pre-existing condition for pet insurance

[Willow and J]

I want to hear from those who have pet insurance how their dog's pre-existing condition was defined and dealt with through an insurance company.

We have Petplan for three years and we haven't been able to use it once. I set my deductible wrong first two years and everything fell under the deductible, which I don't complain because 1) I was stupid and didn't understand Petplan's deductible is per visit 2) Willow's ailment wasn't severe enough to go over the deductible and 3) our vet doesn't charge that much.

But there has been 2-3 claims that I filed for and were all denied for "pre-exisiting condition". Willow came from the breeder with yeast infection in her ears, and because of that, Petplan considered all ear problems (not yeast infection but from unknown causes) or yeast infections (not her ears, but on her face, on her paws) pre-existing condition, which I don't agree but can understand to some degree. Treatment for itchiness whether it's her ears, paws, or whether it's yeast or unknown causes were all the same and relatively cheap - antibiotics, topicals, and steroids. So if they call all of these "pre-existing condition", then, okay, I can take it for now.

Several weeks ago, we went to a vet dermatologist because of persisting itchiness, and she's diagnosed with atopic dermatitis. And Petplan calls this a pre-existing condition too, and my claim was yet again denied. Previous visits relating to itchiness in various parts of her skin was suspected of allergy related symptoms, but there was no systematic diagnosis until now. Does this sound fair / usual to you that Petplan calls this a pre-existing condition too? Is this common across all pet insurance companies? Is there a pet insurance that would be more willing to cover in a case like ours ?

[Lonnie & Libby Lu]

Very good advice Karen!  I wish I would have taken out insurance the minute we brought Libby home.  She ate something in the backyard when she was very young and caused stomach problems and of course off to the vet we went being new Doodle parents.  Luckily it was nothing, but when I applied for the Insurance it was six days shy of being six mos. since she had the episode, so they put into my plan that she has pre existing stomach problems and will not cover anything that has to do with her stomach!  BUT, they did not tell me about the six mos. waiting period until after I paid for the insurance and my plan was all set up.   I complained and they said I could file an appeal on the policy when the first year is up. Thie year is up in next month so we will see what happens. I definitely like what you said about asking the dr. what he puts on your dogs records. I will be doing that from now on!  

[Amy, Cubbie & Ollie]

Yep.  We adopted Ollie in June 2011 and Aug 2011 (2 months before I got our PetPlan policy), Ollie started chewing on his one paw. The vet diagnosed it as pododermatitis gave us some pills and a spray and it cleared up right away.  He started showing his allergy symptoms a year later when in July-September of 2012 he started scratching his face like crazy to the point where he had large open wounds on his face.  We left for work and his face was fine and came home and he was bloody.  The vet treated it with topicals but we dealt with it off and on the whole summer.  I kept asking for a referral to Purdue's vet school to get him checked for allergies and she said that she really didn't think that was the issue.  Then in Oct 2012 Ollie started chewing his paws but this time was way worse than Sept 2011 (I hadn't even remembered the Sept 2011 issue until PetPlan mentioned it).   My new vet gave me a referral to a dermotologist and in January he was diagnosed with atopic dermatitis. 

I filed my claim with PetPlan and it was denied.  I called them and explained that they were 2 different issues, and that pododermatitis could be caused by a number of things.  They told me that one of those things was atopy so it could have been allergies.  I was angry and told them that there were a number of things that "could be" symptoms of the atopy so basically your dog couldn't have been treated for anything before that diagnosis in order to get a payout.   I was told that they only way they would even look at my claim again would be for my vet to update the vet records or for her to fax in a letter stating that the first issue was not a symptom of the atopy. 

I called my vet and explained the situation.  She was hesitant to write the letter but I reminded her how she always insisted that he didn't have allergies and didn't want to recommend the specialist.  She said she would write the letter and fax it in.  That was on Monday so hopefully she has already sent it in.  Now I have to call PetPlan back and ask them to review the claim again.  There is no guarantee that they will remove the pre-existing condition but I have my fingers crossed that they do.  I'll keep you posted.

[Karen, Jasper and Jackdoodle]

It also bothers me that this is going on with the insurance companies, because there is hardly anything that could not somehow be connected to allergies if you tried hard enough. Ear infections, anal gland issues, any kind of skin infection or condition, even some GI issues.  

[Jane, Guinness and Murphy]

I agree that we certainly don't want insurance companies denying claims for invalid "preexisting conditions" which speaks to your earlier point about the specific information the Vet is putting in your dog's medical records.  We should all be asking to see those records before anything is forwarded to the insurance carrier.  I reviewed Guinness's records (many pages) before I let my Vet fax them into the company with his last pancreatitis episode.  That said, I personally DO want companies appropriately denying claims when there is a legitimate preexisting condition.  If they don't, everyone's rates will go up.  The rates being charged assume that the company is not paying claims not supported by the terms of the contract.   I would never let my Vet put anything in the records related to an "allergy related diagnosis" without positive confirmation...and we all know how hard that is to get.  She also did not include her sense that what Guinness had way "chronic Pancreatitis"...just that this was an episode of Pancreatitis brought on by the high fat treats.

[Lucy & AnnaBelle's Mom]

I personally got the handwritten notes and just included them with my claim.   There was a comment in there re Lucy's knee or something back at her 1 year check up we had asked them to check hips etc.  I was afraid they were going to use it against me because they ask for 2 years worth of records and we were like a week or two short of that when the ruptured CCL was noted.  They didn't though so I was happy.

[Jane, Guinness and Murphy]

I think it's great that you got the notes and checked them first.  I know that my Vet is actually not used to dealing with Insurance Companies...she said very few of her patients have insurance.

[Lucy & AnnaBelle's Mom]

Mine as well.  I think I was the only one originally.  Not sure if they have others now or not.  I know that for her with Sophie's chemo treatment it is almost like she doesn't have to feel guilty when she suggests something because she knows we have the insurance.  This new pill she started this week is $50 per pill and she gets 3.  To me that didn't really seem all that bad even if I didn't have insurance.  It is just every 3 weeks.  But to many of her patients that is the end of the world.

[Amy, Cubbie & Ollie]

I'm afraid that if they give me the ok on that pododermatitis that they will then look our June 2011 records and see that he was treated for a double ear infection.  At that point, I will send them the picture of all that dirty ear hair that was removed and ask them to tell me how THAT is allergy related.

[Jane, Guinness and Murphy]

Amy, I really think it's all dependent on what your Vet puts in that letter.  I think she needs to say that based on her examination the pododermatitis was caused by something other than allergies (fungal, bacterial, irritation).  I really believe if they have that from her in writing, you should be okay.  As for the ears, I really think you should be all set....especially if you have the picture.

[Jennifer and Jack]

Jack I got lucky with and he had nothing but healthy well visits before I decided to get him insurance which I believe was around six months but can't remember. Molly had insurance before she was even home to us. I think she had to be six weeks old before it totally took effect though  

The day she was born and we were able to put a birthday on the computer we signed her up for insurance, this way at her well visit when we got her if any thing was documented  it would not be considered a pre-existing condition since we had our breeders vets certificate of health.

I am sure they could have gotten us as pre existing if something would have showed up in the first few weeks but thankfully nothing did..... 

I think even if your dog has pre existing conditions you should still get insurance, a broken bone is thousands to be repaired... any type of accident, cancer or etc would still be covered .. Cancer treatments for dogs are through the roof.... Like mentioned your dog may have one or even two diseases already but unfortunately that doesn't stop other things from happening... I wish....

[Willow and J]

Thank you, everyone, for sharing your experience! 

One of the reasons I decided to post this is to see if there's a difference between one insurance company to another relating to this issue. We got Petplan within 3 months since we got Willow, but she already had a record of ear infection by then. I still want an insurance for Willow, but I wish I could have a bit more faith in the business. I feel I am punished for diligently bringing in my puppy to have her health issues checked and for keeping her healthy and comfortable.

Amy - please do keep us posted. My situation is a bit complicated than yours, since Willow's first vet clinic was with Humane Society and she was assigned to different doctor every time we took her in. I wouldn't know who to talk to for writing a letter for us. And like what you're dreading, I am pretty sure Petplan can pick and choose among 4-5 treatments done on Willow for itchiness and still call Atopic Dermatitis a pre-existing condition. 

[Lucy & AnnaBelle's Mom]

J -- I think that a good example here is if you would ask Karen (Karen and Jackdoodle) if in hind site she wishes that even after she got Jack's Atopic Dermatitis diagnosis that she would have gone ahead and still gotten insurance on him.  Yes the AD is a tough one expense wise, but she has had so many other issues that probably would have been covered if she had the insurance.  I don't want to speak for her, but I'm guessing she might agree!