One more pet insurance question?

[Joe R.]

I've already decided to go with PetPlan, but I got one question though. Why the $30.00 difference in premium if I list them as Goldendoodles vs. Mixed Breed (Medium)? It's more expensive when they're identified as a Goldendoodle.

[Dr. Judith P. LaVorgna]

Jane...do you think the pet insurance industry is regulated the way 'human" insurance
is? I can't find anything about that but it would be interesting to know. I have this sense it is modeled after ours in many respects, but not "regulated" by, say, state or federal legislation. What is your thinking?

[Jane, Guinness and Murphy]

Insurers selling pet insurance are required to be licensed with the state(s) in which they do business and are subject to the rules and regulations of that state. Those rules and regs differ pretty significantly from one state to another. Most will require that all of the policy forms be filed. Scrutiny over rates will vary pretty significantly....but that's also true of all of the state regulated lines of business. Because pet insurance is relatively new, and only about 5% of pet owners purchase it, my guess is that most Insurance Departments aren't spending a lot of time with this product. However, if an Ins Dept receives a well documented complaint which is supported by policy language they are required to investigate.

[Jane, Guinness and Murphy]

Actually, insurance is discriminatory....but it's based on actual experience, so there's really no room for arbitrary distinctions. Pet insurers (and human insurers for that matter) base their rates on individual risk factors that are predictors of future claims. It's all about "slicing and dicing" the data to come up with the most predictive characteristics and then setting a price that will return a fair profit. Zip code is key because vet costs vary pretty significantly by zip. Breed is also a key predictor, both in terms of frequency of claims and their severity. It is possible that not all plans are sophisticated enough to use breed...or they simply don't have enough credible data. If you really want the specifics of how the rate was made and the data supporting it, it is unlikely that you will be able to get that from any of the customer service reps....you would need to talk to one of their Product Mgrs or Actuaries. You could also see if they have filed their rates with the State. If they have, all the specific ratemaking support will be in the filing. States have their own requirements for what must be submitted in support of the rates charged. Some states require nothing, while others require full documentation.

[Nancy, Ned, Clancy, and Charlie]

Did no one think of changing how the dog is listed at the vet's to mixed breed? My vet does not even recognize doodles, they are poodle mixes to him. If I was worried about the vet matching the insurance for breed, I certainly would change the breed on the vet's records. They are mixed breeds. The are mutts. Why pay more?

[Chuck Holliman]

For those of you that have followed Rusty's Cancer Chronicles, which are posted on this site and Judy's Doodle Messenger site, you will see all of the tests, surgery and Chemo therapy that Rusty has undergone. We purchased a policy through Pet Plan when we picked up Rusty almost two years ago; I did not notice any difference in premium for designer breeds, but also was not thinking about it. As Judy has said about the dogs that are on her web site, either without insurance or not covered for pre-existing conditions, it is very tough on the owners trying to provide the care they need vs. the expense. We never expected to need the coverage, however at this time we are very thankful that we had the foresight to purchase it. In our case if there is an extra premium for "designer dogs" it is well worth it; don't quibble.

Rusty's expenses have reached almost $16,000 through July, of which Pet Plan has paid 70%. Pet plan has promptly paid every bill that we have submitted and has not disallowed any of the costs. We will probably reach the policy's annual coverage limit of $12,000 in the next two months. If Rusty was not insured, I am not sure that we would have been able to give him the care he needs if he is going to win the battle against this terrible disease; being retired, it is not possible to replace our funds at this time in our lives. Fortunately, Rusty's Chemo therapy program should be less expensive the next six months and we will begin the new policy year in September (assuming they renew his policy).

Chuck Holliman

[Jane, Guinness and Murphy]

Chuck, you were so wise to purchase this coverage. Because we're also retired, I felt it was extremely important to have "catastrophic coverage". We purchased the policies as soon as we got our Doodles to prevent any documented "preexisting conditions". We can manage the "day to day" vet bills, but I knew we would need to be covered for serious illness. I also chose PetPlan, so I'm really happy to hear that you've had a good experience with them. Thanks for sharing this good advice.

[Lucy & AnnaBelle's Mom]

Chuck --- Which plan did you purchase through Pet Plan? Just curious if you bought a 70% pay or if the 30% you had to pay because of their 30% co-pay for specialists?

[Chuck Holliman]

We have the Silver plan. The 70% is for the referral specialists; our regular vet would be reimbursed at 80%.

Chuck

[Dr. Judith P. LaVorgna]

Chucck, I'm assuming you and Jan have the "burden" of submitting your claims rather than the Veterinarian or the specialist...if so, has there ever been any correspondence with regard to verification of any of your claims. In other words, has the specialist Veterinarian ever had to confirm anything about Rusty's treatment which you submitted? And/or, with regard to your overall satisfaction I'm sensing you are pleased with the process? Last, about how long is the process from submission to reciept of your check (too long, appropriate, within 30 days?)

[Chuck Holliman]

Good Morning Judy!

The claims process has been very easy; I download the forms from the PetPlan website, which Rusty's info is already filled in, the vet fills in one line per claim and initials the form. I sign the form and fax it along with a copy of the billing to PetPlan, and usually receive the check in a couple of weeks.
So far it has been a very painless procedure. PetPlan required a blanket release of Rusty's medical records from his primary vet and Dr.'s Huber & Macy for the first claim (which took a little longer to process), but no other requirements since. If they have contacted the Vet's, Dr. Macy has not said anything about it.

Chuck

[Dr. Judith P. LaVorgna]

Thanks Chuck..it sounds like that part has been a good experience and says alot about PetPlan. I feel as though you are a barometer for this and it sounds pretty forthcoming and relatively easy. I had been following Joe's posts on his search and it makes me comfortable that he's selected a great company. I've played the odds of a savings account for mine over the years and have been lucky, just plain lucky. Lurking in the back of my mind are also the growing odds that something has to go wrong here sometime, so I'm in insurance contemplation at this point. Thanks for the information. Give that Rusty a hug and happy swimming today!

[Joe R.]

Thanks for the information Chuck. Most everyone I've seen who went with PetPlan had the same good things to say about the coverage. I'll definately be interested to see if they renew his policy.