Invisible Voices

a voice for the voiceless

“Pet” Insurance, Part 1

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A friend on a vegan forum asked the other day if anyone had health insurance for their companion animals. The question got me thinking, and wondering whether it would be a money savings. For humans, it seems without question, at least in this country. 45 million people uninsured, at least another 40 underinsured, and you end up with people trying to budget their cancer treatments hoping that what they can afford is enough to keep the disease from killing them. Pretty sad.

And there are a lot of people who will put their “pets” to sleep if the treatment is “too expensive.” Of course, the price they put on their pet’s life depends on the person themselves. Some would argue that it is a privilege of the wealthy to try expensive treatments that might not even help, in the end. Perhaps it seems that way, but I would go into debt with hardly a thought if I had to, to save my companion, whether it was guaranteed to save her or not. (Not that I would prolong her life into abject misery. A different issue altogether.) I owe it to her to do what I can. I took the responsibility of her care and her health when I adopted her, and it seems obscene to distill it down to a dollar amount when asking myself what decisions I would make if faced with expensive treatments for her.

I know I’m not alone. The question is whether we can be smarter about it. Would having health insurance for our non-human family members save us from facing the debt vs. “economic euthanasia” dilemma?

I didn’t know much about it, so I started researching. A few things surprised me. First, that there were so many insurance companies out there specifically for this. Second, that at least one company offers pet insurance as a benefit for their employees. Kudos to that (and any other) company! Third, that only 3% of dogs have health insurance and 1% of cats, and that after a 25% increase from 2006!

One of the reasons given for the increase in insurance coverage is that medical technology is rapidly increasing when it comes to our furry companions. This has increased vet costs significantly – not for the routine exams, but for the treatments that weren’t available in the past. We can now save our companions from diseases that might not have even been detected, and therefore not treated, not too many years ago. The diagnosis costs, however, and the treatment generally costs even more.

tempest and plantI’m sure most of us have stories we can share. I have a friend who spent $15,000 one year on vet bills. I had a cat with a baffling anemia that had me at the vet every 2 weeks for six months until we figured out what was wrong with her (pyruvate kinase deficiency), and then she had a mere 2 weeks left of her extremely short life. My vet gave me breaks on the regular blood checks, and we didn’t do many diagnostic procedures overall because there weren’t many that would have addressed her health problem then. I have never counted up how much I paid in those six months, but I would guess it was no more than $1500. Still, pet insurance for me in that case, and for my friend who had $15,000 in bills, would have definitely helped, assuming that the insurance actually paid some of the costs.

But what about for my healthy 8 year old cat? Aside from her routine checkups and an expensive (but <$500) vet visit this past fall, would insurance for a healthy animal still be worth it? Of course that is a risk in itself – you can never predict the future.

MSN Money did an analysis on this, and they seemed to say that it isn’t generally worth it unless you’re “the type of person who would do anything to save your pet, including spend thousands of dollars on medical treatments.” Not that thousands of dollars is anything to sneeze at, but I couldn’t help but to bristle at the characterization of this being “doing anything”, as if it was the most extreme reaction to an illness or injury in your companion, to spend money saving them.

When I hear comments like that, I can never stop myself from wondering exactly how much money these people spend on monthly cable bills, dining out, new clothes, new cars. I realize that I’m in the minority for not having a TV, but it really is a luxury, though most would give up food before they gave up their TV. The point is that there are many luxuries we spend money on to pamper ourselves. How can we justify not spending a fraction of that money on potentially saving the life of our companions?

The MSN article linked above listed four companies that offer pet insurance. A relatively new one was not listed, one that started with a blog before they were able to offer the insurance itself. And, a quick glance through the recent entries and the links on the sidebars makes me think that this, Embrace Pet Insurance, is probably a quality company. They offer coverage for hereditary diseases, for example, something that not all companies do. The blogging addresses many issues, and at least gives the appearance of responsiveness. They list several pet insurance companies in their links, have some great advice in their blog entries, such as “Big vet bills and no pet insurance?” and in general seems to be a great place to start researching. I have not yet found any reviews from their customers, but so far I’m excited about their blog!

This has become a too-long post as it is, so I’ll continue to research and try to tackle some of the issues (like cost comparison, policy comparison, company reviews, other options) more in-depth another night, as well as track down some additional information on Embrace Pet Insurance. (I’ll make it clear – their blog looks good, but this does not mean I have a feel for the business itself at this point – research needed!) Meanwhile, if anyone has or has had pet insurance, please share! The good, the bad, the ugly. Let it be told.

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27 responses to ““Pet” Insurance, Part 1

  1. RichB July 8, 2007 at 7:31 pm

    I just went back to review this series. I was over a friends last week and they mentioned their vet bills and it woke me up, I need to do something to cover Beanie.
    Thanks for all the work you put into this.

  2. Deb July 8, 2007 at 7:41 pm

    I need to get going on the rest of the issues I want to cover with regards to pet insurance. Mo was really motivating, but I just never seem to have much time to do the research. There are some big considerations when it comes to continuing care, for example, but I know one of your top issues would be homeopathic vet coverage. I also have questions when it comes to (what I would call) secondary illnesses to a primary illness. Such as a diabetic cat, for whom dehydration (if I remember correctly from Kate) is an urgent issue requiring immediate care (possible an emergency room visit) to prevent some of the side effects of diabetes from kicking in. How do insurance companies view that?

    So there are still a lot of questions.

    And actually i need to get tempest coverage as well. I have mostly made my decision, but I feel like I need to finish my research (for now) before actually going through with it. So, hopefully more to come soon!

    If you have specific issues you’d like to see researched, let me know! Laura does pop in to help with some of this, and Mo might have some thoughts too, if I’m stumped.

  3. Mo July 11, 2007 at 12:46 pm

    Deb, I’m only really familiar with primary and secondary illnesses when it comes to VPI, because they do consider them separately. Pet Plan and Embrace say they cover a percentage of the ENTIRE cost, based on regional reasonable and customary charges (not sure if coverage goes up when you’re referred to a specialist because they charge more). Laura hopefully will address the specifics of how Embrace would handle that; Pet Plan is probably similar.

    Pet’s Best is, well…a crapshoot. I’ve had nothing but trouble from them and have had to jump through hoops to get benefits paid that shouldn’t have been in question in the first place. They’ve been a major pain in the neck…when I first bought my policy on my big 3-year old cat they said there would be a temporary 90-day exclusion on vomiting and diarrhea. He developed pancreatitis within that time period so they denied the claim, I assume because diarrhea was one of his symptoms. This required multiple phone calls and finally a nasty letter from me. Last week I called to get that “temporary” exclusion removed (more than a year after buying the policy), but was told it would remain but if he ever had a claim with V/D I “could” just write them a letter explaining how the V/D had been “cured” previously and that this incident had nothing to do with the initial V/D…and have notes from my vet saying they weren’t related! You can guess what my advice would be when it comes to Pet’s Best.

    VPI does cover secondary conditions, even if there are multiple secondary conditions, you would just need to be sure to include the diagnoses on the claim form and copies of labs or whatever would help them (vet notes aren’t usuallly necessary unless it’s a fairly new policy or there’s some other reason for them to believe it was a a pre-existing condition, or the diagnosis is very unclear).

    I think in the specific diabetes case you mention, the emergency care required would be considered coverage for “ketoacidosis” (the dehydration condition you mention) – the ketoacidosis would probably be the diagnosis and considered the primary illness because treatment for diabetes wouldn’t actually be being treated separately at the time (things like blood & urine tests & insulin, with no complications, would be more specifically treatment for diabetes). I had a diabetic cat, so that’s my thinking but I could be wrong. Input from others would be great – it’s an interesting scenario so I’d like to know the answer to that too.

    But I betcha the companies vary in their view on even this type of scenario which is more clear-cut than many other secondary conditions. *sigh*

    I believe most of the companies cover homeopathic vet treatment, but to tell you the truth my brain is fried from all the recent hard-core research! (I feel your pain, Deb.) Their websites are pretty clear on alternative care coverage – if they cover it, they’ll most likely say so in big bold letters. πŸ™‚

  4. Laura Bennett July 11, 2007 at 8:44 pm

    Mo, coverage with Embrace goes up for specialists (it’s reasonable to pay for their specialization and knowledge) as well as emergency care (it’s reasonable to pay for someone to sit around 24 hours a day in a room full of equipment a regular vet doesn’t have access to – assuming it was an emergency of course)

    Laura

  5. Deb July 11, 2007 at 9:31 pm

    Mo, I think I’ll concentrate on some of these tricky issues like the diabetes scenario for some posts. I’ll come up with what I can, as best I can determine, and then hopefully Laura will chime in to help. Or maybe I’ll email her ahead of time so I post with a good understanding. I keep saying I’m going to do this, and I swear if I could just have a couple extra days in the week it would happen!

    As you’ve pointed out, researching specifics on these companies is not always easy, and even when the information is there, it is not always easy to understand what it means for some situations. You’ve really been a lot of help with your explanations and experience, though!

    Laura,
    Thanks for your input, as aways! It is good to know you’ll come through and clarify/correct us if necessary! πŸ™‚

  6. Laura Bennett July 11, 2007 at 10:17 pm

    What I’d really like is for some mystery shopper to buy several policies from each pet insurance company and rate the companies on their products, service and claims payment in an objective way (I wouldn’t be able to say nice things to them while they were rating us :)). The closest I’ve seen to this though are the reports from Deb, Mo, and others on this blog, which is a great service for people interested in pet insurance.

    Consumer Reports has a real hate-on for pet insurance and keeps publishing how it’s all “gone to the dogs” (groan). I just had to respond in my blog but people believe Consumer Reports even though they did no research on it. So frustrating.

    Be happy to help with scenarios although it’s easy to talk in theory but the health history of the pet can make a difference to any claim decision.

    I’ll be quiet now.

  7. Pingback: Pet Insurance - what do you know, what do you think? « Pet Product Reviews

  8. Mo July 12, 2007 at 1:59 pm

    Laura, good to know that on the specialists and emergency care. Actually, I think your website addresses those, but I’m so confused now… πŸ™‚

    Please do NOT shut up!

    I read that Consumer Reports thing via your blog. It was so uninformative (and uninformed) and very blah. I wonder…couldn’t you contact them and give them the broader picture? I realize they might be reluctant because they’re already biased, but they might just welcome your input and print a well-rounded, useful article.

    Deb, oohhh, you are ambitious and brave…good for you for going deeper into this already extremely complex world and attempting to tackle the tricky stuff like secondary conditions. As Laura says, the health history of the pet can affect claims decisions, but also any other potential complication that might exist will throw a monkey wrench into the picture. Very little is clear cut with any of the insurances when complicated diseases are in the picture.

    BTW, you probably already know this but just want to clarify that if a cat or dog is diabetic at the time of enrollment, that condition is pre-existing so related conditions such as ketoacidosis wouldn’t be covered.

    Good luck to you – this is so great of you! πŸ™‚

  9. Deb July 12, 2007 at 5:55 pm

    Actually, my question was for a cat with pre-existing diabetes. I had a feeling the secondary conditions might not be covered.

    It is difficult, because I understand why the insurance wouldn’t cover it (since it is a guaranteed cost to them) but I keep thinking there must be something that would help my friends who have the diabetic cat in case of the sudden unpredictable expense. I mean, it isn’t a routine thing. It is something that might never happen again, or it might happen tomorrow.

    So, maybe there is no good answer. She was known to be diabetic when they adopted her, so they never would have had a chance to have it covered.

    If there was something that could protect people from the really big unexpected expenses, even for cats that are diabetic or..or whatever disease or sickness, it seems like more difficult-to-adopt-out cats and dogs would be adopted. Maybe I’m wrong.

  10. Mo July 12, 2007 at 9:09 pm

    I know just what you mean…I’ve thought many times of adopting a diabetic cat (or one with any manageable condition) from my local shelter because I can provide them with great vet care and I’d like to be their family…but I cannot afford the costs. I’m sure there are many, many other people out there who feel the same way.

    Some little bell is ringing in the back of my head…there may be some insurance company that would cover a pre-existing condition, under certain conditions (no pun intended), and with certain restrictions. That would be a really cool thing to research, which I now see is what you meant.

    I think the non-insurance “programs” might be helpful in cases like this. There are probably more than a few available, but I know someone who uses the PetSmart veterinary clinic and they have a program where you pay a pretty low monthly fee (he pays ~$25/month for a 40+ lb dog), and it covers 2x/year exams, shots, teeth cleaning, and vet services for illness and injury. For emergencies or specialist referrals you’d probably be responsible for the entire cost, but I’m not sure.

    Your friends might want to consider putting away a certain amount of money each month to be available in the event this type of potential emergency presents itself. My 3-year old cat has a heart condition…unfortunately, he had it when I adopted him but I didn’t know it…my vet detected it immediately and of course it’s not covered because it’s pre-existing. I put away about $90/month to cover just the cardiac follow-ups I have done 2x/year. If he were to become sicker and needed more, all of that additional cost will be added on top of the debt pile I already have. My last cat also had heart disease (developed well after he was insured so it was covered), so I’m all too aware of the progression, the heartache, etc. that can suddenly one day show up…and the financial costs can be astronomical. (But everything’s happening so fast you don’t have time or the inclination to worry about the money when that happens!)

    You’re absolutely right that if something was available to help with even a portion of the cost for pre-existing conditions, that would be truly great. I think something like ketoacidosis wouldn’t be considered unexpected for a diabetic cat, though…unforutnately, even for those parents who diligently monitor and medicate their diabetic cats, diabetes is notoriously difficult to regulate in cats. (Probably a combination of their body systems and the fact that they compensate so well that you sometimes don’t know they’re sick until they’re really, really sick.) I hope their cat is one of the lucky many, however, and coasts along nicely with her treatments for many years. And the love of good humans has been known to work miracles in these amazing, mysterious, exquisite creatures.

    I hope your research turns something up. I’m really intrigued now to learn what you discover!

  11. Deb July 12, 2007 at 9:20 pm

    A couple of the pet insurance companies have the vet visits that you can cover. Looking back at my notes, Pets Best (which happens to not be available in my state, which is also where my friends with the diabetic cat live) does have a plan “Pets Wellness” that is a routine care plan, and seems to be something you can choose independent of the actual insurances. So it is more like a human health care plan.

    There is also Pet Assure, of course, which does sort of the same basic thing, but then you’re limited as to which vet you can go to, which…isn’t necessarily in your favor, especially when you have animals with conditions where you really want to know your vet and to have the same person looking at them. If your vet clinic happens to be covered, no problem. Otherwise it might not be what you want.

    And neither would cover emergency care in any case.

    I’ll keep looking into it, and I’ll post if I find anything hopeful!

    That’s a good tip about PetSmart though. There might be other options like that, which aren’t through insurance companies.

    I think my friends do put money away, just in case, but they’ve had that wiped out a few times, so they never really have any feeling of safety. It is hard to predict just how much an emergency would cost. Hence insurance!

  12. Mo July 13, 2007 at 2:01 am

    The PetSmart program isn’t something I’d personally jump at unless necessary because I think it’s like an HMO, similar to what you described, where you don’t necessarily get to have a continuing relationship with a vet and I believe there is more turnover of vets in their clinics. But one could use them for certain things (like the diabetes) if it’s covered and use a different vet for everything else. Not sure if that makes sense…it’s nearly midnight. πŸ˜‰

    I do think your friends would be well-served to get insurance anyway – even if it won’t cover the diabetes, it would cover everything else and because their $$$ is preciously needed for the diabetes issues, having insurance for everything else is extra important. We often subconsciously think that once our companion has one disease, that’s all they’ll have…maybe it’s because we’re so focused on that one disease, but we need to remember they’re still just as susceptible to other diseases cropping up, and in some cases they’re even more susceptible so having coverage is that much more important.

    Also, there are other serious conditions that could arise from diabetes cellular damage that wouldn’t necessarily be considered directly related the diabetes, and could very well be covered.

    I felt kind of sick after my last post…I’d put the thought out of my mind to avoid premature worrying but now I’m back to thinking of how I would pay for it if my cat’s heart condition got worse. I’d have to wipe out my retirement fund (yet again). (I really must stop thinking about that!)

  13. Deb July 13, 2007 at 3:09 pm

    Yes, my friends are definitely looking at the insurance in this way. they have two other cats as well, and one emergency at a time is all they can afford! But…if there is one insurance that will work best, and even cover some of the diabetes related issues, that would be the best thing for them. I’m not sure if such a thing exists. A combination of options might be what they need.

    Good point on the cellular damage issues. I will pass that info on to them, and research that as I look into the issues as well.

    I hope your cat’s heart remains strong for a long time into the future!

  14. Mo July 13, 2007 at 8:10 pm

    It’s really great of you to care so much for your friends and their cats…they’re lucky to have you. I do hope you find something that will work for them (and we will all be interested in what you find!).

    Thanks for your good wishes about my cat…I hope so too. He’s my guardian, guide, protector (like my familiar but stronger). He brightens everything and makes my heart swell. πŸ™‚

  15. Mary Martin, Ph.D. July 14, 2007 at 12:51 pm

    Here’s a small business idea that I would SO pay for: Do all the research for individuals and find the right policy, just like a regular insurance agent, and get a vig. Obviously, you cannot work for any of the companies to be able to do this.

    This is all mindboggling. I have preexisting condition-animals (one of which has diabetes), and I can’t figure out if that makes it easier or more difficult to find a match!

  16. Deb July 14, 2007 at 5:43 pm

    Well, I will definitely let you know if I find anything on diabetes that would be helpful. I think that it makes it much harder when you have pre-existing conditions, especially ones that have so many associated problem and require both constant viligence and what is probably chronic emergency attention. Though Mo certainly brought up a point I wouldn’t have thought of, regarding future health problems that can be caused by the diabetes, and getting them covered.

    I’d feel uncertain recommending insurances to people in general because what looks good on paper might not play out in real life. Which is one reason why Mo’s experiences have been so valuable to hear!

    What would probably be even more valuable is a person who handled the filing of the claims for you. Someone like Mo, who knows how to hound the companies and get what she was supposed to by the terms she signed up under.

  17. Laura Bennett July 15, 2007 at 8:10 pm

    OK, I”m back again. It’s been a busy weekend – month end and all that!

    First of all, I see the discussion on insuring a diabetic cat. At Embrace, we only offer accident insurance (not illness) to diabetic cats and dogs – not what you would hope for of course.

    The reason we went this route is that it’s so hard to define what conditions are related to the diabetes (excluded as pre-existing) and what are not, that every illness claim could be an argument and not a good experience for anyone. We just felt it fairer to cover only accident and injuries we knew would be clearer to understand. We do the same for Cushing’s Disease too for the same reasons.

    With a cat or dog that has had cancer prior to being insured, we will insure for illnesses but exclude all cancers, regardless of the type, because so many cancers can morph into other types and again, it could become painful to argue about pre-existing conditions with a new cancer. We just felt it would be clearer up to talk about it up front rather than creating false expectations and immense disappointments down the road.

    Finally, if your pet has hyperthyroidism, we will cover all usual illness treatments except for hyperthyroidism treatments and medication (as you would expect) and kidney, heart, and high blood pressure conditions are also not covered because again, it’s hard to pinpoint the causes but are often associated with hyperthyroidism.

    We are clear to disclose these restrictions up front in the application process so you find out well before you give us any personal or billing information. We are also clarifying it in our terms and conditions, which leads me to my next comment on surplus lines… [see next comment]

    Laura

  18. Laura Bennett July 15, 2007 at 9:04 pm

    I am going to do a brief outline of surplus lines versus admitted insurance – if you aren’t up for a digression into the nuances of insurance law, I wouldn’t bother to read this. It’s not going to be very exciting. Oon the other hand, if you have a touch of insomnia… πŸ™‚

    First what am I talking about? Surplus lines and admitted insurance are both legal formats of insurance in the US. They are both highly regulated and require people selling the insurance to be licensed (for admitted, you need a producer license and for surplus lines, you need both a producer license and a surplus lines license).

    For admitted policies, you file a sample insurance policy with each state you are going to sell in. Some states need to approve the contract before you start selling and some just require you to file them, no approval required. Once you have done whatever you are required to do (it’s often quite onerous), you can go ahead and sell your policies in that state. If you want to make any changes though, you have to go through the whole process again and refile the changes. These policies are covered by the state’s guaranty fund so that if your insurer goes under, you have some recourse for your coverage.

    For surplus lines policies, the insurer does not need to file that sample policy for approval up front, it can go ahead and sell it without approval (see later for comments on that); however, it does have to file every single individual policy it sells with the Surplus Lines Association in that state, which is quite the nightmare (lots of paper involved). These policies are not covered by the state’s guaranty fund and this is very clearly stated on the front of your policy.

    You can see there are pros and cons for going each way of insurance as the seller of pet insurance. Admitted is a pain in the you-know-what up-front for an insurer and any time you make changes to your terms and conditions. Once you have got through that process though, you only have to report on the policy taxes. VPI uses this method and I think it’s why they haven’t changed their benefit schedule since 2002. Of course, that has not helped VPI’s customers as they get less and less covered each year as veterinary inflation causes costs to rise.

    Surplus lines is easier to get started but the ongoing administration is awful and not scalable – for pet insurance with large numbers of small policies, it becomes terribly painful quite quickly.

    For the surplus lines contract, it doesn’t have to be approved at any point so in theory, an insurer could put in all sorts of unfair provisions to the policyholder. That’s when it’s important as a customer to look at the insurer supplying the insurance coverage behind the policy. If they are a quality organization with a quality brand, then likely they are more interested in upholding their name than putting out a poor contract. On the guaranty fund issue, again it comes down to the insurer behind the contract. How do they rate financially and are they likely to be around?

    As I mentioned before, at Embrace Pet Insurance, we use a combination of methods, some surplus lines and some admitted all backed by Lloyd’s of London. We provide a 30-day money back guarantee so if you feel uncomfortable with any of our terms and conditions, you can cancel your policy and get all your money back (assuming you haven’t claimed). We intend to go admitted down the road as we grow so we’ve made every effort to write our Lloyd’s contract to be approved when we go admitted. I hate rework!

    Other companies also use this method or have done so in the past. The Hartville Group (behind Pets Health Plan and ASPCA) used to be fully surplus lines until a year or so ago, and Pets Best currently has some surplus lines states but is moving to being admitted in those states too.

    So are we all exhausted yet? Feel free to ask questions after you’ve digested for a while.

  19. Mo July 16, 2007 at 10:06 pm

    Mary, it is definitely difficult in most cases, though Laura here explains how Embrace draws a clear line. Although their policy can seem deflating, it is actually a relief – you know up-front what will and will not be covered. As she states, it is very difficult and can become a long-drawn-out-argument that’s extremely emotional for the companion parent. You might want to write to some of the leading carriers and see what they say. A phone call will get you a CSR who may or may not know the answer and may give you wrong information, but you could ask straight out to speak with a manager and you might get some answers, but I’ve found I often get better answers when writing…gulp, via snail mail. Good luck to you, and please let us know what you learn.

    Deb, that’s a great idea about a service that will fight for claims! Thank you for your implied faith in me, but as you said – maybe someone ‘like’ me…personally my success/failure ratio has been pitifully poor…. To add insult to injury, when it’s your own companion you’re fighting for the weight of the battle is magnified 100X and I believe most of the companies count on that, and count on us giving up. A service for this would be awesome.

    Having said that, perhaps most of the work the person would have to do is clearly explaining terms to the client. I can say one thing with confidence, and that is the vast majority of problems occur because people do not understand the Pre-Existing stuff. Embrace is the first company I’ve seen that goes out of their way to try to avoid these conflicts, and talks about the problems with pre-existing conditions.

    Several vet clinics have been shocked when I tell them I can’t get insurance coverage on my cat’s heart condition because they feel that even though he had the murmur, *I* didn’t know about it when I adopted him. All the way from receptionists to the clinic owners/vets, they all see things that way…I’m not sure why the insurance companies don’t! I wish they’d loosen up on that a bit and find some middle ground. If you adopt from a shelter and the cat or dog is given a clean bill of health…well, you know what I’m saying.

    Laura, I’m very interested in your explanation of the insurance types. I almost always have insomnia so I will read it tonight before going to bed (as you suggested). πŸ™‚ Actually, it will probably get my mental gears turning so I better not do that! I will read it when I’m mentally alert. Thanks for giving so much great info.

  20. Deb July 17, 2007 at 5:33 pm

    Thanks for explaining all that Laura!

    Mo, if you’ve had success with the claims filing while in the middle of all the emotional issues of having a companion who is sick, just imagine how much higher your success rate would be if you were outside the situation, filing for someone else!

    I really think it could be a viable business. Though of course actually filing claims and tracking down the proper medical charts from the vets and getting them to send it all in might not actually be your idea of a fun time. πŸ˜‰

  21. Mo August 18, 2007 at 9:04 pm

    Hi there…I’ve been absent for a bit because I’ve been trying to keep my pet-insurance-blood-pressure in check. πŸ˜‰ The day of Deb’s last post I got into a 1.5 hour heated discussion with VPI because I’d made a change to my older cat’s policy a few weeks prior, based on info I was given by VPI. On 7/17 they told me that info was actually the opposite of their actual policy (having to do with switching between their two levels of insurance). I was very upset because it’s a problem that will likely cost me 1/2 the benefit payout for the rest of his life!! I became determined to get to the bottom of the incorrect information I’ve frequently been given by VPI over the past 6-7 years, so that I can work to avoid it happening again. How can I work with something as important as insurance for the health care of my cats if I can’t believe anything they tell me?

    I talked with four people that day, two of whom kept repeating useless information, and one of them admitted he was annoyed with me (when I remarked that he wasn’t giving very good customer service and sounded annoyed), because, he said, his job was to generate revenue for the company, not help with customer problems. He was in the Sales dept…. So I asked him why he didn’t just transfer me to a CSR rather than go on and on, being annoyed and being rude to me? Finally he did. The CSR I then spoke with (and asked why I continue to receive incorrect information and how I could avoid it in the future) told me that if I didn’t like what the CSR’s told me I could just go and read my policy.

    I finally spoke with a manager, and he couldn’t really tell me how I could avoid the problem in the future other than to ask for a floor manager whenever I’d call with a question. Sadly, I felt somewhat satisfied by this because at least he wasn’t rude and he gave a viable answer to my question.

    Bottom line is, VPI has some very pleasant CSR’s, but all too often they’re the stuff of nightmares if you’re the type of person who expects courtesy, professionalism and correct information to aid you in providing for the health care of your pet.

    (So…Deb, I would end up sticking a pen in my eye or something if I tried to work with the insurance companies on claims!) πŸ˜‰

    There’s a second bottom line…two days later I got my benefit check from them for my girl who died in May…the check was for 4-5 times more than I’d expected. I sent all records and diagnostic reports with my claim, and they broke it down so each condition was covered individually, even though the various conditions are part of the primary major disease. I was pleasantly surprised at that, and I want to again emphasize it has been my experience that if you send all backup paperwork, they do dig into all the diagnostics & treatments and cover more than you’d expect.

    I just got a letter in the mail from another company (Pet Care Insurance, who also provides Emergency Care and Shelter Care policies) on another cat’s claim from a while back…it said they wouldn’t consider the claim because the policy was canceled before the treatment dates. That is incorrect – the policy was canceled AFTER the treatment dates, of course. So now I have to call them and go through who-knows-what kind of backflips to get this claim paid. UGH! With all the companies I’ve tried out, at this point I’m 95% sure that most of these companies will first try to get out of paying on a claim so you are required to fight for it, spending your precious time and energy just to get what you’ve paid for.

    I don’t know about anyone else, but I work full time and don’t have the time or energy to do battle like this over and over. Of course, the companies count on that! It’s really a shame because I believe that’s the reason pet insurance has such a bad rap in this country. Hopefully the newer companies likes Embrace will help turn things around, because not only are the policyholders being ripped off, but the worse part is our companion animals end up paying the price. Their humans don’t ‘believe in’ insurance after a bad experience and most of us can’t afford to pay for costly treatments, so the beloved companion may not get treatment it needs.

    Laura, I really appreciate your explanation of the surplus and admitted lines. It’s way over my head but in time it’ll make more sense (I hope!). I fear I’ll have to go to my State Insurance Commissioner (or something along those lines) with my problem with Pet Care Insurance/Emergency/Shelter Care, and I hope they’re not Surplus because then I may have no recourse.

    Well, that’s where insurance has been for me lately….

  22. Deb August 26, 2007 at 5:55 pm

    Mo, thanks so much for the update. From your experiences I definitely feel like VPI has horrible customer service much of the time (if not most of the time) but they do seem to pay out as long as you submit reams of paperwork on each claim.

    The real problem, as you pointed out, is that not everyone has the emotional energy to battle the insurance companies while they’re dealing with the shock or grief or stress of having a sick, injured, or recently deceased companion. It is a shame that they seem to count on that.

    A couple of the newer insurances definitely give me some hope that things could change. Time will tell, I suppose!

  23. Mo August 31, 2007 at 8:59 pm

    Deb, you’re absolutely right…on all points. Here is the best advice I can give, and I believe this is something that will help with virtually ALL of the companies (if you plan for this upfront it greatly reduces the difficulty at claim-filing time):

    When you submit a claim, include:

    – Invoice showing treatments, costs, payments made (they require this)
    – Copies of all lab results (bloodwork, urinalysis, biopsies/histopathologies, etc.) (your vet should readily provide you with these upon request…I almost always get copies when the tests are done so I have them if needed)
    – Copies of any other diagnostic testing results.

    (any/all means related to the condition the claim is being filed for…they don’t need broken leg stuff for diabetes, for instance)

    If this is your first claim and you’ve had the insurance for less than a year, include:

    – Vet records for the past year.
    – Vet records means chart notes and copies of lab results, etc.
    (or if you’ve had the pet for less than a year try to get records from their previous humans’ vet and/or shelter and include those)
    – Adoption documentation (or purchase…something showing when the pet came into your family)

    Particularly for initial claims for a condition, I include a cover letter explaining anything I think the insurance company might have questions on (such as, I tell them I just adopted my kitty two months ago…alas, they will almost always still request vet records which slows down the claims process immensely – some companies flat out deny the claim and you have to start over, so it’s best to provide them with the info up-front).

    It sounds like a lot but it’s worth it, and as I said, plan ahead – when you adopt your pet ask for shelter records; after every vet visit that includes diagnostics or treatments, ask for copies of all lab results.

    It makes for large files sometimes but not only does it help you with insurance, but if your companion continues to be ill or develops additional disease processes you will have all of that extremely valuable medical history if you ever need to go to a specialist and/or change vets for any reason.

    Yes, your vet could send it to the new vet, but trust me, there are times that doesn’t always work out the way you expect. I’ve found that I have to be fully responsible for everything regarding my companions.

    To follow-up on my concern over the PetCare/EmergencyCare/ShelterCare insurance claim, I was fortunate enough to reach the right person when I called and it was quickly resolved. A relief, but it still was a pain that shouldn’t have happened.

    Have a great Labor Day weekend!

  24. Deb September 6, 2007 at 8:41 pm

    Mo, this is excellent. I might have to grab this and put it in its own post to make sure people don’t miss it! Thanks so much!

  25. Mo September 6, 2007 at 11:11 pm

    Deb, you’re very welcome. I feel a bit like a moron, considering it’s taken me 9 1/2 years to get that straight, on top of the mental sorting though so much of it when posting here. πŸ˜‰ Thank goodness you have this blog or I might still be scratching my head about having the specifics in line.

    I’ve re-read what I posted, and it could use some cleaning up and clarification. If you decide to post it let me know and I can clean it up (I assume you have access to my email addy via these posts).

    Either way, thanks – if it’s at all helpful, I’m happy about that! We definitely wanna help the critters out there, eh? πŸ™‚

    I’ll soon have a review on Embrace…I’ve already had to file a claim on my new little girl cat, if you can believe it. Once the check arrives I’ll be able to provide a full picture. I look forward to providing that review!

  26. ozpunk January 5, 2009 at 9:56 am

    hi, i just wanted to add, im looking into pet insurance and ive noticed that petcare insurance .http://www.petcareinsurance.com/

    use a program called ‘eve’ in most states, and they say that if the vet is listed in there list, that you can go to the vet and you only pay the vet the deductable and the vet can claim online and get the remainder back quickly from the insurance company.

    this to me is excellent if you can find the vet that will honor it, i rang a vet that was listed on the eve website called rose city vet in se portland, oregon and they said NO you have to pay it all then then you get reimbursed by insurance.

    i have many others to call. if i find one i will post it on here.

    this is how insurance should be you pay deductable to vet and they get the remainder from insurance company, isnt this why we have insurance in the first place, because we cant afford to take our animals to the vet.

    it really bugs me cuz my rottweiler has a leg injury that im unsure what it is, and vet expenses are extremely high.

  27. Deb January 5, 2009 at 11:45 pm

    ozpunk, thanks for that information! It does sound interesting, and it will be cool to see how this spreads. Ideally there woudl eventually be a program that was independent of specific insurance companies, of course, but it had to start somewhere! good for pet care for starting something like this.

    Don’t forget to look into “care credit” to see if you could use it for your vet expenses. It won’t necessarily reduce the bills themselves, but it would likely make it easier to pay them off without going into some crazy credit card debt.

    Good luck with your rottweiler. Hope he starts healing soon!

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