Insurance question - is this reasonable

[Meridith and Lola]

A few months ago Lola tore her toenail off her back foot so I brought her to the vet.  They ended up having to bandage it up. I had to take her back to the vet the next day to take the bandage off.  I was charged a total of $257 for the two visits  which included 2 $90/office visits, some meds and a few other things.  I am not completely sure it was fair to charge me for 2 office visits just to remove the bandage after 36 hours but I figured I have insurance and I'll get most of it back.  When I got my check from VPI it was only for $54. These seemed quite low but I was busy and distracted and didn't ask VPI to explain.

I now have another claim to send so I thought I would inquire before I send it.  I have gone back and forth with them and they are telling me that because I submitted the two invoices under one claim, they were treated as one claim and paid at the maximum for that visit based on the injury she sustained (they said I can get a total of $111 for a torn toe nail).  If I submitted the second vet visit as a separate claim, I would have gotten the remainder of the $111 they owed me.

This doesn't seem fair or logical?  or is it?  Should I be considering a different insurance based on this policy/response - also is $111 maximum for a torn toe nail reasonable?

 

I know there are some people that are very happy with their pet insurance so would appreciate any feedback/suggestions.  

[Lindsey, Lee, Whopper and Simba]

We use PetPlan so that we do not have set amounts per injury/illness dictated by the insurance company.  Every vet has a different fee and we have found PetPlan to be very efficient at covering our claims in an appropriate manner based on the actual invoice.  I would say just look at what you're paying for the insurance and the coverage they are providing, then determine whether switching may be the best option.  Anything your dog has already been treated for will be a pre-existing condition in most cases so keep that in mind if you decise to consider a switch.

[Jennifer,Chloe & Myla]

I think it's wrong to charge 2 office visits also. If they come right out and tell you that about the claims, couldn't they FIX it for you? Making the customer happy or too bad for you? Don't have much advice about the insurance.

[Lisa, Daisy & Dexter]

I have never had to use our insurance but I think I went with the majority when I chose Pet Plan...you have 3 options (Bronze, Silver and Platinum I believe) and one pays 90% after your chosen deductible so no surprises.

I have never had a VET not charge me for a follow up visit, maybe I have the wrong Vet.

I would call again and state your case, tell them you are unhappy, if you don't like the results you can always switch, and be sure to mention that to them in your discussion in a nice way of course. Freedom of choice.

[Jennifer and Jack]

I use Pet Plan, and have since Jack was just a few months old. I have found them to be terrific. They did recently change hands and they appear to be a bit more picky with wanting more information, something that they never questioned me on. The rate does increase once they hit three years old, and goes up a little more each year till around eight years old.

 

They do not have a max per claim, just a max per year that is quite high. I really love Pet Plan. Another thing Pet Plan does they I just found out is if you work it out with your vet, they will pay your vet directly so you don't have to pay anything other then your out of pocket per illness fee.

[Carla, Lucca and Izzy]

yes Jennifer, Lucca's policy just went up 40% after he turned 3. I did call them on it. It's because of his age, mixed breed and new underwriter increase that they didn't add on last year. I love PetPlan so am sticking with it for now

[Jane, Guinness and Murphy]

I really think the only way you can assure yourself that their handling is fair is to read your policy language.  You can then compare what your policy says they will pay with what they are telling you they will actually pay.  I personally never fully trust the claim rep on the phone....I always read the policy and then I'm clear.  If you believe after reading your policy that they are not settling the claim appropriately, I would definitely ask to speak with a Supervisor.  Good luck.

[Amy, Cubbie & Ollie]

I had PetPlan for Cubbie and then did more research and finally decided to also get PetPlan for Ollie too.  Their policies are pretty straight forward and there are different coverage and deductible levels from which to choose.  Keep in mind that switching once your dog is over 1 tends to cost a little more per month than if you had started with that company from the time Lola was a puppy.

[Lucy & AnnaBelle's Mom]

also keep in mind that if you have any on going issues that they could be considered pre-existing, and therefor not covered,  if you switch.

[Carla, Lucca and Izzy]

Your 2nd visit should have been more like a "tech" to remove the bandage. It's less expensive. but...all that being said, VPI is getting away with not paying you the full fee.They are 2 separate Dates of service so no matter what, they should pay.

We have PetPlan and I submitted all Izzy's invoices at the same time for her elbow surgery. I had no problems. I just sent one in for her ear infection so we'll see what happens.

Bottom line, read the fine print  and the plan very carefully no matter what insurance company you choose.

[Nancie & Gracie Doodle]

I have Embrace Pet Insurance and have not had a problem at all.  Just renewed my second year.  Gracie is 4 years old and my policy rates have not changed at all.  I have submitted two claims and got reimbursed promptly.  Very happy with them.

[Sue, Murphy and Bella ()*o*()]

I have Petplan and it is very clear what they pay and I get just what I expect when submitting claims. I don't see the difference in submitting two claims for the same injury from submitting the total bill for both? Strange .