Trupanion

Hi ***,
I am sorry for the confusion and the cancellationI have reinstated your policyYour premium is $with a $deductible and is due on the 3rd of each monthWhen the policy was cancelled a refund of your prorated January premium was issued, if you receive this
check please do not cash itI will issue a stop payment on that check the policy is not cancelled
I hope you and *** are doing well

Upon receipt of Ms*** complaint, a review was done of her policy to identify the nature of her concernMs*** submitted a claim for the euthanasia of her pet, ***The circumstances of this claim are very sad and our hearts go out to Ms*** during this difficult timeWe have reviewed
the claim in question, claim #***The claim was deemed ineligible as the condition that *** was euthanized for had been present and showing signs and symptoms since prior to policy inception date of 07/06/14.When a pet shows signs or symptoms of a condition prior to policy inception, any claims related to this condition would not be eligible under the pre-existing exclusion of our policy 9.B.i:Exclusions: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. As this claim was adjudicated correctly, abiding by the criteria set forth by our policy we cannot refund the premiums eitherFrom the date of enrollment through the date of cancellation, *** had coverage under our policy, though no claims were submittedMs*** has the option to appeal the outcome of her claim if she feels like the reason for the euthanasia was not related to the pre-existing neurological disorderA letter of clarification provided by the veterinarian can be submitted and then reviewed by our Appeals team. A claims specialist went over this option with Ms***, and she is welcomed to pursue it if she wishes. We are very sorry to hear of ***'s passingWith Sympathy, Malari - Trupanion***

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

Date: 6/10/
Revdex.com case # ***
Policy # ***
Complainant: *** *** ***
We have reviewed the Revdex.com complaint submitted by Ms*** and have been in contact with her to resolve her concernsWe spoke to her on June 8th to advise her that we have been able to honor
her request to return her deductible to the previous amount as we have verified there was a miscommunication between our agent and herself
We believe that we have resolved this issue with Ms*** in a satisfactory manner and that she has a better understanding of her policy and the way that deductible changes work
Sincerely,
Amber S- Trupanion
1-888-733-

April 24th, Dear ***, We are sorry to hear that Alaska needed veterinary careAs pet owners ourselves, we know how difficult it can be anytime our loved ones are sickWe reviewed the claim for Alaska’s recent tooth extractionBased on the information we received from your
veterinarian, we were unable to contribute to this particular visitI have highlighted below the explanation of events in Alaska’s medical history which provided the detailed time line of events for the circumstances that prevented us from extending coverageOwner: *** *** Condition: Tooth Extraction Policy Number: *** Invoice Date(s): 2/27/2017, 3/2/2017, and 3/8/Pet Name: Alaska Invoice Number(s): ***, ***, and *** Claim ID(s): *** v1, *** v1, *** vInvoice Subtotal(s): $116.00, $108.10, $Condition Tooth Extraction - Ineligible Upon review of Alaska’s medical records the following clinic sign(s) which appear consistent with the claimed condition are noted: From Dunwoody Animal Hospital: 1/2/2016: Ulcer’s in mouth As these signs were documented prior to enrollment, there can be no coverage for this claimTrupanion has received the complaint from Mr*** regarding his recent claim experienceWe have reached out to Mr*** to discuss the claim further in detailHe discussed that the current claim was not related to the notations we had documented in the ineligibility letter regarding ulcers but to a separate tooth issueTrupanion reached out to DrE*** at Dunwoody Animal Hospital who had seen Alaska to obtain clarification regarding the notations in the history that showed evidence of an oral issue prior to the policy inceptionWe began our voluntary secondary review process with the information provided by DrE*** clarifying the ulcer notation in the medical history. Upon our second review of the claim the following clinical sign(s) which appear consistent with the claimed condition are noted: From Dunwoody Veterinary Center: 6/2/2016: “Lower left PM [left premolar] suspicious… reassess for dental w/[with] extractions.” Post policy, the following notations also appear to be related to the claimed condition: From Dunwoody Veterinary Center: 3/8/2017: Lower left PM(tooth 307) was extracted4/21/2017: DrE*** from Dunwoody Animal Hospital confirmed that the tooth referenced on 6/2/and the tooth extracted on 3/8/was the same tooth, and that it was extracted on 3/8/due to a resorptive lesionShe also confirmed that the abfinding on 6/2/was erythema at the gum linePrior to enrollment, Alaska was noted to have erythema along the gum line of tooth 307, and it was recommended that this tooth be assessed for possible extractionOn 3/8/tooth was extracted due to a resorptive lesionAs erythema along the gum line is a sign consistent with feline tooth resorption, and the tooth that was noted have this abnormality pre-policy is the same tooth which was extracted (due to a resorptive lesion) on the current claims, this claim is not eligible for coveragePlease refer to the following policy exclusion(s): 9.B.iIllnesses or injuries for which signs or evidence of their potential manifestation existed within themonths prior to the policy enrollment dateMr*** enrolled Alaska on 9/27/As these symptoms which are consistent with the claimed condition were noted prior to enrollment, we are unable to honor Mr***’s desired settlement to refundWe have been in contact with Mr*** to discuss these concerns regarding the outcome of this claim and how the Trupanion policy can work for him going forwardWe encourage Mr*** to please reach out to us directly if he has any further questions or concernsWe are happy to help and hope that Alaska is feeling betterWe can be reached anytime, 24/at Sincerely, Sarah - Trupanion

Complaint: ***I am rejecting this response because: what I was specifically told by the agent was that the office visits themselves would not be covered but if surgery was needed it would beAlso the claim was for both eyes and only the right eye showed swelling. Sincerely,*** ***

Complaint: ***I am rejecting this response because: The information noted by the Trupanion rep is incorrect our dog's name is *** not *** as stated in their message and after waiting almost over a week for review from their end and updating on the multiple claims submitted status of all of them still reads pending/processing via their website access and I am still without any answers or reimbursement for the significant cost that I have accruedI attempted to reach the rep directly at her extension 888-612-ext *** but appears she is not in the office and according to her message on her voicemail box she will be out of the office until 11/2/TuesdayAs you will note today is 11/28/Monday I will be happy to forward images of the claims as they appear on their end via their website upon access to my home computer.Sincerely,*** ***

Complaint: ***I am rejecting this response because:Trupanion was not totally honestI believe they were deceptive on what was covered and how payment would be received concerning not only *** but *** *** as wellI have to pay up front for their care and believe I can start a savings account versus giving away money and not be reimbursedI am not concerned about their fairness to others I am concerned that I paid almost to Trupanion and another out of pocket only to be told ***'s condition is not coveredEven the emergency room doctor states I should fight the decision because there is no evidence that ***'s condition was caused by past medical issuesI am truly disappointed in the insurance and the decision that was made. Sincerely,*** ***

Date: 11/05/2015Revdex.com case # ***Policy # ***Owner: *** *** Secondary Owner: *** ***Pets: *** * and ***We have looked into the matter that *** *** brought to our attentionMr*** called Trupanion and requested to cancel the policy on October 29, Mr*** was advised
that a cancellation agent was not available to cancel the policy but the customer service agent would send a request to the cancellation team and we would call to go over the cancellation process in the next few days.On November 3, an agent called the primary phone number and left a message to contact us to discuss cancellation proceduresI reviewed the outbound call to confirm that the call was completed. We do not know who the primary phone number belongs to, but we are obligated to call the number in our recordsOn November 4, Mr*** called us but again, no cancellation agents could cancel his policy at that timeWe verified the best contact number, this was the other number listed on the policy (presumably Mr*** number) and we advised him that we would contact him as soon as possible to finalize the cancellation.On November 5, our cancellation agent called and left a message on the phone number Mr*** providedThe cancellation agent also sent an email to the email address on file asking for a reply to complete the cancellation request in writingWe require a written request to cancel a policy in their stateOn the same day we received an email from Ms*** confirming her desire to cancel the policyThis policy has been cancelled effective October 29, (the owner’s original request date) and a prorated refund was issued for the unused premiums.A confirmation of cancellation with these details was also emailed to the email address on file.We would like to apologize to Mr*** and Ms*** for this frustrating experienceWe do our very best to handle these requests as quickly as possible and unfortunately we failed in this instanceWe can assure them that we always cancel the policy on the date the original request was made and a prorated refund is issued for any overpaid premiumWe wish Mrand Ms*** and *** and *** the very best in the future, please accept our sincere apologiesSincerely,Amber S

Complaint: ***
I am rejecting this response because: The company does not mail anything to confirm or check addresses, as most insurance companies doThis is their first oversight and lack of customer serviceThey overcharged me for months and did not provide a full refundI have offered to provide documentation that I have resided in RI since August In addition, I have a document that they processed on or around Feb 28th, that included my new address and my vet in Rhode IslandIn addition, they sent mail to my Rhode Island address without any follor check to see why I had mail sent thereThat is the most concerning.I have requested the company to provide me in writing the policy (previously provided to me before this incident) that says they cannot issue a full refund; however, they have not sent it yetI would like the full refund to be provided, as this is what any other insurance company would do had they learned they overcharged you or had you at the wrong rate for any amount of time.
Sincerely,
*** ***

Date: 6/23/
Revdex.com case # ***
Policy # ***
Complainant: *** ***
We have received the complaint filed by Mr*** and understand the concerns that have been presentedWe reached out to Mr*** on 6/21/and left a message for him to contact us to discuss this
matter further but at the time of this response have not heard back from him
We would like to discuss the concerns that Mr*** has expressedThe information he was provided by our agent was correctThe Trupanion policy states that an annual review of the rates will occur on the policy anniversary dateThe policy documents are provided to the owner via email as soon as they sign up for the policyTrupanion also notifies policyholders via email at least days prior to any change in their rate, as required by the insurance board in their stateThis allows the owner time to contact us to make any deducible changes to adjust their premium before the new rate takes effect
Trupanion policies vary state by state, depending on what has been approved in the state of the insuredThose policyholders are sent a document with their rate change notification to advise them of the changes their state has approved regarding their policyThis document is called an Amendatory EndorsementWe also include the policy declaration page, the policy document itself and any applicable riders (additional coverage packages)
In the case of Mr***, he resides in Colorado and the Amendatory Endorsement that was sent with his policy documents, upon notification of the rate change, advises that the section of the policy that discusses a 20% rate cap, is not applicable in ColoradoThe use of Amendatory Endorsements is a common practice in the insurance industry and the document itself states that it is a part of the policyThis is not intended to be confusing or deceiving and Trupanion encourages policyholders to read their policy documents and call us if they have any questions
We are aware that an error occurred when Mr***’ rate change initially occurred and we notified him to advise of the mistakeHe was noticed of and charged for a higher rate than he should have been on April 12, Trupanion made the adjustment to correct the rate and issued a refund check to Mr*** for the differenceWe do apologize for this error and feel we corrected it as soon as possibleMr*** was noticed in March that his rate would change from $to $On April 12, the rate change took effect and we notified Mr*** via email that same day to advise him that his premium should actually be lower at $and issued a refund check to him for the difference of $
The rates Trupanion charges are determined by our actuarial data for the claims that are filed for the “like group” of petsThis helps to spread the risk among pet owners in the same like group so that no one pet owner is penalized for having a sick or injured petIf we see that the rates we are charging for a like group is not covering the costs of the claims we are paying out for that like group of pets, we must make adjustments to the premiums so that we can continue to provide the 90% coverage with no limits on a dollar amount we will cover
We encourage Mr*** to contact us to discuss the rate change and his deductible options so that he can lower his monthly costs, if that is his concernWe cannot honor his request to not raise his rate more than 20% as this is something that has been approved by the Colorado Insurance regulatorsWe also cannot refund Mr*** for the difference in his previously paid premiums as they are accurate for the pet he has insured in his locationMr*** is welcome to adjust his deductible moving forward if costs are a concern and we are happy to assist him in doing soWe are available 24/by phone if he would like to make any changes or get additional information
Sincerely, Amber S- Trupanion
1-888-733-

Complaint: ***
I am rejecting this response because:Attached you will find the letters from our current veterinarian from Woburn Animal Hospital - Dr.S*You can see this letters also as a second opinion about my caseYou will see that Trupanion rejects the payment with an unreasonable reason.
Sincerely,
*** ***SUPPORTING DOCUMENTS REDACTED BY Revdex.com***

Date: 11/19/2015Revdex.com case # ***Policy # ***Owner: *** ***Pet: ***We have reviewed Mr***’ complaint and although he is not asking for anything specific, we would like to address his concerns and explain our policy and clarify our certificate coverage.We reviewed the enrollment
call and Mr*** did not mention that his pet had any issue(s) that he was seeking coverage for specificallyOur policy does not cover any pre-existing conditions and this is made clear in our policyWe obtained medical records to process Mr***’ claim for ***, it is noted that *** had been experiencing issues with the back left leg for about a month prior to enrollingSince this is a pre-existing condition we are unable to cover the costs associated with treatment of that condition.Here is an excerpt from the pet’s medical record which was the reason for the claim being ineligible and specified in the claim outcome letter: 11/2/2015: “P [pet] not putting pressure on back L [left] legBeen going on about a monthO [owner] been trying to keep P quiet… PE [physical exam]: Toe touching, swollen L stifle, medial buttress… pain on palpation… Dx [diagnosis] R [ruptured] ACL [anterior cruciate ligament] L… Discussed confinement, Rm [Rimadyl] wks [weeks], discussed Sx [surgery]”Mr*** was told on the phone after activating the certificate that his coverage would start immediately and that he had no waiting periods, which is correct based on the information we were provided at the time of enrollmentHowever, the absence of waiting periods does not mean that we will cover any claim that is filedWe are still bound by our policy, which specifies that we do not cover pre-existing conditionsWe provide policy documents to our customers and it is their responsibility to review the details of the coverageIt is also the customer’s responsibility to contact us with questions about the coverage We define pre-existing conditions in the policy under 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.”Mr*** also states that his veterinarian advised him that he could activate his certificate and we would cover his dog’s injuryUnfortunately, this information is not correct and we will reach out to the veterinarian to clarify our policy to ensure they are providing accurate information about our coverage.We do not cover conditions pre-existing to the policyWe apologize for the experience that Mr*** had and we wish the best for him and for *** in the future.Sincerely,Amber S.Trupanion ***

Complaint: ***
I am rejecting this response because:It does nothing to provide any concrete information as to why our rates have increasedI would like Trupanion to provide actual evidence/proof that the cost of care/access to services in our new area is 46% higher than our old area (because that is the singular change in our policy that resulted in the 46% increase in our premiums). Changing our policy so that our deductible is times higher doesn't actually solve the underlying problem
Sincerely,
*** ***

Date: 5/31/
Revdex.com case # ***
Policy # ***
Complainant: *** ***
We have reviewed the Revdex.com complaint submitted by Ms*** 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*** 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 manner
We 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 concerns
Sincerely,
Amber S- Trupanion
1-888-733-

Complaint: ***I am rejecting this response because: The way Trupanion worded their letter above makes it appear that my surgeon is in agreement with their and their veterinarian's view of what constitutes a "bi-lateral" condition. My surgeon challenges their view of what constitutes a bi-lateral condition, and, in fact, claims that what *** had was a uni-lateral condition. He is one of the leading surgeons in the United States on crutiate tears, don't you think he would know what a bi-lateral vsa unilateral condition is? Please read his two page letter attached to this Revdex.com complaint. Trupanion continues to push THEIR bi-lateral condition verbiage in their policy to try to cover their refusal to pay out, but its all just smoke an mirrors meant to confuse the Revdex.com and possible new customers. Their pointing over and over again to verbiage on bi-lateral conditions is irrelevant. My dog's injury was NOT a bi-lateral condition, but a uni-lateral condition that came about as the result of a trauma injury to otherwise VERY healthy right leg. NO matter now Trupanion tries to spin their rejection of my claim and link it to unrelated bi-lateral verbiage in their policy, their rejection of my claim is, and always will be, a failure on THEIR part to follow through on a promise to cover their client costs by 90%. They covered NOTHING, after almost a year of my paying them premiums for all four of my dogs every month. They refused to reimburse me for the premiums I have paid saying that my "well, your dogs were covered." REALLY? Well, then, Trupanion, where is the coverage? Because I have shelled out over $4,on my dog's emergency visit for her trauma, and the associated surgery, and have not received from you even one red cent. And it was my very first claim! I'd say that was NO coverage. So what do they say? Well, we can reimburse you for the amount of premium you have paid since you said you want to cancel your policy. TWO WEEKS. Seriously, it's laughable how terrible this company is. The Revdex.com should be giving this company an F when it comes to making good on, and resolving client issues. They could care less. Trumpanion is a FOR PROFIT company that is intent on only one thing -- to make a fortune on scamming their clients out of their hard earned money each month without every having to pay out for a single thing. I'm sure their leadership team are living large on the profits, and laughing all the way to the bank. Buyers BEWARE. Run, don't walk away from Trupanion! They are just scam artists.Sincerely,*** ***

May 24th, Trupanion has received a second rejection notice by Ms*** in regards to the Revdex.com complaint filed to reject our outcome of pet, Pippin’s claim for UTI treatment and request for a full refund. To date, Trupanion has reviewed and processed the claim for UTI in a secondary review process and found the condition to be eligible for coverageTrupanion applied the eligible claim costs from the invoice submitted towards the deductible chosen by Ms***The claim costs did not exceed her deductible amount of $500.00, which is why Ms*** was not issued a physical reimbursement but her claim was covered and paid towards her deductible amountMs*** requested to cancel her pet’s medical insurance policy on 05/18/Trupanion issued a full refund and this was credited to the payment method on file on 05/18/Trupanion considers Ms***’s complaint as resolved. We encourage Ms*** to call us if she has any additional questionsWe can be reached anytime at Sincerely, Sarah - Trupanion

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

Complaint: ***I am rejecting this response because:Sincerely,*** ***
I completely reject Trupanions findings regarding my canines claimNo doubt they furnished Revdex.com and with explanation that at first sounds legitimate until you are made aware of the supporting evidence and context of caseWhich in all due respect requires the intelligence of a year old to sort out and when you understand what I’m attempting to explain you will realize not only is Trupanion flat out wrong but they are clearly dishonesty companyThat being said let me explain the situation from start to finishI’ve supplied all the necessary documents for review and everything I’ve submitted Trupanion has received and reviewed in detail prior
Unfortunately I will need more time to write out in detail what my case is about but the site suggest I only have minutes which is not enough time

Date: 7/7/
Revdex.com case # ***
Policy # ***
Complainant: *** ***
We have received the complaint filed by Ms*** and understand her concerns in regard to her dog’s ineligible skin infection claimUpon the initial review of the claim, Trupanion found that
signs and symptoms consistent with the claimed condition were present prior to her policy coverage beginningIn October of it was noted in the pet’s medical records that the pet had skin issuesIn May of the pet presented for an infection of the skin in a different locationBased on the definition of pre-existing conditions outlined in the Trupanion policy we found we were unable to extend coverage to this claim
We discussed with Ms***, on the phone and via email on several occasions in late June to explain to her why we were unable to extend coverage and how to appeal the claim to have it re-reviewed
On June 23, our Appeal specialist spoke with DrG***, who is treating the pet, to get clarification about the pet’s issues and we received a formal letter of appeal from him which was attached to the policy on 7/1/We are in the process of having the claim re-reviewed with the additional clarification DrG*** has provided
Because there are many medical conditions that have similar signs and symptoms, we must look at the medical relationship that may exist when there are the same or very similar signs and symptoms that are present both pre- policy and post- policyIf we cannot make this medical disconnection, we must uphold the decision that the claim is ineligibleIf we are able to determine that there is a medical disconnection between the signs and symptoms then the claim can be overturned
At this point in time the claim is being re-reviewed and as soon as the claims team is able to make a decision based on the clarification that DrG*** has provided, we will email an outcome letter to Ms*** to advise her of the details of the appeal outcomeSince this is still in process, I cannot advise on the outcome or speculate as to what that will be
We understand that Ms*** has been frustrated by this issue and we want her to know that we are working toward a resolution of this claimWe wish her and her family the very best
Sincerely,
Amber S- Trupanion
1-888-733-