these are not considered pre-existing conditions." (https://www.petsbest.com/coverage) What normal person, wouldn't consider an ear infection, one of these conditions that can be healed, and therefor, not a pre-existing condition? I cancelled my policy because I was mislead, and my money was taken under false pretenses.
Sincerely,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference t[redacted] and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
No claims were filed under this policy for over a year. The one dated January 25, 2016 is the first and ONLY claim ever filed with your organization. You have yet to still respond to this claim and reimburse for it. The reason I was given as to why it has taken longer than 3-5 days in your first email was due to an increase in claims being filed. If that is the case; your company should have taken the appropriate action to staff your facility so that customers--such as myself; are not incurring the lag time of being reimbursed for their policy. This is a company operation issue; not a customer issue.When looking at multiple reviews of your company online; there are quite a few complaints listed stating the same concerns as mine. It seems as though this is your practice to either stall or deny claims on a consistent basis.I delivered my promise by paying for your service each month; your company however; has not delivered the service that was offered and expected. Therefore; I am seeking a reimbursement for the 1 year of premiums that I paid and DID NOT file a claim with your company.Additionally; when I completed the application for my dog; your company was aware I had just rescued her. However; [redacted]alled me yesterday stating that your office called them requesting 18 months worth of medical records. How is this possible to produce those when I haven't owned the dog for 18 months? 
[redacted]
[redacted]

The claim in question was paid on 12/22.

Medical records obtained from your veterinarian indicate that your pet was diagnosed with a chronic, incurable skin condition known as Atopy.  This diagnosis was made in September of 2016.  You purchased your policy with Pets Best in November.  As such, this condition was pre-existing...

to coverage and denied under the pre-existing condition exclusion that exists in all pet insurance policies.  The office visit for which the first claim was made was described in the medical records as a "recheck skin" appointment.  As the condition was pre-existing the denial was appropriate.  We cannot refund premium because a claim for a clearly excluded condition was denied as coverage was present for every other condition your pet may have come down with during the coverage period.

Complaint: [redacted]I am rejecting this response because:
I have already submitted my dog medical record which clearly indicates there was no "pre-existing condition"! The hospital report also states that the injury was actually due to an accident which is the TITLE of the plan I purchased from you after being mislead by one of your sales reps at the time who not only assured that my dog will be covered for any type of accidents including ACL but they also said it will take effect in 14 days or so!! 
Your response MAKES ZERO SENSE, your business is SKETCH!!!
 
You will be hearing from my lawyer :) 
Sincerely,[redacted]

Ms. [redacted]'s complaint is being handled on appeal, by way of a consumer complaint with her state's Department of Insurance, and via communications with the carrier who underwrites her policy.  While we are working our way through those three channels, there is nothing further I can add by way of...

the Revdex.com.  We are in regular communication with Ms. [redacted], as is the carrier who underwrites her policy.  All indications at this time indicate that the condition she is claiming began several months before she purchased coverage.  As the coverage she purchased does not cover pre-existing conditions (as no pet insurance in the country does) the claim was denied as being outside the coverage purchased.  The denial appears to have been appropriate.

Unfortunately, there is nothing that Pets Best can do in this situation.  We are a third party administrator of an insurance contract between the policyholder and the insurance carrier.  The policy in question provides a set amount of wellness benefits per policy year.  These benefits...

reset upon renewal, which is communicated by mail 50 days ahead of the renewal date.  Pets Best cannot pay for services that are not eligible because all the benefits have been used during the current policy year.

Complaint: [redacted]I am rejecting this response because: [redacted]'s exam and treatment record does not mention periodontal disease.Sincerely,[redacted]

Complaint: [redacted]I am rejecting this response because:I stand corrected on the blood glucose reading in October. But, as stated by my veterinarian, and backed up by AAHA diabetes guidelines, that a one time elevated blood glucose reading in a non fasting and stressed animal is by far a sign or symptom of diabetes. I will follow with the second level appeal as agreed upon, but would like to keep this complaint open pending the outcome of the second appeal. Sincerely,[redacted]

[redacted]The policy you purchased has very specific exclusions for dental conditions.  We had understood that you were claiming the extractions as part of your medical coverage.  As such, we have to get very specific records to determine if these extractions fall under the narrow window...

of coverage that the policy provides.  As I now understand from your complaint that you are not actually claiming these extractions, only the associated cleaning, we will process the claim accordingly and will have it completed today.Thank you for the clarification, and I apologize for the delay.

Good afternoon,The policy that you purchased has a very clear exclusion against the payment of boarding fees.  The policy is designed to cover the treatment of medical and health problems that your pet may develop after the policy has been purchased, and in order to keep costs affordable...

includes exclusions to boarding fees, grooming fees, bathing fees, food, toys and all other non-medical, non-veterinary expenses.  This is standard across the pet insurance industry.We have received your previous messages indicating that the boarding that your pet received was "medically necessary". We informed you at that time that if the fees were actually for hospitalization, tpo please submit supporting documentation such as revised medical records or a letter from your veterinarian stating so and we will be happy to reprocess your claim.  To date we have not received anything, but this offer remains open.