PTZ Insurance Agency, Ltd.

We apologize for the customer’s disappointment with their recent claims experience On June 22, we received a claim form, invoice and medical records to be processed. Section of the claim form, filled out by the treating veterinarian, indicates the claim was for “weight
loss & feline resorption lesion #407”. The claim was processed based on this information and was approved and applied toward the customer’s annual deductible for their illness coverage.On November 1, the exam and bloodwork were reassessed as wellness based on the medical records provided and the customer will be reimbursed $via check.We take our customers’ feedback very seriously as we are constantly looking to improve our product and service offerings *** *** Customer Solutions Specialist*** *** ***

We apologize for the customer’s disappointment with their recent claims experience We have reached out to the customer to discuss their concerns and review how their policy works. We have also reviewed any changes the customer may experience with our new Underwriter, *** ***
Insurance Company.We have explained what is necessary to further review the customer’s concerns about their claim and the customer understood We take our customers’ feedback very seriously as we are constantly looking to improve our product and service offerings *** *** Customer Solutions Specialist*** *** ***
***

This company is awfulThey only answer the phone when there is the potential for you to buy a new productCompletely inaccessible unless you email themWe had one pet die and could not get them to pick up the phone to remove that pet from our insuranceThey have denied every claim I have submitted, even though I can verify that it was not a pre-existing conditionHorrible customer servicePlease do your research before ever enlisting with them

Complaint: ***
I am rejecting this response because: My cats of been insured for six years, my rates more than doubled, I have never made a claimThis is just unfairI had to cancel because I can't afford the insurance any longer so the six years I paid was worth nothing.
Sincerely,
*** ***

We apologize for the customer’s disappointment with their recent experience.We issue policy documents annually for our customers’ renewals days prior to their renewal date. On August 2, we issued a renewal package to the customer including the new premium for the upcoming
policy term.As per the customer’s selected terms and conditions:NOTICE OF CHANGEWe reserve the right to make any changes to the Policy upon notice,including but not limited to Rates, Premiums, Fees, Coverage, Exclusions,Maximum Benefit Amounts, Deductibles, and/or Co-paymentIf we increaseYour renewal premium, or make a change to Your Policy we will mail or fax oremail written notice of our offer to renew days before the effective dateof the changeNotice will be delivered to Your last known contact details onfile.This premium increase was larger than our previous increasesWe recently changed underwriters in the United States, and a part of this transition involved undergoing a comprehensive review of our product offerings and a complete market analysisIt was determined, at that time, that a rate increase was required to reflect the actual costs and frequency of treatments and illness for all insured petsIn order to allow us to continue offering the insurance products that our customers expect, and to ensure our products’ sustainability, a rate increase was necessary in order to ensure that the premiums charged reflect the indemnity offered by our productsWe are confident that our new premiums better reflect the high level of care and protection our insurance products provide while still being very competitive in the marketPlease be advised that we have reviewed the customer’s policy, and the latest information provided to the customer regarding their policy premiums has been verified as correct. Ensuring that our products provide our customers with access to the best possible care for their pets, and enabling them to have peace of mind knowing that they can rely on our products throughout the duration of their pets’ lives is of the utmost importance to us.We encourage the customer to reach out to one of our customer service representatives to hear about the options available for downgrading coverage to find a premium that better suits their needs*** *** Customer Solutions Specialist*** *** ***
***

We apologize for the customer’s disappointment with their recent claim experience Management has reviewed the claim, and the customer’s claim for Urinary Tract Infection was reassessed as payable in the amount of $on January 27, Reimbursement has been made to the customer with
check * *** Unfortunately, we were unable to provide coverage for *** treatments related to Pain, secondary to Ovariohysterectomy, including *** *** provided November 7, for prevention of incisional licking and *** Chewable mg prescribed for post-operative pain management, as this condition is secondary to an excluded procedure. In addition, we were unable to provide coverage for *** Pre Paid Fecal Test performed on November 7, as this is considered a preventative and elective procedure As per the customer’s selected policy terms and conditions: EXCLUSIONS- Preventative and elective treatments/ surgeries including but not restricted to vaccinations, cosmetic treatment/surgery, spaying (including for pregnancy), neutering (including crypt orchid neuters), or any treatment /surgery relating to breeding or pregnancy.Claims arising from, or as a result of, any excluded procedure, accident or illness condition.
*** ***Manager, Customer SolutionsT: *** *** ***E* ***

Initial Business Response /* (1000, 5, 2015/08/31) */
Contact Name and Title: Lukasz ***
Contact Phone: ***
Contact Email: ***@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 ***
Manager, Customer Solutions
Tel: *** ext
Email: ***@pethealthinc.com

We apologize for the customer’s difficulty in contacting our customer service team. Unfortunately, at this time, we have not received a claim submission from this policy holderWe have contacted the customer via email to ensure that we are able to quickly resolve this issue and begin
processing their claim Lukasz ***Manager, Customer SolutionsT: *** ext***E: lukasz.***@pethealthinc.com

We apologize for the customer's disappointment with their recent claims experience We have reviewed the customer's calls with our sales and customer service team, and can confirm that the customer was provided complete and accurate information regarding both her 24PetWatch Gift policy, and
24PetWatch ChampionCare policy The 24PetWatch Gift policy is a “Named Peril Policy” which includes coverage for the following accident and illness conditions: Upper Respiratory Tract Infection Urinary Tract Infection Internal Parasites Eye Illness Heartworm Disease Ear Illness Mange/Mites/Ringworm Parvovirus/Feline Panleukopenia Flea Allergy Dermatitis Tick Borne Diseases Foreign Body Ingestion Removal by Endoscopy or Laparotomy Defined Poison Ingestion Motor Vehicle Accident Insect Bites/Stings Lacerations Bone Fractures The customer was explained that if there was no lapse in coverage between their 24PetWatch Gift policy, and 24PetWatch ChampionCare policy, any eligible conditions covered under the 24PetWatch Gift policy, would continue to be covered under the customer's 24PetWatch ChampionCare policyUnfortunately, the conditions claimed by the customer (Decreased Appetite/Soft Stool/Hypersalivation, Episodic Dullness/Decreased Appetite/Drooling/Lethargy/Focal Twitching, and Episodic Dullness/Decreased Appetite/Drooling/Lethargy/Focal Twitching/Suspected Portosystemic Shunt) are not named perils under the 24PetWatch Gift policy, and are pre-existing to their 24PetWatch ChampionCare policy effective November 13,

As previously stated, the checklist
is presented during the online activation process for the
complimentary Gift of InsuranceIt is not possible to activate the Gift of
Insurance online without first being presented with the checklist and accepting
the termsThe Gift of Insurance is not listed on our website as it is
not available for purchaseWe would be happy to
speak with the Policy Holder directly to help clear up any confusion*** ***Manager, Customer Solutions** *** *** *** ***

Complaint: ***
I am rejecting this response because:the rebuttal does not make sense*** was born in and therefore did not have Artrhitis in or before I had my first policy of quick care gold for himyou still have not answered the question as to why last year,2015, your company paid for *** Artrhitis medication - at least 3-times - And now, this year you have not and said it was a pre-existing condition
Your interpretation and what what was said to me by representatives regarding pre-existing conditions continues to be somewhat enigmatic and confusingNone of them had pre existing conditions prior to their first policy*** had his policy I believe since and *** in or - Again, *** did not have arthritis at two years old or prior They had the same policy type until 2015; when I went to Super for *** and Champion for ***
What would be clear to me is if your Company can show me a side by side comparison of the new policy vs the old policy and what it covers and does not cover for my dog *** Please do not send me a ream of policies that may or may not be covered, but specifically - the rebuttal you just sent that I am currently rebuking
Again, I am not clear as to your first paragraph where it sounds like you contradicted what was said about pre-exisiting conditions by saying, however my if it already existed prior to the policy, it won't be covered - but *** condition did not exist prior to getting his first policy I - once again - ask your company why they paid out for his arthritis medication last year - and this year they are not Please help me understand this antithesis
Your company is like "1984" by *** *** - doublespeak - you say one thing and mean another
Sincerely,
*** ***
Sincerely,
*** ***

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID *** and find that this resolution is satisfactory to me I did verify the credit on the credit card I no longer use However, for the record the main focus of the claim was not that I was angry about my denied euthanasia claim I was angry that my pet was euthanized on April 18th and I called the next day to cancel the policy Then several phone calls and emails later I get a refund in December Why can they refuse to accept claims after days but they can take months to process a small refund! This company does not care about the customer
Sincerely,
*** ***

We have reviewed the customer’s policy, and the latest information provided to the customer regarding their policy premiums has been verified as correct. On November 1, the customer called us and cancelled her pet insurance policy. At that time, the customer requested a backdated cancellation to allow for a refund of premiums for the entire billing cycleUnfortunately, our cancellation policy does not allow us to backdate refunds for a period in which the pet had coverageThe customer’s final premium was collected on October 23rd, with the cycle ending on November 22, Based on the customer’s Terms and Conditions, coverage continued until the end of the current billing cycle (November 22)We take our customers’ feedback very seriously as we are constantly looking to improve our product and service offerings*** *** Customer Solutions Specialist *** *** *** ***

We apologize for the customer’s disappointment with their recent service and claims experience We have been unable to locate the customer’s account with the information provided in their complaint. We made multiple attempts to contact the customer with the phone number provided
and have left numerous messages To date we have not heard back from the customer to provide further account details. We encourage the customer to contact us so we can assist them with their concerns.*** *** Customer Solutions Specialist*** *** ***
***

We apologize for the customer’s disappointment with their recent service and claims experience. Due to an internal error the customer’s claim was closed for missing information. Once this error was detected, the customer’s claim was re-opened and we are happy to advise that their claim
was processed on November 23, and reimbursement of $was paid via check.We have been in contact with the customer to discuss their concerns and advised when claim was completed and an Explanation of Benefits was provided.We take our customers’ feedback very seriously as we are constantly looking to improve our product and service offerings *** ***Sales and Service Supervisor*** *** ***
***

We apologize for the customer’s disappointment with their recent claims experience Please be advised that claims are processed based of the information provided at the time of the claim submission When reviewing the account it was seen that we had not received full medical
records fo* *** We requested full medical records from May of to present on July 4th, from Gulf Animal Hospital On July 5th, we received the additional medical records which showed that original diagnosis of pancreatitis was not related to the diagnosis of Low Grade LymphomaWith the additional information provided we were able to reassess the customers claim for Lymphoma and move the pancreatitis treatment back under the digestive categoryOn July 8th, reimbursement of $2,was made via check *** *** *** Customer Solutions Manager *** *** ***
***

We apologize for the customer's claim experience
The customer had adopted a pet from one of our animal welfare partners and received a complimentary Gift of Insurance policy which is offered exclusively through our partnersThe customer did not purchase one of our core insurance
policies, as advertised on our website, and no money was collected from themThe Gift of Insurance policy is not available for purchase, and is not advertised onlineThis policy is there to assist with a specific list of shelter related illnesses that a pet can develop after adoptionThe conditions covered under the Gift of Insurance include:
Upper Respiratory Tract Infection
Urinary Tract Infection
Internal Parasites
Eye Illness
Heartworm Disease
Ear Illness
Mange/Mites/Ringworm
Parovirus/Feline Panleukopenia
Flea Allergy Dermatitis
Tick Borne Diseases
This list of conditions appears within the customer's document of insuranceUnfortunately, Gastroenteritis is not a named peril under this policy
By working with our animal welfare partners to provide new owners with this free policy, our mutual goal is to try and reduce the number of pets being returned to the shelter should they develop these common shelter related illnesses after adoption
*** ***
Manager, Customer Solutions
** *** *** ***
** ***

We understand that the rate increase that the customer experienced was substantial; however, after a comprehensive review of our product offerings and a market analysis it was determined that a rate increase was required to reflect the actual costs and frequency of treatments and illness for all insured pets.The sustainability of our products is of the utmost importance to us. In order to be able to continue providing full comprehensive coverage and allowing our customers access to the best possible care, an increase in premiums was necessary.As a valued member of the 24PetWatch family, the customer was provided with fully comprehensive illness and accident protection. We are sorry to hear that the customer has chosen to move away from this protection. We would like the customer to know we do offer alternative levels of coverage which may better suit their needs and would be happy to discuss these options with them.*** *** *** Customer Solutions Manager *** *** ***
***

The invoice dated December 3, for $was initially declined as a wellness panel; however in our previous response we reassessed this invoice and it was payable toward the Polyarthritis in the amount of $ The invoice dated December 10, for the prescription for $to treat the urinary tract infection was processed and applied toward the deductible for the urinary tract infection The customer’s selected policy has a deductible applied per condition, therefore there were deductibles applied, one for the Polyarthritis and one for the Urinary Tract Infection Upon full review of all information provided for the customer’s claims, we have processed these claims according to the customer’s selected policy terms and conditions We are committed to working with the customer to help them understand the outcome of their claims.Jennifer Traversa Customer Solutions [email protected]

Complaint: ***
I am rejecting this response because:I appreciate the response from the business however, they are providing a very 'pretty' version of what actually transpired I do recognize that we did receive the two letters from PetWatchI have attached copiesThe first, dated 10-12-lets us know that their long-term partnership with *** who administers our plan, I assume- is coming to an end as of October 1, (which was days before this letter was written...)They state they will no longer be able to continue our coverage under our current *** policy, and that policy would terminate at the end of the policy (12-10-16)However...the very next sentence states that they are proactively taking steps to secure coverage through another insurance company, and want to assure us that they are working closely with their new underwriter to have this coverage put in place as soon as possible So, as a consumer, I was fairly confident that my insurance company would be taking care of the matter, because that is what they stated in this letter If something is already in underwriting, it is underway, and in process, is it not?On November 1, 2016, the letter we received was an exact duplicate of the body of the October 12, letterAT NO POINT in this letter were they 'transparent' and 'realistic' and certainly at no point did I get the impression that I needed to seek out other insurance coverage Given the fact my Boxer is years old, I would have known at that point that getting other coverage would be nearly impossibleIt certainly would have sparked panic within me to contact the company sooner than I did I am glad that coverage is now available with PetWatch through another company in Florida, however their claim that "some customers may be negatively impacted from a gap in coverage" leads me to believe that we are going to be hard pressed to obtain this coverageI am shocked that they will be able to get away with what was done to faithful customers, they dropped us without thought or care I feel they must do the right thing and cover the gap that we had no choice in having, and covering *** without "preexisting condition" clauses, if this new coverage is even going to be offered at an affordable rate Further, since this has happened, my confidence in this company is all but diminished What is to say that this exact same thing won't happen to us again in the future? ion
Sincerely,
*** ***