Trupanion

Policy #[redacted]Pet:  [redacted]Enrollment Date: 02/02/2013Upon receipt of Mr. [redacted]’ Revdex.com complaint, a review of his policy was done to determine the nature of his concern. Mr. [redacted]’ 8 year old Siberian male feline, [redacted], was enrolled with...

Trupanion on 02/02/13.Two claims were submitted for [redacted], Claim #1215733 for “Dental Check Up Prior to Cleaning, gingivitis” – which also had charges for a Mast Cell Tumor on it; Claim #[redacted] for “Dental Surgery, gingivitis – feline resorptive lesions (dental x-rays), small pink nodule – excisional biopsy- fine needle aspiration showed Mast Cells”.  Upon receipt of these claims, medical records for [redacted] were collected, as is standard protocol for a Trupanion Claim. Occasionally, the record collection process can take a little while – there can be extenuating circumstances such as technology failures that can delay a process. The good news is that we only ask for records on the first claim, and once received, future claims go by a lot smoother.  Once we received complete records, we were able to finalize [redacted]’s claims. Trupanion was able to extend coverage for the Mast Cell tumor. The initial charges were processed under claim #1215733 and $153.00 was applied to the $300 per condition deductible.  The only ineligible item on this claim was the exam for $65, which is a direct policy exclusion and not something that offer coverage for.On claim #1215745, we were able to extend further coverage for the Mast Cell Tumor. $147 was applied to the remaining deductible for that condition and we paid to policy holder $278.78. The second condition on this same claim was for “Gingivitis and Resorptive lesions” which was also eligible for coverage– We were able to apply $300 for the deductible, and then after the deductible was satisfied, we paid out $94.10. We were not able to cover the teeth cleaning itself, which is considered preventative/routine, in the amount of $268.80, nor could we offer coverage for the microchip implantation in the amount of $37.80, as that is also considered preventative/routine. Trupanion does not offer coverage for routine and preventative care as described under section 7.c in our policy:7.c. Preventative Care – Preventative Care such as, but not limited to, vaccinations or titer test, flea control, tick control, heart worm medication,  dental care and prophylaxis (meaning cleansing of the tooth surfaces), deworming, nail trim, or other grooming.  Policy documents are provided to a policy holder upon enrollment via email and are also always available online.We thank Mr. [redacted] for his feedback and wish him and his family the best in future. Sincerely, [redacted]Trupanion[redacted]

Date: 5/16/2016
Revdex.com case # [redacted]
Policy # [redacted]
Complainant: [redacted]
We have reviewed the Revdex.com complaint submitted by Ms. [redacted] and contacted her to discuss the cancellation process. Ms. [redacted] responded by email stating that she wanted the policy to be...

cancelled and we complied with her cancellation request. In reviewing her past contact with us, she advised us that she would be cancelling her policy and when the agent assisting her asked if she could assist Ms. [redacted] further, Ms. [redacted] ended the call. We are unable to honor that date as her cancellation request date because she did not state that she wanted to cancel the policy and she did not allow us the opportunity to assist her in the cancellation process.
We have processed her cancellation effective May 12, 2016 as that is the date of her Revdex.com complaint requesting the cancellation of her policy. Because the policy was past due at the time of cancellation we are unable to issue any prorated cancellation refund.
Ms. [redacted] requested in her complaint that she wanted a full refund of her insurance premiums. We are unable to issue a refund for the premiums that Ms. [redacted] has paid for the insurance coverage on [redacted] and [redacted] as she was paying for the service of insurance. Trupanion was unable to reimburse for her claims as they were pre-existing to the policy. Had there been a claim that was eligible under the policy, Ms. [redacted] would have been reimbursed.
Ms. [redacted] has been advised of this information via email correspondence as she was not willing to discuss the situation by phone. It is our understanding that this issue has been resolved. We wish Ms. [redacted] and [redacted] the very best!
Sincerely,
Amber S. - Trupanion
1-888-733-2685

Revdex.com:I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. Sincerely, [redacted]

Complaint: [redacted]I am rejecting this response because: It clearly states that the premium will not go up by more than 20%, and that is in their email along with the brochure. It does not say except for Colorado or anything like that. In the email I received, it also did not state how much the premium was changing by. I had to go thru and open 6 different attachments (easily over 8 pages) just to find the section saying how much my premium was changing. This is definitely a deceptive business practice, and I certainly feel that it is intentional. I am sure that I am not the only person who has the payments on automatic withdraw and doesn't have the time to read through every attachment included in every email. To show very clearly that the premiums won't exceed 20%, but then blame me for not knowing that what they emailed me doesn't apply to me seems outrageous. I have had to deal with plenty of false advertising and deceptive business practices in my line of work, so I am very well versed, and this seems like a very plain and simple case of it.Sincerely,[redacted]

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 39 months earlier indicating a finding of facial acne/pustular dermatitis (aka “puppy acne”) on March 6, 2013.  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, 2013 is the same pathology that was identified and treated in a different location on the head in May, 2016 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,
Dr. Raphael G[redacted]
Mamaroneck Veterinary Hospital
914-777-0398
 
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 times. Since enrollment [redacted] has also been noted to have recurrent ear infections, as well as pruritus of the face and feet. Given 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 18 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;
$71.00
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 us. We are here to help you 24 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 5 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 existing. It 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
20 Vesey Street Suite 503
New York, New York  10007
(212) 766-4411 (office)
[redacted] (mobile)Sincerely,[redacted]

Thank you for your response. Trupanion was able to cover the charges associated for both of [redacted]'s recent claimed conditions, the dental issue as well as the mast cell tumor removal. With our policy however, we have to apply a deductible to separate medical conditions. The deductible was satisfied for [redacted]'s dental issue and about halfway satisfied for the Mast Cell tumor condition. When there are charges on an invoice that apply to both conditions (like anesthesia for instance), we pro-rate the charge equally among the conditions. If for some reason, a policy holder believes that we have split the charges inappropriately, we offer an appeals process once clarification is received from the veterinary hospital to allow for a reassessment. Trupanion does not offer coverage for general dental cleanings.Unfortunately, when a policy holder cancels with us, we are unable to reinstate as it is outside insurance regulation. We can certainly start a new policy should they wish to, but it is true that anything that occurred previously would be considered pre-existing and not eligible for coverage. We are sorry that this has been your experience.Sincerely, [redacted]- Trupanion

Wednesday, August 26, 2015Policy # [redacted]Pet: [redacted]Enrollment Date: 9/21/2014 Upon receipt of Ms. [redacted]’s Revdex.comcomplaint, a review of her policy was done to determine the nature of herconcern.Ms. [redacted]’s 7-year-old mixed breed male dog, [redacted],...

wasenrolled with Trupanion on 9/21/2014. Claims for “Lethargy, Decrease inappetite, Vomiting (Emesis), Acute renal failure syndrome, Kidney stone,Bladder stone (Urinary bladder stone)” were submitted for the dates of serviceof 8/1/2015, 8/2/2015, 8/3/2015, 8/4/2015, 8/11/2015, 8/13/2015 as claimnumbers: 1367453, 1365003, 1368176, 1381498, 1381495 and 1381492 respectively.With these claims we determined, based on [redacted]’s medical records, that thiscondition was showing signs/symptoms prior to her policy coverage becomingeffective. Ms. [redacted] coverage for illness became effective after 30 days on10/21/2014. Her dog [redacted] was showing signs/symptoms of urinary issues beginning12/4/2013 in which medical records indicate: “Urinating blood… tx [treat] asUTI [urinary tract infection] O [owner] will watch for urination make sure heis able” The symptoms continue: 12/20/13- “Finished Clavamox, still seeing sm[small] amt [amount] of blood in urine, per Dr. D, ok to refill.” 06/06/14-“blood in urine… Increased frequency of urination and hematuria for 1 week. Doghas had UTI before… Quick U/S [ultrasound] of bladder: Extremely thickenedbladder wall; 1-2 bladder stones… Rad: 2 medium-sized bladder stones” 09/15/14-Urinary s/o [A prescription diet to treat urinary issues] was purchased.After enrollment, he was still noted to have urinary concerns:“08/01/15- “not his usual self… He has been on SO [A prescription diet to treaturinary issues] since a cystotomy last year for calcium oxalate stones. He hasbeen lethargic and not wagging his tail since last night. Again on 08/04/15-“Mobile U/S [Ultrasound] today: renal dilation with small pelvic renoliths, oneurolith in the bladder. Dilation of proximal ureters and urethra”Based on the information in the medical records listed above, wehave determined that this issue is pre-existing to her policy coverage andineligible based on our policy coverage criteria. Information about thiscoverage exclusion can be found in our policy in section 9. B. I : What We DoNot Cover: Pre-Existing Conditions: “illnesses or injuries for which signs orevidence of their potential manifestation existed within the 18 months prior tothe policy enrollment date.”Ms. [redacted] does have the option to appeal her claims withclarification being provided by her veterinarian to help provide a medicaldisconnection between the currently claimed conditions and those the petexperienced prior to policy coverage. Ms. [redacted] has asked to skip this stepin the process to have these claims reviewed by an Independent third Party,which we have attempted to explain cannot happen until she completes thestandard appeal process. If Ms. [redacted] wishes to submit information to startan appeal, we are more than happy to re-review her claim, but the proper appealprocess must be completed.At this time, Ms. [redacted] has requested to cancel her policyfor [redacted] and her other pet. We have attempted to reach Ms. [redacted] to discussthe appeal process again before we finalize her request to cancel the policy,as once a policy is cancelled, we are unable reinstate her coverage and shewould be unable to continue to have this issue covered, If her appeal were tobe submitted and overturned. We thank Ms. [redacted] for her feedback and wish her and [redacted]the very best in the future.Sincerely,Amber – Trupanion[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 account. Also, their own customer service manager couldn't confirm the mailing or email address they claimed was on file. During 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 life. They are manipulating information to try and cover their ineptness.I have been a Trupanion customer for 7 years and I do not appreciate their condescending response about being happy to help me re-enroll. If Trupanion had good customer service and truly valued their customers and the pets they are insuring, they would not be telling me to re-enroll. The cost difference between my re-enrolling versus re-instating my current policy is $100 per month.  It is clear that all Trupanion cares about is getting more money![redacted]

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

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: 12/8/2015Revdex.com case # [redacted]Policy # [redacted]Complainant: [redacted]We have reviewed the Revdex.com complaint submitted by Ms. [redacted] in regard to her policy documents and specifically the verbiage in the [redacted] Amendatory Endorsement. An amendatory endorsement is a standard insurance...

document which alters the policy wording based on changes a state’s insurance board requires. Ms. [redacted] was provided with a copy of this document via email along with her policy and declaration page at enrollment and when the Annual Rate Notification is sent out as well.The [redacted] the Amendatory Endorsement states:“THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE 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 Policy1. Paragraph B.ii.4. of section 1. YOUR INSURANCE AGREEMENT is deleted in its entirety and replaced by the following:4. CHANGES TO YOUR PREMIUM: Your premium will not change due to your pet’s individual claims experience. However, your monthly premium may adjusted (up or down) during the life of the policy as a result of changes in the overall cost of care for your enrollment factors. Such changes will never occur more than once per year. If your premium changes, we will notify you in writing, by mail or by email (to the last addresses made known to us), at least 30 days before your change takes effect.”(The New [redacted] Amendatory Endorsement includes other amendments which do not pertain to this complaint so we have not included them in our response.)The 20% rate cap listed in our standard policy verbiage is removed by the New [redacted] Amendatory Endorsement, as this portion of our policy was not approved for our New [redacted] policyholders.We completely understand that Ms. [redacted] is unhappy with how the information is presented to her as a policyholder. We are sorry to have disappointed her, but it is a standard insurance practice to use amendatory endorsements when a policy is amended. If Ms. [redacted] has any specific questions about her policy coverage and her rate we are always here to help. Bully’s health is important to all of us here and we hope to continue our relationship for as long as it works for Ms. [redacted].Sincerely,Amber S. - Trupanion1-888-733-2685

Complaint: [redacted]
I am rejecting this response because:Simply stating corporate talking points doesnt resolve issue with neither My wife or myself. The main purpose for joining the Revdex.com is to state that you the company are willing to do whatever you, the company can do to please your customers. The Revdex.com is not a mandatory business that a company has to join, the Revdex.com is a company that business join to use in their sales pitch that indicates that they the company's main concern is their customers ( it is a hook) to show that they the company are better than the rest. I have worked for company s who were members of the Revdex.com in fact I was Quality adviser for one of these company's who used the Revdex.com, and I can tell you any company who really believes in the Revdex.coms philosophy, stands by the credo of Rule#1 the customer is always right. Rule#2 If the customers wrong refer to rule #1. The Revdex.com stands for a company going over and above the call of duty. I believe Trupanion just uses their Revdex.com status as a selling point only, and doesn't really believe in the customer comes first credo. I wish I had recorded the conversation where Trupanions rep said to my wife that ALL of the anesthesia would be covered, they do have the call and if they really believe in the truth they would listen to their own recorded conversation, and even though their employee did not give the correct information (thats on their employee) they would do the right thing and do what they said verbally on the phone and not follow corporate speak. Shooting from the hip saying what they think the customer wants to hear,then quoting contracts is deceptive at best. I'm also sure if someone looked into this company they would find a pattern of this, what better way to cut cost than to make a customer so upset that they cancel only to have from that point on, any and all past medical concerns to be preexisting. I simply will not except trupanions response as they clearly show in their actions that they are NOT a sincere member of the Revdex.com and just using their membership as a selling tool. Shame on Trupanion.
Sincerely,
[redacted]

Complaint: [redacted]I am rejecting this response because:  It's absolutely ridiculous that they would cancel a policy without speaking to me personally.  I don't care what the company says, I only received ONE phone call saying that if I wanted to cancel the policy that I would have to call and speak to a representative.  I didn't call back because I had changed my mind.  I NEVER received a letter saying that the policy was cancelled.  For the life of me I cannot understand how they could cancel this without my knowledge.  Now even if I open a new policy I'll be told she won't be covered for anything for months or I'll be told that since she is over 10 years old I won't be able to get a new policy. So I can't win.Sincerely,[redacted]

Date: 5/31/2016 Revdex.com case # [redacted] Policy # [redacted] Complainant:  [redacted] We have reviewed the Revdex.com complaint submitted by Ms. [redacted] and reviewed her concerns. We extend our apologies for the late response to this matter. We have discussed the concerns brought forth in this complaint...

with Ms. [redacted] on 5/18/2016, the same date her Revdex.com complaint was submitted. By 5/23/2016 we were able to resolve her concerns in a satisfactory manner. We believe that Ms. [redacted]’s concerns have been resolved at this time. We 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 1-888-733-2685

Date: 2/24/2017
Revdex.com case ID #[redacted]
Policy # [redacted]
Complainant: [redacted]
Trupanion has received the complaint filed by Mr. [redacted] in regards to his recent premium adjustment. We 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 premium. For example, the age of the pet at enrollment, breed, spay/neuter status, deductible option and geographical location. In this situation, Mr. [redacted] was scheduled for an annual review of his premium which he was notified would be increasing. In addition, he updated his address which contributed to the change in cost.
Trupanion’s policy allows pet owners to visit any licensed veterinarian they prefer. As 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 location. Please 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 premium. He 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 requested. Mr. [redacted] has been advised that if he has any further questions, please don’t hesitate to reach out to us. We are happy to help and can be reached 24/7 at 855.210.8746.
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 me. trupanion accepted and acknowledged how they treated me was wrong and handled my claims accordingly and reinstated their policy. if I would have gotten a call from a claims manager earlier than 3.5 weeks after my initial claims, I may not have been treated as badly as I was. in the end they acknowledged their shortcomings and took care of me.Sincerely, [redacted]

Revdex.com:I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me. However, it remains to be seen if they actually carry out what they promised. I hope they do.Sincerely, [redacted]

Complaint: [redacted]I am rejecting this response because:
In November on at least 3 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]

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

Date: 10/11/2016 Revdex.com case ID #[redacted] Policy # [redacted] Complainant: [redacted] Trupanion has received the complaint from Mr. [redacted] regarding his cancellation and refund. We are sorry to hear this has been a frustrating experience for him. The Trupanion policy does offer a 30 day money...

back guarantee. The Trupanion policy states: Section 3.H. If you cancel your policy for any reason within the first 30 days, and you have not submitted a claim within that period, you will receive 100% of your premium back. We wish to clarify that Mr. [redacted] enrolled his dog in the Trupanion policy on 09/02/2015. The first email or phone call to request cancellation was on 11/02/2015. 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 11/02/2015 going forward. The prorated refund from 11/02/2015 going forward is in the amount of $58.44 which has been mailed to Mr. [redacted] in the form of a check. As our policy verbiage states, we are also unable to provide a full refund if there was any claims filed within the first 30 days. We received a claim dated 9/21/15, which further invalidates a full refund of premiums paid. As 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 30 day money back guarantee and a claim was filed within that time frame. We have been in contact with Mr. [redacted] to relay this information and we will await his response. We wish Mr. [redacted] and his dog the best. Sincerely, Kesa - Trupanion