My entire set of claims, my first ever to this pet insurance company after ~5 years of holding poicies for 2 cats, were denied in full by the company. When today, I asked their customer service representative Jen about the lack of their coverage for flea probems, she trotted out an unwritten new story for me that insisted "we do cover for fleas, but only if the owner can prove they had been using monthly flea prevention for at least the last year and can provide receipts to prove it"...LOL, in other words, knowing there would be incredibly fewer claims, and demanding remarkable adherence to an unwritten policy, they would only then consdier reimbursement from what they call a pestilence flea problem.....
here is what the policy terms state re flea coverage, actually, uder the exclusions section:
"Treatmentsorpreventivetreatmentsforparasitesorconditionsrelatedtoparasites(internalorexternal)unlessthereis no preventive medication for the parasite including but not limited to:
i. Heartworms.
ii. Fleas.
iii. Ticks.
iv. Roundworms.
v. Tapeworms.
vi. Hookworms. "
and regarding exclusion on any dental and teeth claim, here are the words used in te policy:
"6. The cost of any treatment for oral health, including but not limited to dental disease, malocclusions and deciduous teeth, where clinical sign(s) (including, but not limited to, tartar, gingivitis, pulp exposure or halitosis) were observed prior to the effective date of the policy or during the first fifteen (15) days beginning on the effective date of this policy. "
LOL, this is patently ridiculous, and the company knows it but unethically practices their business, since teeth/gum treatment is typically done not at the first sign of a problem, but when the problem merits the risk:benefit of potentally lethal anesthesia for the animal
If that is not unethical enough, LOL again, Petplan excludes from coverage any prior dental care, or, incredibly, any routine or preventative care to prevent advancement of dental or any other illness as follows in their exclusions section:
"6. Routine and preventive care, including but not limited to:
i. Vaccinations (and vaccine titers and nosodes). GPTM 050 0316 8 of 14 © 2016 Fetch Insurance Services, LLC
ii. Preventive medications (including those for heartworm and flea and tick prevention).
iii. Routine examinations.
iv. Dental prophylaxis. "
And on top of this, and the fact that their exclusions state in print that for any signs of "illness", the pet must be seen by a vet within 48 hours to avoid exclusion of claim (!?), there is the following unreasonable and unethical language in the exclusions section, which allows them to worm out of paying on a vast array of potential claims:
"vii. A pet less than six (6) years of age must have undergone a complete examination by a veterinarian within the twelve (12) months prior to the effective date of the policy, or within thirty (30) days following the effective date of the policy. A pet age six (6) years or older must have undergone a complete examination by a veterinarian within the thirty (30) days prior to the effective date of the policy, or within thirty (30) days following the effective date of the policy. Your failure to have a complete examination of your pet may void the policy. If voided, the policy premium will be refunded."
of course !...........LOL, if the amount claimed for a serious illness is higher than the premium and yearly deductible ($500 yearly for each of my 9 year old cats), they have the option, if you miss this tight deadline for unreimbursed veterinary care services on essentially your well pet, to simply void your policy, returning just the premium to you read more