Pet insurers who use flimsy excuses to reject claims...
Like saying vet notes show illnesses you never knew about
PET insurers are wriggling out of payouts by arguing owners knew pets were ill before getting cover.
Insurers delve into medical records from even the first check-up to find grounds for rejection. If they prove the animal showed signs of an illness before insurance was taken out, they can refuse to pay up, as most do not cover pre-existing conditions.
They argue if a pet had a symptom, the owner should have realised it may have a serious condition.
In one case, a woman whose cat was diagnosed with asthma was told she wasn’t entitled to a payout, as she had told her vet it had a cough. The owner said when she took out the policy, she thought this was merely down to fur balls.
But her insurer’s underwriter, Red Sands, refused to pay for treatment, arguing that the asthma was a pre-existing condition.
Another case saw a payout refusal by Allianz when a dog needed ear infection treatment because it had once been treated for eczema and given ear drops as a precaution.
The insurer, which provides cover for Petplan and Sainsbury’s customers, said skin allergies are a cause of ear infections, so it counted as pre-existing. Two vets who examined the dog said there was no link.
The Daily Mail’s City diarist, Henry Deedes, was rejected by Animal Friends, which uses Red Sands, when his West Highland Terrier Lily (pictured) got diabetes.
The insurer said her notes showed she was drinking more water than usual — which can be a sign of diabetes — before the policy was taken out. Yet tests run for diabetes had come back negative.
In many cases seen by Money Mail, insurers reject claims against a vet’s advice. Owners are forced to complain to the Financial Ombudsman Service, which says insurers shouldn’t turn down claims if the owner didn’t know there was anything wrong when they took out insurance.
Complaints about pet cover rose by more than a third from 1,089 to 1,508 in the year to April, its figures show. It found 30pc of claims it reviewed were rejected unfairly.
The ombudsman told Red Sands and Allianz to cover the cat’s asthma claim and dog’s ear infection treatment.
Dr Michael Morrice, partner at Maven Vets, says: ‘It is getting harder to get a payout. Insurers are looking at claims more closely.’ Choosing the right policy is key to avoid rejections. More expensive lifetime policies offer the best coverage.
You are covered for any condition — or recurrence of it — that develops after you take out the policy. If you switch provider, any existing conditions are excluded. Insurers often take advantage of this by hiking premiums every year, knowing that it’s harder to shop around as pets get older. The amount you can claim for a condition per year may be capped. Some insurers have overall annual payout limits.
Cheaper policies can impose a lifetime limit for a condition — it is £500 on the basic Animal Friends policy.
Annual policies must be renewed each year, excluding conditions developed in that time. Accident only policies cover emergencies.
A spokeswoman for the Association of British Insurers says: ‘The small number of cases that end up with the ombudsman are the exception, not the norm.’
A spokeswoman for Animal Friends says it uses ‘qualified veterinary professionals’ when assessing claims and in complaints, the claim is reassessed, taking into account further evidence. An Allianz spokeswoman says those taking out a policy should always disclose pre-existing conditions.