Trupanion

Complaint: [redacted] I am rejecting this response because:At at the very least, euthanasia should be covered because it is a DECISION made by the owner, for whatever reason! Sincerely, [redacted] ***

Date: 11/30/Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] Trupanion has received the complaint filed by Mr [redacted] in regards to his most recent claims for [redacted] He has been in contact with one of our supervisors to discuss his claim concernsWhile we understand this isn’t the claim outcome that Mr [redacted] had hoped for, the industry is highly regulated and we must adjudicate all claims based on the policy verbiage as well as the medical records received directly from the veterinarian Mr [redacted] is correct that the Trupanion policy reads in Section BPRE-EXISTING CONDITIONS: iIllnesses or injuries for which signs or evidence of their potential manifestation existed within the months prior to the policy enrollment dateMr [redacted] enrolled [redacted] in the Trupanion policy on 4/30/Trupanion received medical records from [redacted] ’ veterinarian that stated prior to enrollment [redacted] was noted to have stertorous breathing and stenotic nares which are consistent with brachycephalic airway syndromePost policy medical records note that the brachycephalic airway syndrome contributed to the hiatal hernia due to increased upper airway resistanceBrachycephalic airway syndrome typically involves one or more of the following airway abnormalities: elongated soft palate, stenotic nares, everted laryngeal saccules, and sometimes narrow trachea and laryngeal collapse or paralysis Upon review of [redacted] ’ medical records the following clinical signs which appear consistent with the claimed condition are noted pre policy: From Northwest Veterinary Hospital: • 4/23/14: “minimal stertor; mild stenotic nares...” Post policy, the following notations also appear to be related to the claimed condition: From Northwest Veterinary Hospital: • 12/5/14: “ever since puppy, months? [redacted] has been regurgitating food/liquids at least once a day Occ [occasionally] has some actual foamy, white secretions that he brings up without food elongated soft palate with audible stertor and upper airway noiseStenotic nares; occasional hacking or gagging in room GI [gastrointestinal]: signs are reported as regurgitation; chronic, non-progressive, months duration Assessment: regurgitationDifferential diagnosis: esophageal dysfunction/motility defect, PRAA, hiatal hernia? Stricture of esophagus, etcBrachycephalic syndrome: elongated soft palate and stenotic nares” • 12/10/14: “History: chronic, months (ever since young puppy) of regurgitation also has brachycephalic airway signs (elongated palate, stenotic nares, etc) referred upper airway noise/stertor Assessment: regurgitation due to esophageal disease; megaesophagus? PRAA?...suspect mild bilateral pneumonia” From Seattle Veterinary Specialists: • 1/13/15: “A video xray stud today found that [redacted] has a hiatal hernia where the stomach slips in front of the diaphragm leading to regurgitationThis is most often found in dogs with compromised upper airway flow Diagnosis: sliding hiatal herniaSuspected elongated soft palate” • 1/14/15: “presented for further evaluation of chronic regurgitationThe owner has seen regurgitation since he was a puppy and it is getting worse sterterous breathing present” • 1/15/15: “ The chronic regurgitation is suspected to be due to the hiatal hernia [redacted] likely has secondary esophagitis which can exacerbate the regurgitation The brachycephalic airway syndrome (elongated soft palate and possible everted saccules) do contribute to the hiatal hernia due to increased upper airway resistanceWe would recommend repairing those changes at the time of surgery” • 1/28/15: “ chronic regurgitation and brachycephalic airway syndrome [redacted] had a sedated airway exam today which revealed an elongated soft palate and bilateral everted saccules staphylectomy and bilateral laryngeal sacculectomy performed esophageal hiatus herniorrhaphy also performed” From Northwest Veterinary Hospital: • 1/15/15: “DX [diagnosis] of brachycephalic syndrome (elongated soft palate, nares stenosis and possible everted saccules)” • 4/21/15: “significant brachy upper airway stertor despite recent palate resection and rhinoplasty brachycephalic airway syndrome” • 7/21/15: “did have soft palate resection and bilateral sacculectomy at time of GI surgery excessive resp noise/stridor seems very hit or miss per owner, worse when > degrees, but not observed every day when it is hotDisc [discussed] possible tx [treatment] with cortisone given orally to decreased swelling/edema of soft tissues of pharynx” • 12/9/15: “some brachyceph [brachycephalic] noise/stertor” From Companion Animal Clinic: • 8/22/16: “Surgery: Soft palate resection, tonsillectomy oral exam performed with large, everted and flaccid tonsils present bilateralThere is obvious everted/edematous laryngeal saccules protruding from ventral lumen of trachea when you reflect the soft palate, there is a large formation of scar tissue that is positioned in the retropharyngeal regionWhen the tissue is exposed, it appears to become entrapped in the epiglottis and tracheal openingThis is considered an abhealing of the soft palate” As these signs were documented prior to enrollment and noted to reoccur post policy, there can be no further coverage for this conditionPer Mr [redacted] request, Trupanion has sent these claims to an independent third-party veterinarian, DrH [redacted] BVSc, FRCVS, DipACVS, DipAVDC for an objective final reviewAfter his thorough review of the claimed condition and medical records, DrH [redacted] agreed with the claim decision reached by TrupanionDrH [redacted] advised: “Recommendation: Claim deniedThis decision is based on the evidence for brachycephalic conformational abnormality and clinical signs being present prior to start of insurance coverage.” While we are unable to honor Mr [redacted] desired settlement by removing all exclusions from his policy, we will not require Mr [redacted] to reimburse us for the earlier claim payments and are pleased to confirm that we will settle this claim, however, please be aware that we will be unable to pay claims relating to the hiatal hernia/brachycephalic airway syndrome in the futureWhile the brachycephalic airway syndrome and any associated conditions have been deemed ineligible, this does not hinder [redacted] ’ coverage for future unrelated medical conditions or new accidents going forward We encourage Mr [redacted] to reach out to us if he has any further questions as we are happy to help within our policy guidelinesWe can be reached anytime at Sincerely, Kesa - Trupanion

Date: 12/02/Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] We have received the rejected response from Ms [redacted] and understand her concerns completelyWe apologize about the confusion in the last responseTrupanion is happy to say that after a careful second review of the claims for ***, we were able to cover all eligible expenses submittedTrupanion has issued Ms [redacted] a check in the amount of $to help with ***’s medical treatmentWe have been in contact with Ms [redacted] and believe this matter to be resolvedWe apologize for any inconvenience this claim issue may have causedAs [redacted] and Ms [redacted] are currently enrolled under a trial insurance policy, we have been in contact and notified them if they should wish to continue, when they would need to let us know byIf there is anything else we can do to assist with this matter, we encourage Ms [redacted] to reach outWe are happy to help within our policy guidelines and we wish Ms [redacted] and [redacted] the bestSincerely, Kesa - Trupanion

Complaint: [redacted] I am rejecting this response because: We immediately sought coverage after [redacted] 's initial CCL injury since he was at risk for the same type of injury on his other leg This was clearly expressed when we inquired with Trupanion Plus, we were referred to Trupanion by [redacted] 's pet surgeon - who told us [redacted] is at risk again for the same injury and had recommended Trupanion for coverage.The Trupanion rep did not say that [redacted] will not be covered for a second CCL injury, instead, we were told that [redacted] would be covered for any surgery For this misleading response, I am seeking a refund in our policy Had we been told that [redacted] will not be covered for second CCL surgery, we would not have acquired a policy with Trupanion.Sincerely, [redacted] ***

Date: 6/17/ Revdex.com case # [redacted] Policy # [redacted] Complainant: [redacted] We have received the complaint filed by Mr [redacted] and understand the concerns that have been presentedWe are also reviewing the complaint Mr [redacted] filed with the Department of Insurance as wellSince the complaint with the Department of Insurance is still under review we are able to advise Mr [redacted] with the facts of the situation and once the Department of Insurance complaint has been reviewed we can address his concerns further should he need additional information Mr [redacted] submitted information that was opened as claim [redacted] including an invoice from Studio City Animal Hospital dated 5/26/and claimed conditions are noted as dental disease and eyelid growthThe invoice submitted pertains to surgery, extractions and medications Records from Studio City Animal Hospital note within the policy illness waiting period on 4/22/"lower eyelid growth left eye" and prior to enrollment on 8/6/"dental disease"Pet presented on 5/26/for dental with extractions and removal of eyelid growth left eye The claim was processed based on the information provided in the pet’s medical records and found to be ineligible for coverage because the onset of eyelid growth was within illness waiting period and the onset of dental disease is pre-policy Trupanion policy sections that support the decision that this claim was inelgible: 9.A.I Illnesses that occur or reoccur within the days following the policy enrollment date are deemed pre-existing conditions and not eligible for coverage 7.C.I Endodontic treatments and extractions will not be covered if your pet has any signs of dental disease prior to the policy enrollment date or during the waiting periods 9.B.I Illnesses or injuries for which signs or evidence of their potential manifestation existed within the months prior to the policy enrollment date While reviewing this claim it appears that a portion of the claim pertaining to an extraction of a fractured tooth could potentially be eligible, however complete pre-policy history is not on fileThe claim has been opened as an appeal (secondary review) and is pending records and clarification from the veterinarianRecords and breakdown of the charges on invoice have also been requested from the clinic Once the Appeal (secondary review) is completed, the decision letter will be sent to Mr [redacted] advising him on the outcome of the re-review of this claim Sincerely, Amber S- Trupanion 1-888-733-

Complaint: [redacted] I am rejecting this response because: In November on at least occassions I explained in detail to the customer service reps, who in early November talked me out of cancelling the policy and appealing, that I told the vet that [redacted] was limping in the back and I suspected hip problems Ended up being back problems Strange how Trupanion says going to the vet because of a problem is not covered, yet after appealing, say it is still not covered, but the medication to treat it is This is insurance scamming at its finest I should be refunded all payments or at least from November when I was talked out of appealing Sincerely, [redacted]

Date: 10/6/ Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] Trupanion has received the complaint filed by Mr [redacted] We’ve reviewed the details of his complaint and reached out to Mr [redacted] to discuss his concernsWe would like to thank him for his patience and understanding while we worked to assist him and are pleased to advise that we have reached a mutually agreeable resolution and believe this matter to be resolved If there is anything else we can do to assist, please feel free to reach out to us Sincerely, Kesa – Trupanion

Date: 6/6/ Revdex.com case ID # [redacted] Policy # [redacted] Complainant: *** [redacted] Trupanion has received the complaint filed by Ms [redacted] in regards to her claims being ineligible for her pet, [redacted] Since this complaint has come into Trupanion through both the Revdex.com and the California Department of Insurance, Trupanion will post a response to the complaints at the same time Once a thorough review of the complaints has been completed, Trupanion will post a full response back to Ms [redacted] , the Revdex.com and the California Department of Insurance Thank you, Kesa – Trupanion 1855-210-

Date: 8/29/Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] Trupanion has received the rejection of our response to Ms [redacted] One of our senior supervisors has been in contact with her and we are waiting to hear if she wishes to have us proceed with gathering updated information from her veterinarians in attempt to appeal the giardia claim as well as open a new claim for [redacted] recent ear infection In the meantime, [redacted] has opted to cancel her Trupanion insurance policyIn an attempt to help, our senior supervisor has reached out to Ms [redacted] to confirm this is how she would like to proceedMs [redacted] confirmed that she would no longer like to keep [redacted] insurance activePer Ms [redacted] ’s request, the Trupanion policy has been cancelled effective 8/26/and a confirmation has been mailed and emailed to her, advising her of the cancellation date and prorated refund issued If Ms [redacted] should need any further assistance, she can feel free to reach out to usWe wish Ms [redacted] and [redacted] the best Sincerely, Kesa - Trupanion

Date: 2/15/ Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] Trupanion has received the concerns presented by Ms [redacted] to the Revdex.comWhile we understand this isn’t the claim outcome she was hoping for, the Trupanion policy reviews claims based on the medical records received from the pet’s veterinarian directlyIf a condition is showing symptoms or has been diagnosed prior to enrollment or during the waiting period, the condition would become pre-existing and ineligible for coverageWe have been in contact with Ms [redacted] to help clarify and address any concerns she may have Upon review of Ms [redacted] claims, it was found that the manifestation of allergy symptoms presented themselves prior to enrollment and during the initial waiting periods Per Ms [redacted] request, the claim was sent off for a secondary review by an independent third party dermatology specialist, Joy B***, DVM, MRCVS, DACVDThe specialist’s findings were consistent with Trupanion’s outcome of the claim for allergies and upheld the ineligibility “E) Summary and Claim decision: Unfortunately, I must conclude that signs compatible with canine atopic dermatitis and canine adverse food reaction (they can look identical) were present at enrollment and during the waiting periodTherefore, according to the rules of coverage, atopic dermatitis/canine adverse food reaction must be considered pre-existing and claim denial is upheld for this condition ” We understand that this time frame in which the symptoms presented are unfortunateWe are unable to honor Ms [redacted] desired settlement to retroactively backdate the cancellation to OctoberIn review of the policy on October 28th 2016, she spoke with our claims department and opted to keep her policy active to proceed with the independent third party reviewThe earliest written request for cancellation was dated 1/25/As Ms [redacted] has opted for cancellation, we have cancelled the policy effective 1/25/and a pro-rated refund of $has been returned back to the payment method on file We always encourage Ms [redacted] to please give us a call if she should wish to discuss furtherWe can be reached anytime at Sincerely, Kesa- Trupanion

Complaint: [redacted] I am rejecting this response because: We enrolled [redacted] with Trupanion knowing full well we had to pay for [redacted] s initial surgery and requested that we obtain coverage in case of a recurring injury in his other leg They misled us to believe that he would be covered on his other leg We did not try to obtain coverage for his initial injury from Trupanion In any case, there is a misunderstanding and we request a refund.Sincerely, [redacted] ***

Complaint: [redacted] I am rejecting this response because: I had previously filed a complaint under [redacted] on November 18th with the Revdex.com that this company did not refund my money as they promisedAnd, as of this writing, I have no check from themI had multiple emails from them, one dated November 22nd, text of which as follows, 11/22/ [redacted] ***?? [redacted] ***? Policy: [redacted] Dear [redacted] , Per your request, this letter confirms that your policy for Martini was cancelled effective on 08/24/Your refund of $will be mailed to your above noted address separatelyIf you have questions or think this information is incorrect, please contact us at Sincerely, The Trupanion Team 888.733.2685" I also spoke with Kesa at Trupanion last week who said they mailed the check, but, as of now, I have no checkMy issue is not yet resolved.Sincerely, [redacted]

Date: 8/4/Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] We have received the complaint filed by Ms [redacted] and have reviewed the concerns presented hereWe have been in contact with her and are currently waiting for her to advise us on how she wishes to proceed with her concernsWith the Trupanion policy, all claims are adjudicated based on the notations in the pet’s medical records, therefore if a condition such as Giardia, was symptomatic prior to the policy inception or during the five day waiting period for accidents and day waiting period for illness’ Trupanion would have to deem the condition or injury ineligible for coverage, as we would consider it pre-existing and the policy does not cover pre-existing conditionsThe most recent claims reviewed by Trupanion pertaining to Giardia were considered ineligible due to medical records received from Bellevue Animal Hospital; Bellevue Animal Hospital on 4/07/16, during the initial day illness waiting period: “Roundworms have resolved but now positive for giardiaNot shedding so poss [possible] that pt [pet] is not infected but as he is a puppy do recommend treating with another round of panacur.” • 4/19/16: “Gastrointestinal: very liquidy diarrhea for days now ”• 4/19/16: “All of PE [physical exam] good with the exception of Liquid Diarrhea – light brown in colorBar [Bright, alert, responsive] although a little quieter than his normalAte Breakfast Normally this morningNo vomiting at any pointHad Giardia weeks ago on a fecal – was on a panacur Course” Trupanion deemed this claim to be ineligible under Section 7.aand 7.bof our policy document: 7.aIllnesses that occur or recur within the first days of the policy enrollment date (or from policy enhancement date) 7.bIllnesses for which any evidence and/or symptoms of their potential manifestation already exist at, or prior to, the policy enrollment dateMs [redacted] enrolled in the Trupanion policy on 3/20/16, which means Ms [redacted] ’s waiting period for illness expired after 4/19/The notations from [redacted] were present during the stated day illness waiting period and the onset of symptoms began at or near the date of enrollmentGiardia is an infection that can be treated and resolveWe want Ms [redacted] to know that future instances of this condition may be eligibleTrupanion would need to see a clear resolution to the claimed instance of Giardia before we would be able to consider it for coverage in the futureUpon review of Ms [redacted] ’s phone call with a Trupanion supervisor, she requested to cancel and receive a full refund of premiumsWhile Trupanion is not able to offer a full refund, as she is paying for the service of insurance should her pet need to utilize the coverageShould an owner wish to cancel, a prorated refund of premiums based on the cancellation date would be issuedTo authorize cancellation, the Trupanion supervisor sent an email to the confirmed email address on file asking Mrs [redacted] to confirm her request to cancel in writingThere may have been a miscommunication with the email provided by Trupanion, as Ms [redacted] ’s policy does remains active and intact, until Trupanion receives a reply to the cancellation email to confirm the cancellation request in writingWe understand Ms [redacted] ’s concerns and are waiting to hear from her to see if she wishes to pursue her claim concern’s furtherWe wish her and [redacted] the best! Sincerely, Kesa- Trupanion

Wednesday, October 28, Policy # [redacted] Pet: [redacted] Enrollment Date: 4/3/ Upon receipt of Ms [redacted] ’s Revdex.com complaint, a review of her policy was done to determine the nature of her concern.Ms [redacted] ’s month old, female Chihuahua dog, ***, was enrolled with Trupanion on 4/3/ [redacted] had a fracture to her left front leg prior to enrollment where a plate and screw were surgically inserted to fix the leg fracture, this occurred 3/11/while the dog was playing with her larger dog Ms [redacted] enrolled with Trupanion on 4/3/through our websiteWe do not have any record of a conversation with Mr [redacted] prior to her enrollment or at all until 8/11/when she called to change her payment methodOn 8/20/she called to inquire for coverage for ***’s leg that was broken (a second time) while playing with her larger dog and she was advised that we cannot guarantee coverage over the phone, that the only way to know if it would be eligible for sure would be to file a claim or a pre-approvalBased on the notes on the policy the agent clarified this information with an internal department that handles claim questions and advised Ms [redacted] that coverage would depend on whether this fracture was a new fracture or a complication of the prior fracture.Ms [redacted] filed a pre-approval for the leg fracture which was not able to be completed prior to the surgery she had scheduled to amputate the leg, as there were delays in getting the pet’s complete prior medical records and radiographs that were needed to determine eligibilityMs [redacted] proceeded with the amputation surgery and her initial pre-approval claim for the leg fracture was completed as ineligible because the second leg fracture was seen as a complication from the original leg fracture.The outcome letter for the pre-approval details the information from ***’s medical records that were used to make the decision on eligibility: “Bone fracture (Fracture) - IneligibleUpon review of ***’s claim, it appears the left front radius and ulna fractures are a complication of the fractures dated 03/11/as noted: Noted prior to enrollment: From Ingle [redacted] • 3/11/15- “non-weight bearing lame LF [left front], mild to moderate soft tissue swelling proximal to the carpus Rads: distal L radius and ulna are fractured and proximally displaced Strongly recommend referral to orthopedic surgeon for repairThis type of fracture does not heal well with conservative treatment like splinting Radiograph report: Case history: P [pet] presents for acute non-weight bearing lameness LF [left front]O [owner] states that pet was playing outside this am with their larger dogs grade 5/lame LF [left front], mild to moderate swelling proximal to the L [left] carpusFindings: There is an interdigitating transverse fracture of the distal radial and ulnar as describedRecommend surgical repair given the breed involved and the type of fractureAlthough no Physeal injury is noted at this time; delayed repeat radiography is recommended not only to assess fracture healing but to assess for occult trauma to the physes ” From [redacted] of Arizona• 3/12/“Presents for left R/U [radius/ulna] fracture Assessment: Distal L [left] transverse R/U [radius/ulna] fracturePlan: recommended open reduction and internal fixation with a bone plate for best chances of healing well ” From [redacted] • 3/13/ “Fx [fracture] repair set up for Tuesday” Post policy, the following clinical signs are noted to continue: From [redacted] : • 8/20/“Patient was playing with other dog in household and owner heard a yelp about minutes ago Left forelimb-non-weight bearing with valgus deviation of distal forelimbAssessment: left forelimb-lateral deviation of distal left forelimb-fracture viewed radiographs with owner - informed owner that fracture appears to be in the place as previous fracture in March 2015- discussed that there also appears to be areas of bony lysis on lower (distal) part of the radius- not certain if area is where screw was seated but discussed that there appears to be no healing that has occurred between March and today- discussed that when bone heals properly a callous forms- no callous is seen ” • 8/21/“Radiograph Report: Relevant History: had fracture repair in March for distal radial and ulnar fracture-was repaired at another facilityOwner stated that was playing with other dog in home late this afternoon when leg broke againFindings: Markedly displaced, closed transverse distal left radial and ulnar fracture at distal plate screwConclusions: The prior fracture had healed but the distal screw hole can act as a stress riser and the plate can cause some osteopeniaRecommendations: Repair is possible with platingPlate removal may be indicated after bony Union to reduce the risk of refracture ” As 03/11/fracture is not claimable as per section 9.B.I we are unable to extend coverage for this claim Upon review of the records I have found that prior to enrollment, [redacted] is noted to have a fracture of the left front leg that was surgically repaired with plates and screwsShe presented post policy on 8/20/for limping on the left front leg in which the radiograph report showed that the previous fracture had healed but that the current condition could be a complication of the previous plate/screws as the previous screw hole can act as a stress point and the plate can cause some osteopeniaOur policy is based on clinical signsWe are not able medically disconnect the current condition from the clinical signs noted prior to enrollment as it appears that ***’s current condition is a complication of the fracture that occurred prior to enrollmentAs such we are unable to extend coverage for this condition.” Based Based on the information in the medical records listed above, we have determined that this issue is a complication of an injury that was pre-existing to her policy coverage and ineligible based on our policy coverage criteriaInformation about this coverage exclusion can be found in our policy in section 9.B.i: “Illnesses or injuries for which signs or evidence of their potential manifestation existed within the months prior to the policy enrollment date.” And in section: 9.D.vi: “We do not insure the costs, fees, or expenses associated with complications of or diagnostic tests for illnesses and injuries excluded or restricted by this policy.” After this review Ms [redacted] had an appeal of the claim started where a complete re-review of the claim was done and we came up with the same findings, the post policy leg fracture was a complication of the pre policy leg fracture because the screw used to repair the leg caused a stress point in the bone Based on the information in the medical records listed above, we have determined that this issue is a complication of an injury that was pre-existing to her policy coverage and ineligible based on our policy coverage criteriaInformation about this coverage exclusion can be found in our policy in section 9.B.i: “Illnesses or injuries for which signs or evidence of their potential manifestation existed within the months prior to the policy enrollment date.” And in section: 9.D.vi: “We do not insure the costs, fees, or expenses associated with complications of or diagnostic tests for illnesses and injuries excluded or restricted by this policy.” After this review Ms [redacted] had an appeal of the claim started where a complete re-review of the claim was done and we came up with the same findings, the post policy leg fracture was a complication of the pre policy leg fracture because the screw used to repair the leg caused a stress point in the bone Ms [redacted] then elected to have the claim reviewed a third and final time through our Independent Third Party Review processThese reviews are done by a specialist in the field that they are experts inMs [redacted] calls attention to the fact that the specialists are compensated for the time to review these casesI do wish to clarify that they are not employed by Trupanion and have no reason to make a decision based on anything other than the facts of the case they are reviewing as they are paid for their time to review the case, regardless of the outcome Ms [redacted] has received a fair and thorough evaluation of her claim each of the three times it was reviewed for coverageShe paid for the service of insurance coverage and this claim was not eligible under the terms and conditions of her policy with TrupanionWe are unable to refund Ms [redacted] for the cost of the policy simply because we were unable to cover her claims related to this issueShe canceled her policy on 10/7/and we issued a prorated refund for the remainder of what she had already paid for through the end of her billing period in the amount of $ We wish Ms [redacted] and [redacted] the best in the future Sincerely,Angela – Trupanion [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 meHowever, it remains to be seen if they actually carry out what they promisedI hope they do.Sincerely, [redacted]

Complaint: [redacted] I am rejecting this response because: you went through a third party that is believed to be in your pocketYour "third party" is neither a practicing surgeon or practicing vetThey are all professors at universitiesThat is completely unacceptable! Why was I not able to pick my own third party from a list of [redacted] 's neurosurgeon's PRACTICING equals? You have already received several letters from Dr [redacted] informing you that there is no evidence of it being the same issue as the first surgeryIn fact, he has produced and sent you evidence PROVING it is not a preexisting conditionI have read many reviews on your company, and it seems you like to claim "PREEXISTING" for quite a lot of cases using your so called third partyThis is both unacceptable and negligent behavior! I am expecting payment in full! And it seems a little piculuar that you have done nothing to resolve this with me until I contacted the Revdex.comSincerely, [redacted]

Date: 09/07/Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] * [redacted] Trupanion has received the complaint from Ms [redacted] in regards to her recent claims experienceWhile we understand this isn’t the claim outcome that Ms [redacted] was looking for, the insurance industry is a highly regulated industry and we have to adjudicate claims based on the policy verbiage as well as the medical records receivedWe always encourage policy holders to review the policy verbiage so that they are fully aware of how the insurance can work for themThe Trupanion policy reads in Section AWAITING PERIODS: iIllnesses that occur or reoccur within the days following the policy enrollment date are deemed pre-existing conditions and not eligible for coverageSection BPRE-EXISTING CONDITIONS: iIllnesses or injuries for which signs or evidence of their potential manifestation existed within the months prior to the policy enrollment dateUpon review of Ms [redacted] ’s policy, Trupanion has deemed the gastrointestinal issues to be ineligible as the first signs or symptoms of the condition were noted to be present prior to attainment of the full coverageMs [redacted] enrolled her dog in the Trupanion policy on 3/24/Under the Trupanion policy, there is a five day waiting period for accident coverage to take effect and a day waiting period for any illness coverage to take effectMs [redacted] ’s waiting periods for accidents finished on 3/29/and the illness waiting period finished on 4/23/As all claims are adjudicated based on the medical records received from her veterinarianThe medical records received showed signs and symptoms of gastrointestinal issues recurrent and present prior to the date of enrollment: Banfield –Norwalk noted • 03/24/16- “Recurrent colitisDiscussed that I am concerned there is an underlying cause for recurrent illnessMetronidazole was dispensed“ Two days later, during the initial enrollment waiting periods on 3/26/it was noted from Banfield – Nowalk: • “Patient has had off and on diarrhea since OctoberHospitalized at CUVS in November because she was vomiting/diarrhea/collapsedAfter reviewing the record and seeing the history of the CUVS visit, I agree that Addison’s is definitely something we want to rule out.” Continuing during the waiting periods, from Banfield – Norwalk • 04/01/16- “Took longer to eat breakfast today and vomited after eating grassStill on GI dietColitis.” Again, we completely understand that Ms [redacted] is unhappy with the outcome of this claimWe must be fair to all policyholders and process claims per the terms and conditions of the Trupanion policyWe are unable to honor Ms [redacted] ’s desired settlement to refund all of her premiums as she is paying for the service of insurance coverage in the event an accident or illness occursAs Ms [redacted] has opted to cancel her insurance for [redacted] effective 8/19/2016, a prorated refund in the amount of $has been mailed to the address on file including a cancellation confirmationIf Ms [redacted] has any questions, concerns or would like to discuss the policy details further, we encourage her to give us a callWe can be reached 24/at (855)210-Sincerely, Kesa - Trupanion

Complaint: [redacted] I am rejecting this response because: They have also denied [redacted] uti claimThere was no protein in urine but they say it's related to pleThey did this without even requesting updated medical recordsStill a fraudulent businessThey are also dragging this out so I won't be able to get full refund if it comes down to thatThis is not resolved Sincerely, [redacted]

Trupanion has received the complaint from Ms [redacted] regarding her cancellation refundWe apologize as the incorrect refund was issued for this cancellation requestAs Ms [redacted] enrolled her pet on 07/26/and requested cancellation via email on 08/24/2016, a full refund of premiums and enrollment fee has now been issued to Ms [redacted] in the form of a checkThe full premiums and membership fee paid equals $In September Trupanion had previously issued Ms [redacted] a check of $The remaining balance refunded is $and has been issued to her todayTrupanion has also sent Ms [redacted] a new cancellation confirmation showing the correct date and refundTrupanion has reached out to Ms [redacted] to apologize for the inconvenience and confirm the refund correctionWe believe this matter to be resolvedWe will await her response as to her satisfactionIf there is anything else we can do to assist, please don’t hesitate to reach out to usWe can be reached 24/at Sincerely, Kesa - Trupanion

Policy # [redacted] and [redacted] Pet: [redacted] Enrollment Date: 07/02/2010Upon receipt of Ms [redacted] Revdex.com complaint, a review of her policy was done to determine the nature of her concernMs [redacted] year old mixed breed female canine, [redacted] , was enrolled with Trupanion on 07/02/A claim was submitted for “Lumps” for the date of service as 02/05/under claim # [redacted] Within this claim, there appears to be different masses: one lipoma on the chest, one on the left hind leg, a dermatofibroma on right front leg, apocrine cyst right front leg, and a hamartoma on the right rear legAs all the masses are different, they are completely different conditionsWe have biopsy results to confirm that those are all different conditions; as such Trupanion is unable to apply these conditions under one deductible.Our deductibles are “per medical condition” meaning that for each new medical condition, a new deductible is appliedThis information can be found under section 9.f of our policy:9.f: Deductible- the monetary amount that you pay for each conditionOnce the deductible is met for a specific condition, the policy will then pay out for all future losses subject to all other terms and conditionsTrupanion representatives have discussed our deductible application over the phone with the policy holders and discussed the option of appeal An Appeal was initiated by Trupanion who reached out to the veterinarian and left a message Policy holder [redacted] called into Trupanion on 05/20/and advised that she would follow up with her veterinarian regarding an appealAt this time, an appeal has not been startedTrupanion offers a variety of deductible options ranging from $0-$Ms [redacted] chose the $deductible range for pet [redacted] She is able to change her deductible for future, unrelated conditions should she wish to do soWe thank Ms [redacted] for her feedback and wish her and [redacted] the best in futureSincerely, [redacted] –Trupanion [redacted]