Petplan woes

[Willow and J]

I have posted about my frustration with Petplan already, and because there are so many DK members who LOVE Petplan, I am a bit hesitant to bring this up again. But I am puzzled if I am particularly unlucky with Petplan every time I send claims or I am less patient then others? For those who love Petplan and have successfully received reimbursements, I'd like to hear your experience. 

I haven't been able to get reimbursement once during 2+ years of Willow being on the Petplan. That's not my main frustration. But it's about how they communicate and handle cases. Last time when Willow's AD was declined for "pre-existing condition", they did not indicate which diagnosis from the past that contributed to their decision. Did they decide AD was genetic and thus pre-existing, or a diagnosis from XX month in 201X has gotten them thinking this is a pre-existing condition? If it's genetic, then I basically know to not to bother with any allergy related illnesses in the future. Yes, they have a # to call if I have questions, but why do I have to spend more time, when they could just write that information on the letter? Why forcing sick animals' parents to dwell longer on this matter? (BTW, it took them more than a month to investigate and finally sent this useless letter.)

Another example: this time, I've submitted two claims, and they keep saying they did not get one part or the other - they have receipt from this one but not the claims for the other, and when the receipt is sent, they say claims form is not there, and they are doing this for each. So, in total, I've sent 4 faxes and still my claim is "incomplete" on their end.

Before someone remembers and asks, I know claims this time won't be accepted by Petplan since they've already declined a claim for AD in Jan. Long story short, I had to goto another clinic for the same illness because of first AD diagnosis was made without a test and I needed a second exam for Willow. Petplan will no doubt call this "pre-existing" condition again. But why did I do this? I've spent over $1000 so far for Willow's AD test and allergen shots, and I wanted them to look at this one more time. What I didn't foresee was how my experience with Petplan will go down the hill every time I try. This time, they can't even keep track of faxes sent to them.

Also, their email is lengthy and seemingly sympathetic, but these stock letters and emails with cut and pasted paragraphs ask this and that makes me mad. Instead of "if you haven't done so already~", why can't they check what they need and specifically ask for from which clinic from which period? They should have multiple copies of Willow's records from several vets office by now from previous claims. It also seems like each agent deals with case differently, and some agent just gets medical records etc. on their own, but this time, this one asks to provide "everything" without telling me what they have already. By now Willow has gone through two out-of-town clinics and three in-town vets. Do I have to provide everything from all of them? What's the point of sticking to one insurance company if they are not keeping records for individual client!?

I still want to believe that so many on DK can't be wrong and I should stick to Petplan, but I also feel like I could save a lot of my time and energy if I didn't have to deal with them over the years (and getting "$0" so far). One accident / illness might prove I'm wrong and it was all worth it, but meanwhile, should I give this company more money? Or, am I the exceptionally unlucky one?

(Apologies for this long post and for venting!) 

 

[Lucy & AnnaBelle's Mom]

It was the same way with Sophie.  They looked at a whole bunch of other things before they finally ended up with Lymphoma.  I was a little nervous about how they were going to pay those.  I wrote a note on the form saying that these were all things done to rule out other illnesses before they came to the lymphoma diagnosis.  No issues with their payment.  Only thing they didn't pay was the Vacation Cancellation deposit because it had to be for an illness that came on w/i 7 days of departure that resulted in lifesaving treatments.  I wasn't aware of the 7 day rule and I was upset that they didn't feel that my having to stay for Sophie's chemo was life saving treatment.  They just stuck to the 7 day thing though.  I wrote a letter not asking them to relook at my situation for payment, but that I felt the policy and the 7 day rule needed looked at.  I felt my situation is one that should have been covered under the cancellation policy.  I was just asking for $150 cancellation fee.  If I had cancelled 7 days out it would have been $2200. 

[Willow and J]

Thank you, everyone! It was already helpful to have the outlet for my frustration, and I am grateful for taking your time to share your experience with me. So it is not very uncommon for insurance company (seems like not Petplan only) to lose records, forms, and other documents, and also they are not known for effective communication. Hmmm...  I don't know if I should be happy that I am not alone in this boat or in despair that we are indeed all in the same boat. :)

I think I have been more stressed because on top of AD, Willow has been limping on and off for several weeks now. She has seen vets three times, was on painkillers twice, but it's not improving. We are thinking an X-ray and a proper diagnosis on ACL tear would be next. Willow is such a sweetie and never complains, but she attaches to me more when she's not feeling well (she wants to nap with me the whole time!), and it just breaks my heart. Least I want to do at times like this is to be on the phone with an insurance company, recounting on illness of my furbaby, and ask money. But, I realize many of you had to do it even at much more stressful moments, and again, I am thankful for writing your experience here.  

I will pick a time this week and make a call. I will ask them to put in details in their letters and emails in the first place too.

[F, Calla & Luca]

I hope Willow's limp turns out to be nothing serious.

[Karen, Jasper and Jackdoodle]

Ditto. 

[Willow and J]

Thank you! 

[Diana Erhart]

I think if you call you may be able to get some answers.  I called them over the weekend with some questions about purchasing a plan for my parent's new puppy.  I currently have PetPlan for my Charlie and they have been good about paying the two claims I made.  Anyway, the PetPlan person told me that as a new insured we could request that they do some thing (she called it some kind of underwriting) where they would look at the puppy's records to date (he has had a bad "gut infection" already) and let us know what would be considered a pre-existing condition for him.  I found that interesting.  

[Star and Goldie]

I have Petplan but before I got it Goldie was seen for vomiting. They pretty much chalked it up to her being a puppy and eating something she shouldn't have. After a round of meds she was fine and I had the insurance the following day. I think about that all the time though. I'm afraid if anything ever happens related to her stomach they will do the pre-existing denial:(

[Karen, Jasper and Jackdoodle]

One thing some of us have learned is that you need to see exactly what is written in your dog's vet records. The wording could make a difference down the road when you have to submit a claim. 

[Amy, Cubbie & Ollie]

you might want to check with PetPlan but I know that they have something where a condition won't be covered for a period of time until you pass a waiting period.  So Ollie had an ear infection before I got insurance and we had to go a year or 2 (I can't remember which) with no ear infections to remove that pre-existing condition.  Not sure if that will change now that he was diagnosed with AD and ear infections can be a symptom, but might be something for you to look into.

[Willow and J]

Here are a couple more:

1. Do you think there are differences between one adjuster to another? When I started with Petplan 2 years ago, at least my cases (were declined but) were handled quickly.  I feel it's getting worse.

2. Per incident deductible:

I've been telling myself that if we go in for Willow's x-ray for limping, they can't deny this one, and I'll restore my trust in Petplan. But my DH who became much more skeptical than I have been thinks Petplan will find a way to not to pay. One thing they can do is to chop my claim into several incidents (like they did with Sophie's cancer treatment, and they've done it once for me in the past) and make each lower than my deductible. I am on high deductible plan, and they won't have to pay a cent even if anything new (and not pre-existing) comes up. (Or am I too paranoid???)

How do you feel about "per incident" deductible Petplan has? Did it work for you? I chose Petplan because I liked their flexible deductible-premium plans, but now I  wonder I should have chosen a plan with annual deductible, since per incident deductible allows them to define "incident" differently from me. I stupidly and belatedly discovered "per incident" is not same as "per visit" nor "per illness". I think one time they divided my claim up, they separated exam and treatment and made it into two smaller "incidents" which fell under my deductible.

[Diana Erhart]

I have the $200 deductible, 90% coverage for Charlie. We have had 2 smaller claims this past year. The first one took a little longer to pay out because they had to get all of his records (he is 7 years old) and go through them first. The second one was paid quickly. If there is no problem noted in his file about his leg in the past, there is no reason for them to deny coverage. And also when one claim is a follow-on claim for an illness the deductible should only be taken out once in the policy year. So it shouldn't matter if the claim is split into pieces or all filed at once as far as the payout goes.
On another note, I am looking at raising Charlie's policy to the 100% coverage. When I did the calculations, the premium amount isn't that much more and would have paid for itself in the two small claims that I had last year. So for a larger claim I am sure it would be worth the extra premium.