Update: Annoyed with VPI

[Heather & Brinkley]

So Brinkley has had GI issues in the past but NEVER before we had pet insurance. When Brinkley had his very scary bout last August, we had some pretty hefty vet bills totaling $1300.00

When we first got insurance we did everything over the phone... I never filled out the paperwork on my own. Well, when I finally submitted the claim they are claiming he had a pre-existing condition and they won't cover a dime. He had never been sick and I didn't fill out the paperwork...the agent did. He had only had an ear infection.

My vet called and tried to get them to overturn it...but they didnt budge with her. This is my first experience with them and I already hate them.

Is there anything I can do other than take them to small claims court?

Here's the update thus far:
The reason they denied the claim was becase when we first got insurance I told them he had diarrhea once. Apparently that one answer ruled out all GI sues even if they were the complete opposite, as this one was with constipation (which really doesn't make sense to me.). I actually said to the lady "the last time I checked, those two things were opposite, so I'm not sure how rules out the other." I didn't like that they really seem like they were playing vet-- she was rambling off a lot of things about GI issues and Gastroitits (sp?) but Brinkley never was diagnosed. My vet just put symptoms and treatment, yet VPI put a label as if he did have a diagnosis.

The good news thus far: I don't have refund check yet. We will see how this progresses. We first had to apply for a review of his records to strike the GI issues from his records. Apparently If you had something on record when getting insurance and the pet hasn't seen the vet for a reoccurring issues for 6 months, you can apply to take it off (good for everyone to know!) that was just approved late last week. Now we have to resubmit the claim, which the agent did. Now I wait.

I will keep you updated.

Update #3/Final update:
When they reviewed the claim, they said they wouldn't cover GI issues because he had diarrhea when he was a puppy. They used the term Gastroitits multiple times, which he actually never had, but they had put that label on him because of the aforementioned diarrhea. I told them that this didn't make sense because he had constipation during the sickness related to the claim that was denied. They the said all GI issues were ruled out because of the diarrhea answer.

They then offered a next step of them gathering all medical records from our Vet so they could review his file and have me apply for the medical issues to be wiped off his record. Basically they were seeing if he had to be seen on a repetitive basis for GI issues that were linked or if they were isolated times (which they were isolated). (Just a note, if a dog hasn't been seen for a similar issue for 6 months, you can apply to have it taken off as a pre-existing condition).

Last week, his file review came back clean so it has been wiped off his file. At that point, they resubmitted the claim on an express status. I got the call yesterday that my claim was accepted and I will be receiving a refund minus my $100 deductible.

Yay! So glad they worked it out. And now I'm really glad I complained to all of you because this situation was rectified because a VPI social media expert saw my complaint!

[Heather & Brinkley]

No, never had to submit any of that!!

[Moe]

I just checked them with the Better Business Bureau, they have an A+ rating. I would mention that if this is not resolved to your satisfaction then you are going to lodge a complaint with the BBB. HERE is a link to look them up. You have to change your 'search by' to website. You will see a link to lodge a complaint. I would give VPI the opportunity to resolve the issue before you submit the complaint. I've found that if you can get a supervisor and mention the BBB they take you more seriously.

I think going to the vet and asking to view the records would also be a good idea. You will get a sense of where they got the information.

[Heather & Brinkley]

Thanks everyone. I don't back down. Actually, with my job I have to be pretty forceful and people tell me I should have followed in my father's footsteps and become a lawyer,

My vet did find out that if there haven't been any problems in 6 months, you can get the file reviewed and appeal to have the condition taken off his file. Which I will do as soon as I get this settled.

[Adrianne Matzkin]

I am so sorry that you are going through this. Working with insurance companies for humans trying to get reimbursed is what I do for a living and I feel your pain! 

Is this the only vet you have used for Brinkley? Can you find out what the office staff sent to VPI? Did they send a summary of every visit? 

I would also tell them that you are a member of a social doodle site with thousands of members and those thousands of members have friends and so on. Their decision can make your blog a positive one or one that could hurt their business. You can add this to the going to court 'threat'.  

I was so annoyed for you that I did a little research and came up with the email address for

Carol McConnell, DVM, MBA

Dr. McConnell is vice president of Underwriting and chief veterinary medical officer for VPI Pet Insurance.

[e-mail] 

 

Good luck!!

[Heather & Brinkley]

Adrianne, you are awesome!!!! This is the only vet I have sed until 2 weeks ago. We moved 40 minutes away so I got Brinkkey's shots at a new vet...but other than that, it has always been at Churchland Animal Hospital. I love them and was very sad to leave them, but I would have to travel through the busiest tunnel in our area which could make the commute even longer, like 1 1/2 hours.

I spent quite a bit of time in the phone with the vet and she said they've never sent VPI anything... The only thing VPI has is what I sent them which was the info for the visits when he was sick. VPI is claiming we filled out paperwork claiming he had past tummy issues but I never physically filled out paperwork... It was done over the phone. And Brinkley had only had an ear infection up until the point of getting insurance when he was one.

I'm going to start gathering my info from bith VPI and my vet and then I'm going to fight! My dad is also willing to write a letter as my attorney if need be (it helps that I got married and we have different last names now).

Thanks for the email address!!!

[Leslie J]

This sounds very strange.  When Cocoa was 1 1/2 she was in the doggie hospital for GI problems (over $800), thought to be toxicity (but unconfirmed).  I signed up for Pet Plan after that and had all of her vets forward paperwork.  She then had her next GI episode (to the tune of over $2,000) and PetPlan reimbursed me immediately.  Unless the GI problem is chronic it shouldn't be a preexisting condition.  Be aggressive and public with your concerns.

[Heather & Brinkley]

Thanks! I will. Sounds like PetPlan may be a better one. I was unsure of which one to choose... So I was wasting precious time NOT making a choice so I finally just picked one. Now I am stuck with them because it will be considered a pre-existing condition if I went with a new company. I'm hoping to work ths out without too much fuss... But I'm not afraid to be a pest if need be.

[Karen, Jasper and Jackdoodle]

I do think PetPlan is much better about paying claims than most other companies, including VPI, from what I hear.

[Heather & Brinkley]

Is it worth it to switch or will this always be a pre existing condition with a new company?

[Karen, Jasper and Jackdoodle]

I have no personal experience with any of the pet insurance companies. It was a relatively new thing when I adopted Jack. I had never had extraordinary vet bills with previous dogs, and with him, because I knew that he was a large dog bred in a puppy mill from untested parents, my main concern was HD. At that time, there were very few companies offering pet insurance, VPI being the largest. I looked into it, and found that at that time, HD was not covered, as it was considered genetic and VPI did not cover genetic diseases, so I didn't pursue it. (Big mistake, as Julia Roberts would say. Huge.)

It might be worth contacting PetPlan to see what their policies are on pre-existing conditions. There may only be a period of time for which a certain thing is not covered, after which it would be. Maybe some others who have more experience with this will chime in.

[F, Calla & Luca]

I agree with Karen. The only way to tell would be to speak with them and if need be confirm things in writing. When I got Pet Plan, they told me there would be an exclusion period for knees, I can't remember if it was 3 or 6 months, unless I had my vet check the knees and document it. I took them to the vet, she did a simple physical for their knees and got the insurance.

[Jane, Guinness and Murphy]

I think you need to get it resolved before you switch.  It is not a preexisting condition and you are going to need to get them to admit to that after doing the appropriate research and validating with the Vet what you have told them.  Otherwise this invalid "preexisting condition" assumption will follow you.