Complaint: [redacted] I am rejecting this response because: How can you send a letter from last November to tell me there will be changes in and expect people to remember? I am sure I am not the only one that is in angry mode and wants their money back This is unacceptable Sincerely, [redacted]
We apologize for the customer’s disappointment in their recent claim experienceWe would like to clarify our mailed claim processIn order to ensure that we can better serve our US customers we offer a US mailing address which allows us to ensure that our customers have the option to submit physical documentation to us using a domestic addressThe mail received at our PO Box is automatically forwarded to our office where the documentation is processed by our administrative teamUnfortunately, due to this process once a trackable package is delivered to our PO Box, further tracking information will not be updated with ***The customers claims for wellness were received on May 12th, and applicable reimbursement in the amount of $was made via direct deposit [redacted] Customer Solutions Manager [redacted]
We apologize for the customer’s disappointment with their recent claims experience On June 27, we received a Claim Form for “Resorptive Lesions –multiple teeth, Periodontal disease stage to 3” dated April 4, This was rejected as an incomplete claim submission and a request was sent to the customer to advise them in order to submit a complete claim, we require a claim form, invoice and medical records We did not receive anything further from the customer, leading the claim to remain rejected.On December 1, the customer spoke with one of our customer care representatives and was advised we did not have the necessary documents to process the claim The representative also explained to the customer that their policy does not provide coverage for dental procedures or dental related.As per the customer’s selected policy terms and conditions:EXCLUSIONSThe Insurer shall not be liable for:Claims for dental procedures and/or dental diseases.The customer opted to cancel their coverage due to this exclusion We are committed to working with the customer to help them understand the claims submission process and their coverageWe take our customers’ feedback very seriously as we are constantly looking to improve our product and service offerings[redacted] Customer Solutions Specialist [redacted]
We apologize for the customer’s disappointment with their recent claims experienceTo clarify, on April 1st, we had received a completed claim form and medical records with no associated invoicesOn April 12th, we had received claim forms, dated March 25th, and April 9th, 2016, with no associated invoices or medical records On April 21st, we reached out to the customer via email advising that we were missing the associated invoices necessary to continue the claim processOn May 6th, we received invoice [redacted] invoice [redacted] and invoice [redacted] totaling $Unfortunately, there was no claim form or medical records submitted by the client with this submission On May 18th, we reached out to the customer via email advising that we were missing the associated claim form and medical records necessary to continue the claim processUnfortunately, the information received was not sufficient to process and complete the claims at that timeAs per the customer’s selected policy Terms and Conditions: Section – HOW TO CLAIM COMPLETING THE CLAIM FORM Complete the sections on the claim form indicated to be completed by YouAsk Your Veterinarian to complete the sections indicated to be completed by the VeterinarianBe sure the Veterinarian has signed the Veterinarian Declaration and used the clinic stampYou sign the customer declarationCollect the detailed paid invoices and Your Pet’s medical records As a customer service gesture, we have brought all information provided together for the client to allow claims processing The customer’s claim was process on May 31st, and reimbursement of $will be made via direct deposit An explanation of benefits has been sent to the customer to explain the breakdown of the claim [redacted] Customer Solutions Manager [redacted]
We apologize for the customer’s disappointment with their recent claim experience size="3"> Please be advised that all claims are processed based on the information made available to us, including information contained within the claim form and medical records Management has reviewed the customer’s claims and the original processing of the claims stands The claim for [redacted] was approved in the amount of $90.00, however this amount was used to satisfy the portion of the customer’s $deductible and therefore no reimbursement was made As per the customer’s selected policy terms and conditions: Section – EXCLUSIONS Any treatment related to an excluded procedure, accident and/or illness Dental and orthodontic health care, Dental Treatment, Dental procedures and/or Dental diseases including but not limited to Treatment of the teeth and gums, dental caries (cavities), gingivitis, periodontitis, retained deciduous teeth, malocclusion, periodontal disease, root canals, caps, crowns, or abscessed teeth, unless otherwise specifically covered by Our Dental Fees Rider, and coverage is in force under that Dental Fees Rider As per the customer’s claim form, the veterinarian noted: “dental disease felt to be possible cause of infection/hepatic enzyme elevation” Therefore, we are unable to respond to the portion of the customer’s claim for Dental Disease and Elevated Hepatic Enzymes At 24PetWatch, we offer a reassessment process which allows customers to provide us with additional information to appeal the processing of their claimWe invite the customer to request a reassessment of their claim by filling out one of our reassessment forms and providing us with additional medical records and a statement from their veterinarian regarding the conditions claimed [redacted] Manager, Customer Solutions [redacted]
We apologize for the customer’s disappointment and frustration in their recent experience with 24PetWatchOn February 15, the customer purchased a microchip identification tag and was advised the time frame for receipt was to weeks Unfortunately, due to an internal error the order was delayedAs the customer has yet to receive the tag, he has been communicating with our contact center and we are in the process of resolving this matterWe have attempted to reach out to him however have not yet been successful in reaching him to discuss the resolution furtherWe encourage the customer to contact our office at [redacted] to speak with one of our Customer Solutions Specialists in order to resolve the matterWe take our customers’ feedback very seriously as we are constantly looking to improve our product and service offerings [redacted] Customer Solutions Specialist [redacted] @pethealthinc.com Tell us why here
Complaint: [redacted] I am rejecting this response because:The proposed new policy is significantly more expensive than the one I had signed for years agoI have had no insurance claims during this time frame and as soon as my pet aged and began suffering health problems they have switched to a way more expensive coverageI demand full refund of the premiums I have made for all these years.Sincerely, [redacted]
We apologize for the customer’s disappointment with their recent experience We issue policy documents annually for our customers days prior to their policy’s renewal date On June 16, we issued renewal packages to the customer for two pets indicating their current Pet Insurance Policies, underwritten by Praetorian Insurance Company, will no longer be available and will not be renewedThe documents also indicated the customer must contact us to enroll their pets in newly offered policies by September 29, or the coverage would be terminated.Please note, this is an insurance underwriter change, and not a new insurance company.On July 12, the customer spoke with a sales representative about the package he received The representative advised the customer that we would have a member of the Customer Care team get in touch to address their questions about the renewal package Unfortunately, our attempt to contact the customer back on July 12, was unsuccessful.We received no communication back from the customer about their desire to oto the new policies The customer’s policies cancelled effective September 29, [redacted] Customer Solutions Specialist [redacted]
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution is satisfactory to me Sincerely, [redacted] ***
Upon receipt of this inquiry, we carefully reviewed the issues raised by our customer The policy is a month policy that automatically renews each year A new policy packet for the upcoming term was provided to the customer, along with notice of a rate increase and new underwriter for the policyWith a new underwriter, the products were evaluated, which did result in a rate increase to more accurately reflect the value of the coverageThis information was provided in August 2016, more than days in advance of the new term set to begin on October 19, 2016, to provide the customer ample advance notice of the changes and give her an opportunity to contact us with questions or take other actions Based on the customer’s letter, we reviewed the account We were not able to locate where she withdrew her previous authorization to bill her payment method on file, nor was there a request to cancel or select a different coverage With no direction from the customer otherwise, per the notice, the payment method was automatically billed on October 19, for the new plan periodFinally, the customer referenced a claim that was recently submitted We reviewed the claim in question and confirmed that it was processed accurately A large portion was not eligible because it was for wellness treatment which is not covered under the policy terms and another portion was applied to the annual deductibleWe will again reach out to the customer to discuss her concerns[redacted] Customer Solutions Specialist [redacted]
We sent the customer renewal documents indicating we required action by September 30, for the pets’ coverage or the coverage would not continue We received no communication from the customer about these offers Our policies are available for pets’ age weeks to years; unfortunately we are unable to set up comprehensive coverage for pets older than years We can only offer an accident only policy [redacted] Customer Solutions Specialist [redacted]
We apologize for the customer’s disappointment in their recent claim experienceUpon the customer’s upgrade on June 1st, for [redacted] from QuickCare Gold to 24PetWatch Super the customer was advised that any condition that was covered under their QuickCare Gold policy would continue to be covered under their upgraded policy and would not be considered pre-existingPreviously excluded conditions would continue to not be eligible for coverage as these are considered pre-existingAs per the customer’s medical records for [redacted] from [redacted] Veterinary Hospital on October 17, 2008: Hip radiographs -DJD of left stifle As per the customer selected policy terms and conditions: Section – COVERAGE RESTRICTIONS PRE-EXISTING MEDICAL CONDITIONS We do not cover: Any ILLNESS Medical Condition or Illness complication directly resulting from a Condition that manifested, first occurred, displayed signs and/or symptoms , was noted, treated, diagnosed or has been known by You and/or Your Veterinarian prior to the Coverage Effective Date of the Policy and/or during Your Policy’s ILLNESS Coverage Waiting PeriodIn all cases, this includes any Associated Condition or complication directly resulting from a condition that manifested, first occurred, displayed signs and/or symptoms , was noted, treated, diagnosed or has been known by You and/or Your Veterinarian prior to the Coverage Effective Date of the Policy or in respect of illness medical conditions during the Illness Waiting PeriodTherefore the condition of Degenerative Joint Disease is pre-existing to the customer’s original policy start date of November 1st, and remains permanently excluded from coverageUpon review of the account no past claims for Zack’s Arthritis have been payableAll eligible claims for Jake have been reimbursed to the policy limitsAs the policy has been administered and claim processed in accordance with the customers selected policies terms and conditions, a refund of any premiums is not available [redacted] Customer Solutions Manager [redacted]
Initial Business Response / [redacted] (1000, 9, 2014/07/03) */ We apologize for the delay in responding to the consumers' complaint Regarding the infected toe, it was presented to us as the condition being claim was Osteomyelitis which is a musculoskeletal condition which is not a named peril under the QuickCare for Indoor Cats policyThe Consumer had contacted our Company directly appealing our decision regarding the declination of the claim Management has reviewed the claims and medical history on file for [redacted] Based on this review, we have reassessed (as Onychomycosis) this claim in the amount payable of $A more detailed breakdown of the claim will be found on thhe Explanation of Benfift letter accompanying the reimbursement Reimbursement would have left our office on June 19th or the next business dayPlease note that this is coming from our Head Office in [redacted] as such please allow for additional delivery time for receipt
We apologize for the customer’s disappointment with their recent claims experience size="3"> Please be advised, on two separate occasions the customer submitted invoice [redacted] for $& invoice # [redacted] for $Unfortunately, on both occasions, the Claim Forms was cut off and the appropriate medical records were not submitted We spoke to the customer on May 6th, and advised of the missing documentation and requirements for a complete claim As per the customer’s selected policy Terms and Conditions: Section – HOW TO CLAIM COMPLETING THE CLAIM FORM Complete the sections on the claim form indicated to be completed by You Ask Your Veterinarian to complete the sections indicated to be completed by the VeterinarianBe sure the Veterinarian has signed the Veterinarian Declaration and used the clinic stamp You sign the customer declaration Collect the detailed paid invoices and Your Pet’s medical records On July 13th, we confirmed for the customer receipt of a complete claim form, medical records and invoice [redacted] for $31.46, invoice # [redacted] for $66.34, invoice [redacted] for $10.25, invoice # [redacted] for $ On July 20, we were able to respond to the customer’s claim for Pancreatitis prescription diet; however, the majority of the claimed amount went to satisfy the customer’s $annual deductible The customer will receive reimbursement in the amount of $via direct deposit [redacted] Customer Solutions Manager [redacted]
We apologize for the customer’s disappointment with their recent claims experience Our Chief Veterinary Advisor has reviewed all of the information the customer has provided regarding reassessment of their declined claimUnfortunately, the declination of this condition stands as their selected policy does not cover treatment of the teeth or gums We have not received any further information from the customer such as a veterinary statement or diagnosis by histopathology to indicate this condition is anything other than treatment for the teeth and gumsAs per the customer’s selected policy terms and conditions:Section – EXCLUSIONSExclusions list what we do not cover and what we will not be liable for.We will not reimburse and pay for any expenses related to:Dental and orthodontic health care, Dental Treatment, Dentalprocedures and/or Dental diseases including but not limitedto Treatment of the teeth and gums, dental caries (cavities),gingivitis, periodontitis, retained deciduous teeth, malocclusion,periodontal disease, root canals, caps, crowns, or abscessedteeth, unless otherwise specifically covered by Our Dental FeesEndorsement, and coverage is in force under that Dental FeesEndorsement.We are committed to working with the customer to help them understand the outcome of the reassessment[redacted] Customer Solutions Specialist [redacted]
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution is satisfactory to me Sincerely, [redacted]
We apologize for the customer’s disappointment with their recent service and claims experience At the time of the customer’s original claim submission in December 2016, the claim form listed two conditions being claimed for; “Right thoracic limb lameness” and “Tracheal collapse” The medical records made note of these two conditions as well; this is why there were two deductibles applied.As per the customer’s selected policy documents; Coverage Chart: Deductible Per Illness Condition: $100Upon receiving a statement from the customer’s veterinarian indicating the tracheal collapse was not addressed at the time of the visit in question, we have reassessed the second deductible applied The customer will receive reimbursement from this reassessment via check We have emailed an Explanation of Benefits to the customer for this reassessment.We recently underwent an underwriter change in the United States that resulted in some of our products not being available moving forwardWe were committed to ensuring all pets were able to continue receiving coverage, so we found the most similar insurance policy available and offered to switch them without repercussion of pre-existing conditionsWe were obligated, however, to have these customers agree to change their coverage, or have their policy lapseA package was issued to the customer on January 10, requiring them to contact us by April 6, to let us know if they wished to continue coverage This package explained that effective April 7, we are offering the customer a new policy to be underwritten by The [redacted] Insurance Company, as their current policy was no longer availableThis was not a decision based on the age of a pet or the claims history, but the unavailability of a product moving forwardWe apologize that our representatives did not address the renewal when the customer called about their claim during the renewal period We have made an exception to re-open the offer previously provided for the customer’s renewal policy We will be contacting the customer to finalize their policy change.We take our customers’ feedback very seriously as we are constantly looking to improve our product and service offerings[redacted] Customer Solutions Specialist [redacted]
Initial Business Response / [redacted] (1000, 9, 2014/08/14) */ After speaking with the Consumer on 7/22/the declined claim was submitted for reassessmentManagement has reviewed the claim(s) and medical history on file as well as contacted the clinic(s) [redacted] attendedBased on this review, we have reassessed this claim in the amount payable of $Reimbursement is enroute if not already received Coverage is subject to the Terms and Conditions of the consumers specific Policy including any previous amounts claimed, any pending claims submitted, any applicable co-payment and deductibleThe Consumer is advised to refer to their policy documents, which includes their Document of Insurance, your Policy Specific Product Chart and Policy Terms and Conditions for further details Claim for Hernia, Inguinal Treatment Start Date: 04/21/ Treatment End Date: 04/21/ Total Claim Submitted $ Total Uninsurable Amount $ Deductible $ Co-Payment $ Total Amount Payable $
Initial Business Response / [redacted] (1000, 5, 2015/08/31) */ Contact Name and Title: Lukasz [redacted] Contact Phone: [redacted] Contact Email: [redacted] @pethealthinc.com We apologize for the delay in processing the customer's claims, and for the customer service issues the customer had experienced The customer's claims were processed on August 27, after we received a confirmation of payment for the invoices submitted from Eastside Dog and Cat Hospital on that same day A summary of the customer's policies is below: 24Petwatch Gift of Insurance Effective date: April 27, - May 26, 24Petwatch Essential Policy Effective date: July 2, - Present We were able to respond to the customer's claim for Intestinal Parasite Infestation with an onset date of April 27, as this is a named peril under the 24Petwatch Gift of Insurance PolicyCheck #in the amount of $was cut on August 27, and mailed to the customer along with the claim outcome letter dated August 27, We were unable to response to the customer's claim for Dietary Indiscretion, Interdigital Dermatitis and GastroenteritisThe condition of Dietary Indiscretion with an onset date of July 10, falls within the day waiting period of the 24Petwatch Essential PolicyThe condition of Interdigital Dermatitis with an onset date of June 29, 2015, is pre existing to the customer's 24Petwatch Essential PolicyThe condition of Gastroenteritis with an onset date of April 27, is not a named peril of the 24Petwatch Gift of Insurance policy Regards, Lukasz [redacted] Manager, Customer Solutions Tel: [redacted] ext Email: [redacted] @pethealthinc.com
Complaint: [redacted] I am rejecting this response because: I spent over an hour on the phone and was never told the police would cancel I was under the impression that my policy would remain in affect under the new underwriting I have no issue with resigning for a new policy , but now to be declined overage because of patient age,When he was covered since being a puppy is unacceptable Again , at the least I need the company to allow me to reinstitute an insurance policy , for illness and accident Josh Sincerely, [redacted] ***
Complaint: [redacted] I am rejecting this response because: How can you send a letter from last November to tell me there will be changes in and expect people to remember? I am sure I am not the only one that is in angry mode and wants their money back This is unacceptable Sincerely, [redacted]
We apologize for the customer’s disappointment in their recent claim experienceWe would like to clarify our mailed claim processIn order to ensure that we can better serve our US customers we offer a US mailing address which allows us to ensure that our customers have the option to submit physical documentation to us using a domestic addressThe mail received at our PO Box is automatically forwarded to our office where the documentation is processed by our administrative teamUnfortunately, due to this process once a trackable package is delivered to our PO Box, further tracking information will not be updated with ***The customers claims for wellness were received on May 12th, and applicable reimbursement in the amount of $was made via direct deposit [redacted] Customer Solutions Manager [redacted]
We apologize for the customer’s disappointment with their recent claims experience On June 27, we received a Claim Form for “Resorptive Lesions –multiple teeth, Periodontal disease stage to 3” dated April 4, This was rejected as an incomplete claim submission and a request was sent to the customer to advise them in order to submit a complete claim, we require a claim form, invoice and medical records We did not receive anything further from the customer, leading the claim to remain rejected.On December 1, the customer spoke with one of our customer care representatives and was advised we did not have the necessary documents to process the claim The representative also explained to the customer that their policy does not provide coverage for dental procedures or dental related.As per the customer’s selected policy terms and conditions:EXCLUSIONSThe Insurer shall not be liable for:Claims for dental procedures and/or dental diseases.The customer opted to cancel their coverage due to this exclusion We are committed to working with the customer to help them understand the claims submission process and their coverageWe take our customers’ feedback very seriously as we are constantly looking to improve our product and service offerings[redacted] Customer Solutions Specialist [redacted]
We apologize for the customer’s disappointment with their recent claims experienceTo clarify, on April 1st, we had received a completed claim form and medical records with no associated invoicesOn April 12th, we had received claim forms, dated March 25th, and April 9th, 2016, with no associated invoices or medical records On April 21st, we reached out to the customer via email advising that we were missing the associated invoices necessary to continue the claim processOn May 6th, we received invoice [redacted] invoice [redacted] and invoice [redacted] totaling $Unfortunately, there was no claim form or medical records submitted by the client with this submission On May 18th, we reached out to the customer via email advising that we were missing the associated claim form and medical records necessary to continue the claim processUnfortunately, the information received was not sufficient to process and complete the claims at that timeAs per the customer’s selected policy Terms and Conditions: Section – HOW TO CLAIM COMPLETING THE CLAIM FORM Complete the sections on the claim form indicated to be completed by YouAsk Your Veterinarian to complete the sections indicated to be completed by the VeterinarianBe sure the Veterinarian has signed the Veterinarian Declaration and used the clinic stampYou sign the customer declarationCollect the detailed paid invoices and Your Pet’s medical records As a customer service gesture, we have brought all information provided together for the client to allow claims processing The customer’s claim was process on May 31st, and reimbursement of $will be made via direct deposit An explanation of benefits has been sent to the customer to explain the breakdown of the claim [redacted] Customer Solutions Manager [redacted]
We apologize for the customer’s disappointment with their recent claim experience size="3"> Please be advised that all claims are processed based on the information made available to us, including information contained within the claim form and medical records Management has reviewed the customer’s claims and the original processing of the claims stands The claim for [redacted] was approved in the amount of $90.00, however this amount was used to satisfy the portion of the customer’s $deductible and therefore no reimbursement was made As per the customer’s selected policy terms and conditions: Section – EXCLUSIONS Any treatment related to an excluded procedure, accident and/or illness Dental and orthodontic health care, Dental Treatment, Dental procedures and/or Dental diseases including but not limited to Treatment of the teeth and gums, dental caries (cavities), gingivitis, periodontitis, retained deciduous teeth, malocclusion, periodontal disease, root canals, caps, crowns, or abscessed teeth, unless otherwise specifically covered by Our Dental Fees Rider, and coverage is in force under that Dental Fees Rider As per the customer’s claim form, the veterinarian noted: “dental disease felt to be possible cause of infection/hepatic enzyme elevation” Therefore, we are unable to respond to the portion of the customer’s claim for Dental Disease and Elevated Hepatic Enzymes At 24PetWatch, we offer a reassessment process which allows customers to provide us with additional information to appeal the processing of their claimWe invite the customer to request a reassessment of their claim by filling out one of our reassessment forms and providing us with additional medical records and a statement from their veterinarian regarding the conditions claimed [redacted] Manager, Customer Solutions [redacted]
We apologize for the customer’s disappointment and frustration in their recent experience with 24PetWatchOn February 15, the customer purchased a microchip identification tag and was advised the time frame for receipt was to weeks Unfortunately, due to an internal error the order was delayedAs the customer has yet to receive the tag, he has been communicating with our contact center and we are in the process of resolving this matterWe have attempted to reach out to him however have not yet been successful in reaching him to discuss the resolution furtherWe encourage the customer to contact our office at [redacted] to speak with one of our Customer Solutions Specialists in order to resolve the matterWe take our customers’ feedback very seriously as we are constantly looking to improve our product and service offerings [redacted] Customer Solutions Specialist [redacted] @pethealthinc.com Tell us why here
Complaint: [redacted] I am rejecting this response because:The proposed new policy is significantly more expensive than the one I had signed for years agoI have had no insurance claims during this time frame and as soon as my pet aged and began suffering health problems they have switched to a way more expensive coverageI demand full refund of the premiums I have made for all these years.Sincerely, [redacted]
We apologize for the customer’s disappointment with their recent experience We issue policy documents annually for our customers days prior to their policy’s renewal date On June 16, we issued renewal packages to the customer for two pets indicating their current Pet Insurance Policies, underwritten by Praetorian Insurance Company, will no longer be available and will not be renewedThe documents also indicated the customer must contact us to enroll their pets in newly offered policies by September 29, or the coverage would be terminated.Please note, this is an insurance underwriter change, and not a new insurance company.On July 12, the customer spoke with a sales representative about the package he received The representative advised the customer that we would have a member of the Customer Care team get in touch to address their questions about the renewal package Unfortunately, our attempt to contact the customer back on July 12, was unsuccessful.We received no communication back from the customer about their desire to oto the new policies The customer’s policies cancelled effective September 29, [redacted] Customer Solutions Specialist [redacted]
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution is satisfactory to me Sincerely, [redacted] ***
Upon receipt of this inquiry, we carefully reviewed the issues raised by our customer The policy is a month policy that automatically renews each year A new policy packet for the upcoming term was provided to the customer, along with notice of a rate increase and new underwriter for the policyWith a new underwriter, the products were evaluated, which did result in a rate increase to more accurately reflect the value of the coverageThis information was provided in August 2016, more than days in advance of the new term set to begin on October 19, 2016, to provide the customer ample advance notice of the changes and give her an opportunity to contact us with questions or take other actions Based on the customer’s letter, we reviewed the account We were not able to locate where she withdrew her previous authorization to bill her payment method on file, nor was there a request to cancel or select a different coverage With no direction from the customer otherwise, per the notice, the payment method was automatically billed on October 19, for the new plan periodFinally, the customer referenced a claim that was recently submitted We reviewed the claim in question and confirmed that it was processed accurately A large portion was not eligible because it was for wellness treatment which is not covered under the policy terms and another portion was applied to the annual deductibleWe will again reach out to the customer to discuss her concerns[redacted] Customer Solutions Specialist [redacted]
We sent the customer renewal documents indicating we required action by September 30, for the pets’ coverage or the coverage would not continue We received no communication from the customer about these offers Our policies are available for pets’ age weeks to years; unfortunately we are unable to set up comprehensive coverage for pets older than years We can only offer an accident only policy [redacted] Customer Solutions Specialist [redacted]
We apologize for the customer’s disappointment in their recent claim experienceUpon the customer’s upgrade on June 1st, for [redacted] from QuickCare Gold to 24PetWatch Super the customer was advised that any condition that was covered under their QuickCare Gold policy would continue to be covered under their upgraded policy and would not be considered pre-existingPreviously excluded conditions would continue to not be eligible for coverage as these are considered pre-existingAs per the customer’s medical records for [redacted] from [redacted] Veterinary Hospital on October 17, 2008: Hip radiographs -DJD of left stifle As per the customer selected policy terms and conditions: Section – COVERAGE RESTRICTIONS PRE-EXISTING MEDICAL CONDITIONS We do not cover: Any ILLNESS Medical Condition or Illness complication directly resulting from a Condition that manifested, first occurred, displayed signs and/or symptoms , was noted, treated, diagnosed or has been known by You and/or Your Veterinarian prior to the Coverage Effective Date of the Policy and/or during Your Policy’s ILLNESS Coverage Waiting PeriodIn all cases, this includes any Associated Condition or complication directly resulting from a condition that manifested, first occurred, displayed signs and/or symptoms , was noted, treated, diagnosed or has been known by You and/or Your Veterinarian prior to the Coverage Effective Date of the Policy or in respect of illness medical conditions during the Illness Waiting PeriodTherefore the condition of Degenerative Joint Disease is pre-existing to the customer’s original policy start date of November 1st, and remains permanently excluded from coverageUpon review of the account no past claims for Zack’s Arthritis have been payableAll eligible claims for Jake have been reimbursed to the policy limitsAs the policy has been administered and claim processed in accordance with the customers selected policies terms and conditions, a refund of any premiums is not available [redacted] Customer Solutions Manager [redacted]
Initial Business Response / [redacted] (1000, 9, 2014/07/03) */ We apologize for the delay in responding to the consumers' complaint Regarding the infected toe, it was presented to us as the condition being claim was Osteomyelitis which is a musculoskeletal condition which is not a named peril under the QuickCare for Indoor Cats policyThe Consumer had contacted our Company directly appealing our decision regarding the declination of the claim Management has reviewed the claims and medical history on file for [redacted] Based on this review, we have reassessed (as Onychomycosis) this claim in the amount payable of $A more detailed breakdown of the claim will be found on thhe Explanation of Benfift letter accompanying the reimbursement Reimbursement would have left our office on June 19th or the next business dayPlease note that this is coming from our Head Office in [redacted] as such please allow for additional delivery time for receipt
We apologize for the customer’s disappointment with their recent claims experience size="3"> Please be advised, on two separate occasions the customer submitted invoice [redacted] for $& invoice # [redacted] for $Unfortunately, on both occasions, the Claim Forms was cut off and the appropriate medical records were not submitted We spoke to the customer on May 6th, and advised of the missing documentation and requirements for a complete claim As per the customer’s selected policy Terms and Conditions: Section – HOW TO CLAIM COMPLETING THE CLAIM FORM Complete the sections on the claim form indicated to be completed by You Ask Your Veterinarian to complete the sections indicated to be completed by the VeterinarianBe sure the Veterinarian has signed the Veterinarian Declaration and used the clinic stamp You sign the customer declaration Collect the detailed paid invoices and Your Pet’s medical records On July 13th, we confirmed for the customer receipt of a complete claim form, medical records and invoice [redacted] for $31.46, invoice # [redacted] for $66.34, invoice [redacted] for $10.25, invoice # [redacted] for $ On July 20, we were able to respond to the customer’s claim for Pancreatitis prescription diet; however, the majority of the claimed amount went to satisfy the customer’s $annual deductible The customer will receive reimbursement in the amount of $via direct deposit [redacted] Customer Solutions Manager [redacted]
We apologize for the customer’s disappointment with their recent claims experience Our Chief Veterinary Advisor has reviewed all of the information the customer has provided regarding reassessment of their declined claimUnfortunately, the declination of this condition stands as their selected policy does not cover treatment of the teeth or gums We have not received any further information from the customer such as a veterinary statement or diagnosis by histopathology to indicate this condition is anything other than treatment for the teeth and gumsAs per the customer’s selected policy terms and conditions:Section – EXCLUSIONSExclusions list what we do not cover and what we will not be liable for.We will not reimburse and pay for any expenses related to:Dental and orthodontic health care, Dental Treatment, Dentalprocedures and/or Dental diseases including but not limitedto Treatment of the teeth and gums, dental caries (cavities),gingivitis, periodontitis, retained deciduous teeth, malocclusion,periodontal disease, root canals, caps, crowns, or abscessedteeth, unless otherwise specifically covered by Our Dental FeesEndorsement, and coverage is in force under that Dental FeesEndorsement.We are committed to working with the customer to help them understand the outcome of the reassessment[redacted] Customer Solutions Specialist [redacted]
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution is satisfactory to me Sincerely, [redacted]
We apologize for the customer’s disappointment with their recent service and claims experience At the time of the customer’s original claim submission in December 2016, the claim form listed two conditions being claimed for; “Right thoracic limb lameness” and “Tracheal collapse” The medical records made note of these two conditions as well; this is why there were two deductibles applied.As per the customer’s selected policy documents; Coverage Chart: Deductible Per Illness Condition: $100Upon receiving a statement from the customer’s veterinarian indicating the tracheal collapse was not addressed at the time of the visit in question, we have reassessed the second deductible applied The customer will receive reimbursement from this reassessment via check We have emailed an Explanation of Benefits to the customer for this reassessment.We recently underwent an underwriter change in the United States that resulted in some of our products not being available moving forwardWe were committed to ensuring all pets were able to continue receiving coverage, so we found the most similar insurance policy available and offered to switch them without repercussion of pre-existing conditionsWe were obligated, however, to have these customers agree to change their coverage, or have their policy lapseA package was issued to the customer on January 10, requiring them to contact us by April 6, to let us know if they wished to continue coverage This package explained that effective April 7, we are offering the customer a new policy to be underwritten by The [redacted] Insurance Company, as their current policy was no longer availableThis was not a decision based on the age of a pet or the claims history, but the unavailability of a product moving forwardWe apologize that our representatives did not address the renewal when the customer called about their claim during the renewal period We have made an exception to re-open the offer previously provided for the customer’s renewal policy We will be contacting the customer to finalize their policy change.We take our customers’ feedback very seriously as we are constantly looking to improve our product and service offerings[redacted] Customer Solutions Specialist [redacted]
Initial Business Response / [redacted] (1000, 9, 2014/08/14) */ After speaking with the Consumer on 7/22/the declined claim was submitted for reassessmentManagement has reviewed the claim(s) and medical history on file as well as contacted the clinic(s) [redacted] attendedBased on this review, we have reassessed this claim in the amount payable of $Reimbursement is enroute if not already received Coverage is subject to the Terms and Conditions of the consumers specific Policy including any previous amounts claimed, any pending claims submitted, any applicable co-payment and deductibleThe Consumer is advised to refer to their policy documents, which includes their Document of Insurance, your Policy Specific Product Chart and Policy Terms and Conditions for further details Claim for Hernia, Inguinal Treatment Start Date: 04/21/ Treatment End Date: 04/21/ Total Claim Submitted $ Total Uninsurable Amount $ Deductible $ Co-Payment $ Total Amount Payable $
Initial Business Response / [redacted] (1000, 5, 2015/08/31) */ Contact Name and Title: Lukasz [redacted] Contact Phone: [redacted] Contact Email: [redacted] @pethealthinc.com We apologize for the delay in processing the customer's claims, and for the customer service issues the customer had experienced The customer's claims were processed on August 27, after we received a confirmation of payment for the invoices submitted from Eastside Dog and Cat Hospital on that same day A summary of the customer's policies is below: 24Petwatch Gift of Insurance Effective date: April 27, - May 26, 24Petwatch Essential Policy Effective date: July 2, - Present We were able to respond to the customer's claim for Intestinal Parasite Infestation with an onset date of April 27, as this is a named peril under the 24Petwatch Gift of Insurance PolicyCheck #in the amount of $was cut on August 27, and mailed to the customer along with the claim outcome letter dated August 27, We were unable to response to the customer's claim for Dietary Indiscretion, Interdigital Dermatitis and GastroenteritisThe condition of Dietary Indiscretion with an onset date of July 10, falls within the day waiting period of the 24Petwatch Essential PolicyThe condition of Interdigital Dermatitis with an onset date of June 29, 2015, is pre existing to the customer's 24Petwatch Essential PolicyThe condition of Gastroenteritis with an onset date of April 27, is not a named peril of the 24Petwatch Gift of Insurance policy Regards, Lukasz [redacted] Manager, Customer Solutions Tel: [redacted] ext Email: [redacted] @pethealthinc.com
Complaint: [redacted] I am rejecting this response because: I spent over an hour on the phone and was never told the police would cancel I was under the impression that my policy would remain in affect under the new underwriting I have no issue with resigning for a new policy , but now to be declined overage because of patient age,When he was covered since being a puppy is unacceptable Again , at the least I need the company to allow me to reinstitute an insurance policy , for illness and accident Josh Sincerely, [redacted] ***