Topic: can i sue petplan (Read 4653 times)

Gill (sneakiefeline) · « **Reply #21 on:** April 02, 2009, 20:03:41 PM »

I wish I had an answer for you but I dont.

Sounds like your vet is not being very helpful, can you get a second opinion from another vet? If you can you really need to speak to the new vet first and come absolutely clean with him about the situation with Petplan and your current vet and your cats pre-existing condition as told to petplan.

Do you have copies of the correspondence that your vet has sent to Petplan? If not demand a copy of everything cos you have paid for this.

Other than this I can only say definately take it to the ombudsmen but that of course will not save your cats life. What is your cats name cos I hate just calling her your cat. How old is she.

Do you have the support of your current vet for radiotherapy or is this something you are insisting on against advice......sorry to ask this cos I know we all will do anything for our cats

tan160581 · « **Reply #20 on:** April 02, 2009, 18:59:00 PM »

well that is the thing i have my vet who is telling me is could be possible what you said, but highly unlikelly, and i have another vet who is treating me with the chemo that its impossible, but as its the other vet that is dealing with petplan the other vet doesnt want to step in

Susanne (urbantigers) · « **Reply #19 on:** April 02, 2009, 18:52:52 PM »

You could try the citizens advice bureau for advice on the best way to proceed, but I don't think any option is going to be quick. Your insurance documents should contain a definition of a pre existing condition. I dont' think it actually has to be the actual condition present, but something that could cause or leade to it. For example (Im' not saying this is the case, it's just a theoretical example) if the same virus that could be causing colds could also cause lymphoma, then they could argue that the colds indicated the presence of this virus which also caused the lymphoma. I think you'd have to have some veterinary knowledge to fight the case as it would all rest on whether it is reasonable to suppose a link between the colds and the current condition.

tan160581 · « **Reply #18 on:** April 02, 2009, 18:34:08 PM »

that is another question i dont think i would get legal aid as i work full time and i was thinking about no win no fee but they seem to be for humans and not animals, one solicter quoted me 150 for a hour and said it would come to more then what the vet fees would come to, and if i had that money i would be spending that on my cat not to some solicter, as said any help appreciated - may look into watchdog as well as someone mentioned earlier

Tiggerman · « **Reply #17 on:** April 02, 2009, 18:28:52 PM »

Sorry to hear of your problems.

Life is always hard when you are forced to deal with morons at call centres.

In the short term I think the Ombudsman may be the best option.

You can always sue petplan through the small claims court as well but not sure how long that would take.

Does anyone have a clear legal definition of what is a pre-existing condition?

tan160581 · « **Reply #16 on:** April 02, 2009, 18:09:18 PM »

yeah there is someone i can complain to, but takes up to 4 weeks, which i dont think my cat would have or would be to strong to have the radiotherapy time isnt on my side, so i dont know what to do, i guess sueing would take time as well, i just dont know what to do

Susanne (urbantigers) · « **Reply #15 on:** April 02, 2009, 18:01:35 PM »

I've found this. Not read it all, but it might be of interest

http://www.financial-ombudsman.org.uk/publications/ombudsman-news/65/65-pet_insurance.html

it looks like pet insurance is regulated by the financial ombudsman

Susanne (urbantigers) · « **Reply #14 on:** April 02, 2009, 18:00:29 PM »

It sounds like your vet isn't really on your side which is a shame. The problem is that a cat doesnt' ahve to be diagnosed with a problem, but if he previously exhibited symptoms related to the problem then they will consider it pre-existing. I'm not a vet so really don't know whether there is any relationship between having frequent colds and developing lymphoma in the nose. Is there anything on your insurance documents or petplan website about any sort of appeals procedure or any sort of adjucication body? It sounds like that's the sort of thing you need. Some impartial 3rd party who can look at the claim and adjudicate.

tan160581 · « **Reply #13 on:** April 02, 2009, 17:53:55 PM »

my vet has wrote, but wont ring as he said that is not the vets policy to ring petplan!!!!!! he just shrugs his shoulders and says they have made there decision but he has stressed in the letters that we found the lymphnia in jan 2009 and its not pre existing and is nothing to do with the cold my cat has experience before

tan160581 · « **Reply #12 on:** April 02, 2009, 17:51:08 PM »

that is what i am trying to say how can it be pre existing when i never knew that he had it, but they are saying cause he suffered from colds and that is where the lymphonia is they dont have to pay out as they think it was that which was causing it, and as i have no x rays to prove that about the cold they dont have to pay out, but why would someone x ray a cat with a cold, it was hardly anything, but me being a worrier used to take him as i didnt want him to suffer and i would take him to be on the safe side

MrsR · « **Reply #11 on:** April 02, 2009, 17:47:29 PM »

Tan have you thought of contacting Watchdog about this.

I am so sorry you are going through this.

Susanne (urbantigers) · « **Reply #10 on:** April 02, 2009, 17:47:12 PM »

Quote from: tan160581 on April 02, 2009, 17:40:57 PM

hi, my vet has ben very good and hence the letters and faxes he sends and they always claim they get lost, and then i have to wait another 7-10 days while they await there results to be told they never received it and then it has goes in a chain again, he has put all that and still they wont budge, i dont know what to do, as i can only speak to the call centre people or the supervisers who are hopeless, i want to talk to a claims handler but have been told they dont deal with the public

But what has your vet said about petplan's claim that the lymphoma is related to the colds? Regardless of what forms he has sent in, what does he say to you? Does he seem bothered that petplan have turned down the claim? Or is he just sending in forms because you have asked for them? I think claims handler is what I meant in my previous post - that's the line that is only for vets to ring. So your vet can discuss this over the phone with them but obviously he will only do that for you if he feels you have a good case and that they should pay out. If he can talk directly to the claims handler and reach some agreement with them, then you are in with a chance. The surgery can fax documents and then ring to check they have been received. But I think how much they are prepared to do for you will depend on whether they think you should be paid. When I took Jaffa for his dental, I knew that dentals could be tricky to get pay outs for but they told me that they would make sure I got paid and had recently had a cat in for a dental and petplan had paid out. They were prepared to fight for me to get the money, although in the end it came through very quickly (although I was not party to what was said on the phone between the vet and the claims handler).

Susanne (urbantigers) · « **Reply #9 on:** April 02, 2009, 17:41:38 PM »

Quote from: trigger on April 02, 2009, 17:23:57 PM

how does insurance work with rescues, then? there must be loads of times when someone takes on a rescue who unbeknown to them has a pre-existing condition - how can they be expected to declare what they don't know about?

if you don't know about it, it's not a pre-existing condition. A pre-exisiting condition is something you know about or something that a cat has already been treated for in the past. If a cat has presented at a vet with similar symptoms previously - even if no insurance claim was made - they may exclude that if the vet states when the cat first presented with symptoms.

tan160581 · « **Reply #8 on:** April 02, 2009, 17:40:57 PM »

hi, my vet has ben very good and hence the letters and faxes he sends and they always claim they get lost, and then i have to wait another 7-10 days while they await there results to be told they never received it and then it has goes in a chain again, he has put all that and still they wont budge, i dont know what to do, as i can only speak to the call centre people or the supervisers who are hopeless, i want to talk to a claims handler but have been told they dont deal with the public

Janeyk · « **Reply #7 on:** April 02, 2009, 17:32:46 PM »

Hasn't the vet already sent in the details? as I say I don't have insurance so not sure how things work but I would have thought that your vet will have done so and maybe the insurance are just being difficult which is the last thing you want right now. If you haven't already discussed this with your vet I agree that you may have to get your vet to push things for you.

Kay and Penny · « **Reply #6 on:** April 02, 2009, 17:23:57 PM »

how does insurance work with rescues, then? there must be loads of times when someone takes on a rescue who unbeknown to them has a pre-existing condition - how can they be expected to declare what they don't know about?

Susanne (urbantigers) · « **Reply #5 on:** April 02, 2009, 17:21:28 PM »

Sorry to hear you are having a terrible time with petplan. I used to be with petplan and have only had good experiences. Pre-exisiting conditions are always difficult areas as it's hard to prove whether something is or isn't related to the pre-existing condition. Petplan do have a vet line which is a line for vets to ring on and discuss cases - or at least they used to have - maybe you could ask for that number and get your vet to discuss it with them? I know that when I put in a claim for a dental, the receptionist didn't put enough information on the form but after petplan had had a chat with my vet it was all sorted out quickly. What does your vet think about this? Does he think it could be related to a pre exisiting condition or is he sure that it is unrelated? I think your vet is your best bet - if he is prepared to fight your corner with petplan, you might get somewhere. If not, I think it will be much harder. I'm not sure whether there is an ombudsman for pet insurance services, but I would have thought there might be. That's the kind of route I would imagine you would need to go down if you dont' agree with petplan's decision.

Tiggy's Mum · « **Reply #4 on:** April 02, 2009, 16:47:57 PM »

Sorry to hear what you and your cat have been going through

Have you asked your vet to write to them stating in their professional opinion there is no connection between the pre-existing condition and the lymphoma and on that basis the claim should be met?

Janeyk · « **Reply #3 on:** April 02, 2009, 16:43:05 PM »

Very sorry but I have no advice either as I don't have pet insurance myself but I really feel for your situation

to your poor kitty and yourself and wish you all the best in sorting something out

Stuart · « **Reply #2 on:** April 02, 2009, 15:56:30 PM »

Sorry I have no advice on your question, maybe others would have a better idea

Am So Sorry that your babe is not doing to well
My Misty has Lymphosarcoma, so I know how you are feeling

Sending Positive Vibes Her way

tan160581 · « **Reply #1 on:** April 02, 2009, 15:46:52 PM »

please help me, petplan have treated myself and my cat terribly, in dec my cat became really ill and lose of apetite and bleeding nose and was in the vets for 10 days not eating and had to be drip fed and lost half his body weight, eventually tests came back that he had a lymphona in his nose and my vet said his only hope was radiotherapy as he didnt think my cat was a ideal candidate for chemo

anyway to cut a long story short i had a pre existing condition with my cat with was upper respitory system as he used to get colds, so petplan are saying because the lymphona is in the nose that is why he must of been getting the colds and its a pre existing condition and they dont have to pay out, this was like 2 years ago and i have read that a lymphonia without treatment you would be dead in 6 weeks so i dont think he would be here now, as well as that they have been rude to me on the phone, not calling me back when they promised they would and laughing when i call up repeatless times to see if they will pay out, as well as that they have lost vital countless information and one perseon would say they had received it and then i would wait there 7-10days policy and ask if they had made there decision only to be told they hadnt received it, even through members of there team said they had, and i was fobbed off they had made a mistake, i have sent 10 pieces of documentation and i placed this claim in dec and we are now april, my cat is here as i am paying for his chemo ( i cant afford radiotherapy) and i am trying a trial drug which is 100 every 3 weeks as that is all i could afford, but this week his looking not to good and i am so worried and angry how i have been treated my cat is only 5 - does anyone think i have a claim or am i being to senistive and should give up - please advise

Author Topic: can i sue petplan (Read 4653 times)