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- May 25, 2022
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We had to say goodbye to our beloved Flora last weekend....She was diagnosed with small cell lypmpha last year and in the past month it became high grade and very aggressive. I am in the middle of sorting out her affairs, including her final vet bills and the pet insurance company is giving me a hard time.
I purchased pet insurance for Flora around the time she was having elevated liver/dental issues, the policy was effective April 21, 2022. I did this as a sort of wake up call, just in case she had other issues down the line, with the understanding that liver conditions and dental issues would not be covered.
She had the dental, made a full recovery and her liver values were normal for the rest of her life. However, several months after her dental, we noticed that she was losing a lot of weight despite normal appetite and vomiting frequently. We went through many tests including multiple ultrasounds and an endoscopy to finally diagnose that she unfortunately had small cell lymphoma. We started treatment, she gained her weight back, and we seemed to have a good control of the disease for several months.
The whole time, these procedures, bloodwork, rechecks etc. were all covered and paid out by her insurance. It wasn't until our policy renewed in April 2023 with no lapse in coverage, when I submitted a claim for a routine blood recheck with her oncologist, it was denied citing that because it was mentioned in her vet records that she "vomited occasionally" which was dated prior to the effective policy date which means that any related illnesses (her cancer) were considered pre-existing. I can't deny that it does mention vomits occasionally in her vet notes (what cat doesn't...), however this was pertaining to vomiting once in a while and accompanied with hairballs! At the time I appealed the decision (which was reviewed internally.... go figure...) and the denial stood. I wasn't able to escalate it further, and I let it go at the time because after the deductible, it would only be $100 or so and I figured it wasn't worth the extra stress. I just recently submitted to insurance a bill of her recent emergency visit because Flora was very sick and wasn't eating. During this visit, blood was drawn and an ultrasound was performed which showed that her cancer had become high grade...This claim was denied for the same reason as the previous one.
I feel that they are misconstruing the vet notes as a means to deny the claim... I'm sure it's a tale as old as time and I doubt my experience is unique. Seems that insurance companies love to use vomiting as a means to deny claims. I am in the middle of arguing with them that the vomiting that they claim is pre-existing is unrelated to her cancer. I have not pointed out to them the fact that they have approved and paid out previous claims pertaining to Flora's vomiting/diagnosis of lymphoma...meaning that they did not view it as pre-existing! I only hesitate because I don't know if they can come back and say "you're right" and ask for the money they paid out back. If they did that, that would be pretty sketchy and to me they should not be in business. That would mean they could approve claims, and then go back and ask for the money back if they change their mind.
It is unfortunate that I have to deal with this while grieving over the loss of our beloved family member...Any advice, commiseration, support would be greatly appreciated. Thank you in advance.
I purchased pet insurance for Flora around the time she was having elevated liver/dental issues, the policy was effective April 21, 2022. I did this as a sort of wake up call, just in case she had other issues down the line, with the understanding that liver conditions and dental issues would not be covered.
She had the dental, made a full recovery and her liver values were normal for the rest of her life. However, several months after her dental, we noticed that she was losing a lot of weight despite normal appetite and vomiting frequently. We went through many tests including multiple ultrasounds and an endoscopy to finally diagnose that she unfortunately had small cell lymphoma. We started treatment, she gained her weight back, and we seemed to have a good control of the disease for several months.
The whole time, these procedures, bloodwork, rechecks etc. were all covered and paid out by her insurance. It wasn't until our policy renewed in April 2023 with no lapse in coverage, when I submitted a claim for a routine blood recheck with her oncologist, it was denied citing that because it was mentioned in her vet records that she "vomited occasionally" which was dated prior to the effective policy date which means that any related illnesses (her cancer) were considered pre-existing. I can't deny that it does mention vomits occasionally in her vet notes (what cat doesn't...), however this was pertaining to vomiting once in a while and accompanied with hairballs! At the time I appealed the decision (which was reviewed internally.... go figure...) and the denial stood. I wasn't able to escalate it further, and I let it go at the time because after the deductible, it would only be $100 or so and I figured it wasn't worth the extra stress. I just recently submitted to insurance a bill of her recent emergency visit because Flora was very sick and wasn't eating. During this visit, blood was drawn and an ultrasound was performed which showed that her cancer had become high grade...This claim was denied for the same reason as the previous one.
I feel that they are misconstruing the vet notes as a means to deny the claim... I'm sure it's a tale as old as time and I doubt my experience is unique. Seems that insurance companies love to use vomiting as a means to deny claims. I am in the middle of arguing with them that the vomiting that they claim is pre-existing is unrelated to her cancer. I have not pointed out to them the fact that they have approved and paid out previous claims pertaining to Flora's vomiting/diagnosis of lymphoma...meaning that they did not view it as pre-existing! I only hesitate because I don't know if they can come back and say "you're right" and ask for the money they paid out back. If they did that, that would be pretty sketchy and to me they should not be in business. That would mean they could approve claims, and then go back and ask for the money back if they change their mind.
It is unfortunate that I have to deal with this while grieving over the loss of our beloved family member...Any advice, commiseration, support would be greatly appreciated. Thank you in advance.