Trupanion

Date: 5/31/Revdex.com case # [redacted] Policy # [redacted] Complainant: [redacted] We have reviewed the Revdex.com complaint submitted by Ms [redacted] and reviewed her concernsWe extend our apologies for the late response to this matterWe have discussed the concerns brought forth in this complaint with Ms [redacted] on 5/18/2016, the same date her Revdex.com complaint was submittedBy 5/23/we were able to resolve her concerns in a satisfactory mannerWe believe that Ms***’s concerns have been resolved at this timeWe contacted her and left a phone message earlier this morning to apologize for the late response to her Revdex.com complaint and to let her know she can contact us if she has any other concernsSincerely, Amber S- Trupanion 1-888-733-

Date: 8/4/ Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] *** Trupanion has received the complaint filed by Ms [redacted] and has been in contact with her to discuss her concerns in further detailWhile we understand this isn’t the claim outcome that Ms [redacted] was hoping for, we must review claims based on the policy terms and conditions in addition to the medical records received from the veterinarian Ms [redacted] enrolled her pet, Blondie on 2/27/ Noted in the medical history from Canyon Creek Pet Hospital on 2/26/2017: “Mild right stifle effusion is present and there is mild osteophyte production around the joint Mild bilateral stifle joint osteoarthrosis with evidence of complete cranial cruciate rupture on the left.” As osteophytes and osteoarthrosis are signs consistent with cruciate ligament disease and these signs were noted to be present in the right limb prior to enrolment this precludes coverage for this condition and complications of the condition as pre-existing under our policy Upon review of the enrollment call, Trupanion advised that we do not cover pre-existing conditions or anything related to any pre-existing conditionsWe also advised that we recommend reviewing the policy terms and conditions that were emailed to her at the time of enrollment to fully understand how the Trupanion policy can work for her We are unable to honor Ms***’s desired settlement to reimburse for the claimed condition as it was noted prior to enrollmentWhen discussing the claim outcome with Ms***, she had requested cancellation effective 08/2/Trupanion has sent an email to Ms [redacted] asking her to confirm this cancellationWe will await a response from her as to how she would like to proceed regarding the cancellation of her Trupanion policyWe can be reached anytime, 24/at Sincerely, Kesa

Complaint: [redacted] I am rejecting this response because:They have not issued a full refund, they just applied the amount towards the deductible and told me that they are unlikely to cover another UTI if she had one Sincerely, [redacted]

Date: 1/27/ Revdex.com case # [redacted] Policy # [redacted] Complainant: [redacted] * [redacted] We have reviewed the complaint filed by Ms [redacted] and it appears that all of her open claims were processed and finalized on 1/20/ We understand that Ms [redacted] was concerned about the length of time her claims took to processIn looking into this concern it appears that we had encountered issues with collecting the required medical records from the clinics her pet had visited and that delayed the claims process causing us to close the claims due to lack of medical records Ms [redacted] spoke to supervisors at Trupanion to get assistance with her concerns and it appears she was advised of why we had closed her claims originally- we had not been able to successfully obtain the necessary medical recordsOnce we received clarification on the records from her clinics that the pet did not have any medical records from the dates requested, we were able to reopen the claims and process them We apologize for the delay that Ms [redacted] experienced in having her claims processed, it was certainly not our intention to delay the processing of her claimsIt is our hope that she has found a satisfactory resolution now that her claims have been completedMs [redacted] has requested her policy be cancelled and we processed her cancellation request on 1/26/We wish her and her pets the very best Sincerely, Amber S- Trupanion 1-888-733-

Complaint: [redacted] I am rejecting this response because: My vet responded to Trupanions denial as follows: To Whom It May Concern: I am writing on behalf of our mutual clients, [redacted] and [redacted] , regarding your denial of their claim for services relating to [redacted] right facial skin fold dermatitis diagnosis and treatment The claim was apparently considered a pre-existing condition based solely on a notation in the medical record from months earlier indicating a finding of facial acne/pustular dermatitis (aka “puppy acne”) on March 6, Puppy acne is a common presentation of young dogs; especially brachycephalic breeds who tend to be messy eaters That presenting complaint on the ventral muzzle resolved quickly and has not recurred since I believe your interpretation of this notation is in error, and that [redacted] case warrants reconsideration The presumption that [redacted] puppy acne in March, is the same pathology that was identified and treated in a different location on the head in May, is a ludicrous and medically unsound theory While there may or may not have been any association between the two incidences in light of general breed dispositions, this is a clear overreach of interpretation with no firm medical basis to back it up The medical evidence of such a relationship between these two clinical presentations simply does not exist We all recognize that as a Pug, [redacted] is likely to have a mechanical predisposition to hygiene-related skin inflammation and infection However, if and when these episodes do occur, they are in themselves independent and unrelated to previous incidences I strongly disagree with the medical basis of Trupanion’s judgment in this case; and I would urge you to reverse your denial of this claim for coverage I have historically been comfortable recommending Trupanion to my clients as a reliable and fair pet insurance provider Cases like this, however, raise serious concern and cause me to doubt my faith in your company’s integrity I have been both disappointed and aggravated by Trupanion’s position “creating” pre-existence where there is none, and the baseless and inane arguments your representatives have made both to me and to our clients to defend these indefensible judgments I look forward to an honorable and satisfactory resolution to this case for this family, and an opportunity to restore my own faith in your company going forward Please do not hesitate to call me if you have any additional questions regarding this case Thank you very much Sincerely, DrRaphael G [redacted] Mamaroneck Veterinary Hospital 914-777- Thereafter, I received an email from trupanion that said the following Upon review of the records I have found that we unfortunately remain unable to extend coverage for this claim [redacted] was noted to have facial pustular dermatitis on his muzzle which continued post-policy, and was noted to recur several timesSince enrollment [redacted] has also been noted to have recurrent ear infections, as well as pruritus of the face and feetGiven the continuum of clinical signs and their frequency I was unable to fully differentiate the claimed condition as having no potential relationship to the clinical signs noted prior to enrollment Please refer to the following policy exclusion(s):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 Other: Ineligible Items 9.D.I We do not cover the costs, fees, or expenses associated with: Examinations; $ We understand that this is not the outcome you were hoping for, and should you have any additional questions or desire more information, please don’t hesitate to contact usWe are here to help you hours a day, seven days a week as I explained before - I think their response has no merit and is unacceptable to me as a consumer does it make sense that if a dog has an infection on his skin and then gets another separate infection years later - that they are related??? imagine if I went to my doctor and said I had a sore throat and then years later went back with another sore throat and the insurance company disclaimed and said that I had a sore throat before so its pre existingIt clearly is improper what they are doing and that is why I am seeking the intervention of the Revdex.com We appreciate any assistance that you could provide Best, [redacted] B [redacted] , Esq., of counsel EBANKS & [redacted] , LLP Attorneys for Plaintiffs Vesey Street Suite New York, New York (212) 766-(office) [redacted] (mobile)Sincerely, [redacted]

Complaint: [redacted] I am rejecting this response Complaint: [redacted] I am rejecting this response because Trupanion is continuing to falsely claim that they received no response from me regarding cancellation because they weren't aware of the change to my contact info However, when I called them to access my account with the new phone number they claimed they never knew about, they somehow were able to pull up my accountAlso, their own customer service manager couldn't confirm the mailing or email address they claimed was on fileDuring my phone conversation with Ashlyn she gave the wrong mailing address for where my cancellation notice was sent and in her email to me she stated that the email address they had on file for me (where cancellation notices were alsosent) was a Yahoo account; yet, I have never had a Yahoo account in my lifeThey are manipulating information to try and cover their ineptness.I have been a Trupanion customer for years and I do not appreciate their condescending response about being happy to help me re-enrollIf Trupanion had good customer service and truly valued their customers and the pets they are insuring, they would not be telling me to re-enrollThe cost difference between my re-enrolling versus re-instating my current policy is $per month It is clear that all Trupanion cares about is getting more money! [redacted] ***

Ok, we will wait for your reply Thanks,

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 metrupanion accepted and acknowledged how they treated me was wrong and handled my claims accordingly and reinstated their policyif I would have gotten a call from a claims manager earlier than weeks after my initial claims, I may not have been treated as badly as I wasin the end they acknowledged their shortcomings and took care of me.Sincerely, [redacted] ***

Date: 10/11/Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] Trupanion has received the complaint from Mr [redacted] regarding his cancellation and refundWe are sorry to hear this has been a frustrating experience for himThe Trupanion policy does offer a day money back guaranteeThe Trupanion policy states: Section 3.HIf you cancel your policy for any reason within the first days, and you have not submitted a claim within that period, you will receive 100% of your premium backWe wish to clarify that Mr [redacted] enrolled his dog in the Trupanion policy on 09/02/The first email or phone call to request cancellation was on 11/02/As this is outside of the 30th day for a full refund, per the regulations and our policy verbiage, we are required to issue a prorated refund of any unused premiums from 11/02/going forwardThe prorated refund from 11/02/going forward is in the amount of $which has been mailed to Mr [redacted] in the form of a checkAs our policy verbiage states, we are also unable to provide a full refund if there was any claims filed within the first daysWe received a claim dated 9/21/15, which further invalidates a full refund of premiums paidAs insurance is a highly regulated industry, we are unable to honor the request for a full refund of premiums as the request to cancel came in after the day money back guarantee and a claim was filed within that time frameWe have been in contact with Mr [redacted] to relay this information and we will await his responseWe wish Mr [redacted] and his dog the bestSincerely, Kesa - Trupanion

Date: 8/17/ Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] Trupanion has received the rejection of our original response and appeal request from Ms [redacted] regarding her recent claim for degenerative joint disease, as well as the letters from her veterinarianTrupanion has opened a secondary review of her claim and upon that review the claim remains ineligibleThe below explanation was sent to the owner from one of our staff veterinarians, DrSarah N***: “Upon review of the records and the information you provided I have found that we are unable to extend coverage for the treatment of hind leg lameness [redacted] was noted to be on a joint supplement, aspirin and fish oil in April Also, he was noted to have crepitus in both stifles in August He was found to have crepitus in both stifles in the current claim and was diagnosed with degenerative joint disease (osteoarthritis) in his stifles on radiographsWe do not determine if a condition is pre-existing based on the date of diagnosisOur policy specifically states that if any illness for which signs or evidence of their potential manifestation existed within months prior to enrollment or during the days after enrollment that it is considered pre-existing.” We understand this isn’t the claim outcome that Ms [redacted] has hoped forWe encourage her to please give us a call if she should wish to discuss this claim outcome furtherWe’re here for her 24/at Sincerely, Kesa

Complaint: [redacted] I am rejecting this response because:You did not allow me to choose what third-party I would be most comfortable withThe email sent on March was sent to the wrong email As stated in the email sent by trupanion on 5/ I never agreed to a third-party Select it's solely by Trupanion! I states before, I request a full refund of $6800Sincerely, [redacted]

Complaint: [redacted] I am rejecting this response because: I have not recieved any calls or communications regarding this issueYour company is causing alot of financial problems in my life you should be ashamed of your treatment Sincerely, [redacted]

Date: 8/30/Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] Trupanion has received the complaint from Ms [redacted] in regards to the outcome of her most recent claimsWe understand her concerns regarding the outcome of the secondary reviewBased on the most updated information available, we show that an independent third party review is currently being assessed in regard to this claimThis third party review is an opportunity for a neutral specialist to review the details of the case as they pertain to the pet’s condition and make a determination based on their findingsAs this third party review is still in process, we are unable to speak to the outcome at this timePer Ms***’s request, a claims manager has left a voicemail and sent an email to set up a time to discuss the claimed condition furtherWe want Ms [redacted] to know that we understand this is a difficult condition and we hope that her discussion with our claims manager is helpful to address her concernsOnce the independent third party review is finalized, a full report along with the outcome will be sent to Ms [redacted] via emailWe wish Ms [redacted] and her dog the very bestPlease feel free to reach out to us if we can be of any further assistance with this matter Sincerely, Kesa – Trupanion

Date: 12/21/Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] * [redacted] Trupanion has received the complaint filed by Mr [redacted] regarding the cancellation of account number [redacted] We have spoken with [redacted] to provide clarification about his concernsThe [redacted] family had two separate policies enrolled with TrupanionThe first policy number [redacted] was activated on April 10th, in ***hew [redacted] ’s name onlyThe second policy number [redacted] was activated for a separate cat on August 22nd, in [redacted] ’s name only***’s policy, [redacted] was activated as a thirty day certificate that had an automatic expiration date of 9/23/if not continuedWe believe the confusion may have started when she had called on October 4th, to confirm her policy had been cancelledWe did confirm that policy number [redacted] , in ***’s name, had not been continued and automatically expired after the day coverage periodTrupanion has reviewed the conversation with our representative on October 4th, and unfortunately there was no mention of having multiple policiesFurthermore, [redacted] would not have been authorized to cancel ***’s policy, [redacted] on October 4th, as she was not named as an authorized policy holder to make changes As the first cancellation request from [redacted] for his policy, [redacted] came in on 12/14/16, we have honored that date for cancellation and emailed a confirmation of cancellation to the email address on file and he should also expect a pro-rated refund of $to be mailed in the form of a check to the address on file While we understand this may have been confusing as Mrand Ms [redacted] had two separate policies in place, we must follow the guidelines outlined in our policyWe have discussed the situation further with [redacted] to help resolve his concernsWe encourage them to reach out to us with any further questions about the events that occurred and we believe this matter to be resolved Sincerely, Kesa - Trupanion

Complaint: [redacted] I am rejecting this response because we were in fact told that because ***'s leg had been declared 100% healed prior to the second break by an impartial third party as evidenced in her file via report, it would not be considered pre-existing by Trupanion I've When I disputed this decision, Trupanion sent their decision to a NOT impartial third party for confirmation (they pay the professionals who make their final determinations on whether or not a decision is upheld or reversed)I have several professionals who state that her leg was completely healed and it shouldn't have been considered pre-existing That the way the second break occurred, it would have broken whether or not there was the first break earlier in the year or not The first break is not relevant to the second break When an 85lb dog jumps up and lands on the leg of a 4lb dog, the leg will break Trupanion needs to live up to their obligation and pay all costs aside from the $deductible I signed up for If you would like a copy of the document that states ***'s leg was 100% healed prior to the second break, please don't hesitate to let me know and I'll get that from her vet for you Trupanion likes to take excerpts from multiple pages and put them together so that the wording suits their purposesThey haven't given a 100% accurate accounting of anything yet Including the fact that I'm not a "Mr.", and no "Mr." has ever had any contact with themSincerely, [redacted]

Date: 8/7/ Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] * [redacted] Trupanion has received the complaint filed by Mr [redacted] regarding his cancellation request We’ve been in touch with him to finalize his cancellation requestAfter discussion with Mr [redacted] , he has opted to keep his policy active and as is As such, we believe this matter to be resolvedWe encourage if Mr [redacted] has any other questions or concerns, to please reach out to us directlyWe can be reached anytime, 24/at Sincerely, Kesa

Date: 1/27/Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] Trupanion has received the complaint from Mr [redacted] regarding our advertisements discussing our veterinarian direct pay optionWe have been in contact with Mr [redacted] by phone to address his concerns and feel that we were successful in doing so In the industry, Trupanion is very proud to offer the veterinarian direct pay option through our unique softwareIf the veterinarian should wish and has software that is compatible, we can install a program that allows for direct pay in a matter of minutesWe also have the option of direct deposit and/or check reimbursement to the veterinarian or the pet owner directlyAs Trupanion allows their policyholders to visit any licensed veterinarian in the US, Canada and Puerto Rico, we don’t have a list of specific veterinarians that offer this optionThe veterinarians can choose how they would like payment to be completed We know that Mr [redacted] ’s kitty Waldoff is going through some diagnostic testing this week and we wish the best for him and hope that all is wellWe encourage Mr [redacted] to please reach out to us if there is anything else we can do to assist Sincerely, Kesa – Trupanion

Date: 2/24/ Revdex.com case ID # [redacted] Policy # [redacted] Complainant: [redacted] Trupanion has received the complaint filed by Mr [redacted] in regards to his recent premium adjustmentWe have been in contact with him to help address some of his concerns and understand that premium adjustments can be frustrating Many factors determine the Trupanion monthly premiumFor example, the age of the pet at enrollment, breed, spay/neuter status, deductible option and geographical locationIn this situation, Mr [redacted] was scheduled for an annual review of his premium which he was notified would be increasingIn addition, he updated his address which contributed to the change in cost Trupanion’s policy allows pet owners to visit any licensed veterinarian they preferAs such, the premiums are directly related to the geographical location, the availability and the type of care in that area which would be reflected in the cost with the new address provided We understand that Mr [redacted] is not happy with the amount of the premium adjustment, but would like to assure him that the premiums are accurately priced based on his pet’s factors and his locationPlease understand we don’t enjoy adjusting our premiums by any means but it is something that has to happen to keep our coverage where it is; 90% with no payout limits and few exclusions, rather than keeping our premiums the same and reducing our coverage and/or payout When discussing with Mr [redacted] the factors that create the premiums, we also discussed the option to make adjustments to the deductible to lower the monthly premiumHe has opted to raise his deductible in order to lower his monthly premium going forward and should have a confirmation email outlining this change In conclusion, we are unable to honor Mr [redacted] ’s desired settlement to reduce his premium based on his address change and refunding the difference in premium as requestedMr [redacted] has been advised that if he has any further questions, please don’t hesitate to reach out to usWe are happy to help and can be reached 24/at Sincerely, Kesa – Trupanion

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 meSincerely, [redacted]

We have reviewed the Revdex.com complaint submitted by *** [redacted] on the annual rate change notificationWe understand that a rate increase is not ideal and we want to assure *** we do not change premiums without reasonOur policy offers 90% coverage of eligible costs based on the actual invoiceWe do not have caps or limits on what we pay for eligible conditionsSince our policy has such great coverage we must adjust premiums when necessary to continue offer the same great coverage.Our rates and policy are reviewed by each state to be fair and not excessive or discriminatory***’s rates are determined based on many factors including the pet’s age at enrollment, breed, gender, spay/neuter status and zip codePremium changes cannot be attributed to the covered pet’s individual claimsWe do not share our detailed actuarial data with policyholders as that is proprietary information and involves thousands of pricing factorsWe are hopeful this information is helpful to *** to help understand how we determine the cost of the policy.The secondary concern that *** has is in regard to the policy verbiage about the rate cap***’s policy includes a document called an amendatory endorsement which is a standard insurance document used to customize the policy based on what has been approved by each state where the insurance in offeredThe California Amendatory Endorsement was included with the policy documents that were sent to *** at enrollment and at each policy anniversary date when the rate notification is sent out.That document states:“CALIFORNIA AMENDATORY ENDORSEMENTTHIS ENDORSEMENT CHANGES YOUR POLICYPLEASE READ THIS DOCUMENT CAREFULLY AND KEEP IT WITH YOUR POLICY.This endorsement, which is attached to and made a part of the policy, modifies insurance provided under the following:Trupanion Pet Health Insurance Policy Paragraph Bii4.b of section INSURING AGREEMENT is deleted in its entirety.”The above referenced paragraph B.ii.4.bis written into our basic policy and states: “This annual adjustment will never exceed 20% in any given year.”As stated in the California Amendatory Endorsement, that paragraph is deleted from the California policyCalifornia did not approve a 20% rate cap for the policy which means that Trupanion will price the policy without a cap and so the premiums could change by more than 20% in a year if that is what the actuary data reflects for that group of like pets.We can’t negotiate the rate for the policy, but we can change the deductible to a more comfortable paymentWe think it is important to point out that since *** has been enrolled she has had many covered conditions, many of which are ongoingWe hope that *** has seen the value in the policy coverage and has a better understanding of how we adjust premiums We are always available via phone or email to discuss options for a deductible that may help reduce the monthly costs and still keep pet protectedWe are available by phone 24/at 1-888-733-