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cy1266
19th December 2007, 04:15 PM
FYI...for those of you that have VPI...this article was in today's Chicago Tribune:

Dog's fix gives insurer pause

Pug had surgery to treat ailing hip

Jon Yates | What's Your Problem? December 19, 2007 http://m1.2mdn.net/viewad/817-grey.gif (http://ad.doubleclick.net/click;h=v8/362d/0/0/%2a/p;44306;0-0;0;12925750;21-88/31;0/0/0;;~sscs=%3f) http://ad.doubleclick.net/ad/trb.chicagotribune/news/opinion;tk=10059;tk=10075;tk=10077;tk=10080;tk=100 85;tk=10086;tk=10098;tk=10101;tk=10102;tk=10103;tk =10106;tk=10114;tk=10115;tk=10121;tk=10128;tk=1020 3;tk=10232;tk=10260;tk=10321;tk=10337;tk=10419;tk= 10423;tk=10490;tk=10508;tk=10512;tk=10567;tk=10598 ;tk=10604;tk=10696;tk=10743;tk=10758;tk=10797;tk=1 0830;tk=10867;tk=11165;tk=11186;tk=11268;tk=11284; tk=11294;tk=11381;tk=11467;tk=11620;tk=11628;tk=11 750;tk=11753;tk=11763;tk=12319;tk=12340;tk=12375;t k=12400;tk=12525;ptype=s;slug=chi-problem_demlerdec19;rg=r;zc=60610;pos=1;sz=88x31;t ile=2;ord=21762854? (http://ad.doubleclick.net/jump/trb.chicagotribune/news/opinion;tk=10059;tk=10075;tk=10077;tk=10080;tk=100 85;tk=10086;tk=10098;tk=10101;tk=10102;tk=10103;tk =10106;tk=10114;tk=10115;tk=10121;tk=10128;tk=1020 3;tk=10232;tk=10260;tk=10321;tk=10337;tk=10419;tk= 10423;tk=10490;tk=10508;tk=10512;tk=10567;tk=10598 ;tk=10604;tk=10696;tk=10743;tk=10758;tk=10797;tk=1 0830;tk=10867;tk=11165;tk=11186;tk=11268;tk=11284; tk=11294;tk=11381;tk=11467;tk=11620;tk=11628;tk=11 750;tk=11753;tk=11763;tk=12319;tk=12340;tk=12375;t k=12400;tk=12525;ptype=s;slug=chi-problem_demlerdec19;rg=r;zc=60610;pos=1;sz=88x31;t ile=2;ord=21762854?)

The surgery was more than $2,000, but Klaus the pug was limping so badly that Mariel Demler decided she had no choice.

Besides, she thought, this is precisely why she bought pet health insurance -- for emergencies. In the literature provided with her $20-per-month policy, treatment for Klaus' ailment, an operation called a femoral head ostectomy that involves removing part of the hip joint, was covered.

So on Sept. 20, 11-month-old Klaus went under the knife.

To pay for the operation, Demler opened a line of credit through the veterinarian's office. Then she submitted the bill, $2,486.45 including the diagnostic work, to her carrier, Veterinary Pet Insurance.

She knew the entire amount would not be covered. Discounting for co-payments and certain exclusions, Demler calculated she was entitled to $909 for the operation, and several hundred more for the diagnostic tests.

Veterinary Pet Insurance calculated her benefits a bit differently: $0.

The insurance company, which formed in 1982 and now insures almost a half-million pets, denied her claim entirely, saying Klaus' condition might have been hereditary, excluding it under the policy.

Upset, Demler wrote the insurer on Oct. 23.

She said there was nothing to indicate Klaus' hip problem was hereditary, and nothing in the insurance company's fine print that justified such a determination.

"I understand that you are a business first and foremost, and there are times lesser claims must be denied so that larger claims can be paid. I get it," Demler wrote. "But this is a major claim. This is the entire reason that I signed up with VPI. This is why I have been paying my premiums every month."

She tried to get Veterinary insurance to change its mind, but it wouldn't. So she wrote What's Your Problem? for help.

"It seems pretty arbitrary. [The insurance company] can decide to exclude just about anything," she said. "I just think it's a total crapshoot in terms of what they're going to cover."

The Problem Solver called Veterinary insurance spokesman Brian Iannessa, who forwarded Demler's information to the company's claims department. The claims department then contacted Klaus' veterinarian, who supplied the pug's medical records.

After reviewing those records, Veterinary insurance determined Klaus' hip problem could have been trauma related, which is covered under Demler's policy.

So the insurer reversed its earlier decision and agreed to pay Demler $1,040.94, covering portions of the surgery, the diagnostic testing and anesthesia costs.

"Since there was some confusion [about the diagnosis], we decided in favor of the policy holder," Iannessa said.

Iannessa said Veterinary insures about 450,000 pets, making it the largest pet insurance company in the country. Policy holders who aren't happy with a claim can call the company, he said, and ask why it was denied.

"If they ask us to do a review of the claim, we will do it and send it to our disputes department," he said. "We can work with the vet and see if there's anything that was missed the first time we processed the claim."

Iannessa said that if Demler had requested a second review of her initial claim earlier, she would have gotten her $1,040.94 check more quickly.

As of Tuesday, the money still hadn't arrived in Demler's mailbox, but she did receive a call from a Veterinary representative Monday night, saying the check is on the way.

"It's just such a relief," she said. "I guess they're reimbursing about half. As far as insurance goes, I wasn't expecting more than that. I was expecting less."

Demler said she will use the money to pay down the credit account she established to pay for the procedure. Under terms of the account, her first three months were interest free. Starting in January, the interest rate climbs to 22.98 percent.

"At least now I can pay off this huge chunk of it," she said. "It won't be so bad."


Klaus still walks with a bit of a limp, but Demler said the pug is getting better every day.

"He's a happy guy," she said. "We went to a holiday party where there were a lot of pugs and he was running around. He's doing really well."

Karlin
19th December 2007, 05:43 PM
This is why VPI is not a good choice for cavaliers. Most of the illnesses they have a good chance of getting are considered hereditary and wouldn't be covered, including MVD and syringomyelia as well as certain eye problems.

Cathy T
20th December 2007, 03:02 AM
In a word...VPI stinks! I had it and was very discouraged by their policies. Jake had diahhrea.....so they excluded anything related to upset tummies. I had PetCare and just recently switched over to PetPlan. Hoping to get more satisfaction from them and have heard wonderful things.

My vet wrote a very long and detailed letter to VPI, including Jake's medical records...and they still excluded things that are common and recurring. Very disappointing.

Lexie in CA
20th December 2007, 08:54 AM
A friend of mine recommended VPI for me. But after reading on here that people preferred petplan, that's the insurance company I went with. I'm sure glad I did that instead of signing up for VPI.

Daisy's Mom
22nd December 2007, 04:42 AM
I have Petcare. We had a $700 claim last summer and they paid it no problem. I picked them because they were one of the few that did not exclude hereditary conditions. Daisy had coccidia in her first 30 days with us, so that is now excluded for her lifetime, and she had a lot of pain with her first round of shots (with us), so they have excluded vaccine reactions from now on, too. That was a little annoying because it wasn't a reaction to the vaccine itself, but the way the vet gave the injection that caused her pain. I didn't fight it because again, I don't think it was a reaction to the vaccine so I don't expect any problems in the future anyway. I found it all a little confusing at first with submitting things that I knew wouldn't be covered, and having them underwrite her policy only after we submitted our first claim, etc. But I don't really have anything to compare them to, so I have just continued on with Petcare.

Why did you switch away from them, Cathy T? Did you have a problem? They did reduce benefits on our policy after the first year (or else we would have had to pay $48 a month instead of $40 if we wanted to keep the exact same level), which annoyed me. I stayed with them, though, because it is really only the major expenses that might come along that I'm worried about insuring against, so I agreed to a higher co-pay to keep the premiums the same.

Cathy T
22nd December 2007, 04:26 PM
Why did you switch away from them, Cathy T


I didn't have a specific problem with them. But, they excluded diahhrea!! How in the world can they exclude something like that? I can see the specific cause but not the symptom in general. What if he got into poison, would they not treat him? I liked the coverage on PetPlan better. I will only use mine for out of the ordinary treatment. I have a $200 deductible (and that's for each incident/illness) but have $0.00 co-pay. I like that the coverage is $20,000 overall, not split into specific categories. I know that one day I will have to deal with mvd, it's almost inevitable, and both of mine are currently heart clear. I wanted to find the coverage I was comfortable with and could stick with while we are still heart clear. I have waivered between the two plans and, after reading Natalie's story about coverage with Bianca, decided this was the plan for me.