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was scared about insurance...

laurenlyn1

Well-known member
i have signed up for pet care insurance (i should have done it sooner because brady is now 9 months) i went to the vet to day for boratella vaccine and i was talking with my vet...see the story is...she thought she heard a murmur when he was younger, and i went to a cardiologist to to clear things up. i was afraid that they may not cover anything heart related since i have already done this...well, when i went to the cardiologist he didn't find a murmur and he was give a clean bill of health on his heart. she said that because of that, it's not related so i should be good if anything ever comes up in the future regarding his heart. that made me kinda happy because i was worried, but i figured even if they didn't cover heart related stuff i'm sure there would have been something else that would come up
 
that's great news that brady's heart is a-ok!!!

the whole insurance issue is really sticky isn't it? i didn't realise until reading some of today's posts how lucky we are in ireland to have such cheap pet insurance---mine is about E13 a month and indy's tests this week just paid for the whole year's premiums.
 
That's great that you can keep your insurance on Brady. I tried PetCare insurance, but Riley has/had a murmur at a very young age (clearly diagnosed by a cardiologist with Doppler ultrasound) and they put an Exemption on my policy for any heart related problems. Turns out that I had him re-examined by a cardiologist last month and she said she still hears the murmur, i am getting a second opinion by another Cardio. in about a week. Anyway, PetCare wasn't going to cover Riley for heart or gastrointestinal issues because they were pre-existing conditions. Not much you can do when your puppy has these problems when you get him at 10 1/2 weeks. So I ended up canceling the policy.
I'm glad that you will be able to keep PetCare for Brady and that his heart murmur is gone.
 
You will still probably have to take on the insurance company over this issue. I'd talk to them and see what you need to get to make sure this isn't considered an exclusion to your policy. They will probably want a letter and full info on diagnosis from the cardiologist and you may need to pay for additional cardiac testing -- Judy on this board had to do this on her policy in pretty much this same kind of case, and I'm sure would tell you what she went through. It is better to do this now while you can contact these people as even the fact that there was an investigation and concern could be taken to indicate a potential problem that remained undiagnosed and the company has the right to make that exclusion. I'd call your insurance company and talk to them about this and make SURE it is clear on your policy what is covered and what isn't. Chances are any heart issues would show up years from now when you'd be unable to challenge them then.
 
With PetCare insurance your policy is not underwritten until the first claim is made, meaning it doesn't matter what you think is covered, they will go back and re-examine all of your records. I didn't even know what that meant (i seem to learn everything after the fact :roll: ) . I thought that since they accepted my full years premium, received all of my records (which were clean) and I was past the 30 day waiting period...I was covered for everything...I was wrong. I am now awaiting an appeal for Molly's SM exclusion..thanks to the intervention of two terrific Vets who came to bat for us.

I read somewhere that Petplan Insurance underwrites your policy at the beginning so you know exactly what is covered and what is excluded. I think when my year is up I will be switching to them.
 
Lauren, if PetCare has all your records, it seems likely that you will have at least a temporary exclusion for heart things, probably a permanent one. You should fairly soon get a copy of your policy in the mail which shows what is excluded and whether temporary or permanent. I would do what Karlin suggested. First, wait til your policy comes and see what is excluded. If there's any heart exclusion, call them and tell them what happened and ask what they need in order to have the exclusion removed, since the Board certified expert gave a clean bill of health. If you get a letter from your cardiologist and they still don't remove the exclusion, contact the underwriting manager to ask for help in getting the exclusion removed. I got to that point with them and she quickly took care of it properly. Let me know if you need her contact info. You can also have your cardiologist call them before writing a letter to ask them what they need from him/her. in my case the expert was a radiologist and she offered to call them, and she did write what they told her, and they changed it from a permanent to a temporary heart exclusion, but that was still unjustified so that's when i contacted the underwriting manager to make a complaint and ask for her help. I was actually about to file a complaint with the state insurance commission, and i let her know that in my letter. When you do that, the state gets involved and intervenes to try to help you arrive at a solution with the insurance company, but it wasn't necessary, she was very nice and acted immediately after getting my letter.

if you don't get a copy of your policy in the mail, you can call and ask them if you have any exclusions and go from there if they say yes. But they should always send you a copy any time there's any change.
 
Molly's mom said:
...I thought that since they accepted my full years premium, received all of my records (which were clean) and I was past the 30 day waiting period...I was covered for everything...I was wrong. I am now awaiting an appeal for Molly's SM exclusion..thanks to the intervention of two terrific Vets who came to bat for us....

Bev, that's terrible. I don't understand it, how they could do that. If it's after the 30 day waiting period, and if the condition hasn't been noted before, they seem to advertize that you are covered. Can you explain this some more?

Anyone considering choosing this company should know about this. If no symptoms of SM were ever noted before in the records, and the dog starts having symptoms and is diagnosed after the waiting period is over, how do they justify excluding SM? I understand you said that was your first claim. But even if they then review your records, if SM was not noted in the records before the end of the waiting period, what is their logic for excluding it?

They tell us they cover hereditary conditions. I want to understand how they are trying to get out of it. Did you contact the underwriting manager? I don't understand the part about not underwriting until the first claim is made. I think i've heard this before, but like you, didn't know what it meant, and didn't know that it mattered. They still have lead us to believe that if it's not a pre-existing condition, it's covered.

I hope you win your appeal, and hope you will report back on how this goes.
 
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