Update: Annoyed with VPI

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!

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Permalink Reply by Karen, Jasper and Jackdoodle on June 11, 2012 at 7:48am

I thought that might be the case.

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Permalink Reply by Heather & Brinkley on June 11, 2012 at 5:50pm

I thought so also. I didn't call today. Work was too busy to spend time on the phone on a non-work item. Hoping I have time tomorrow.

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Permalink Reply by Leslie J on June 11, 2012 at 9:24am

Speaking with them (and getting the response in writing) might be the way to go. I think that there's a distinction between having a similar illness and having a chronic illness. Your vet can help you with determining which applies to Brinkley. I don't think PetPlan will cover a preexisting chronic illness, but if it's not chronic they might. Cocoa seems to have a habit of ingesting things which make her sick (and incurring expensive vet bills), but since they are unrelated illness they aren't chronic or preexisting.

I hope that you can get it all straightened out!

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Permalink Reply by Ellen Patrick on June 11, 2012 at 12:07pm

:( This sucks, it feels so crappy to be screwed by the system ... if you don't make any headway with them, you could look into getting a membership with a veterinary discount program; which usually cover preexisting conditions.

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Permalink Reply by VPI on June 13, 2012 at 12:30pm

Hi Heather,

I'm sorry to hear that you are disappointed, and about Brinkley's illness. I hope he's feeling much better now. I just wanted to let you know that I've asked a Customer Advocate Liaison to take a look at your policy to ensure that everything has been processed correctly. Someone should be in touch with you very soon. If you need anything in the meantime, please feel free to email me at ncross@petinsurance.com.

Thanks,

Nicole

Social Media Specialist for VPI