Thursday, July 29, 2010

How can i get legal advice regarding a pet health insurance company who denied a claim. I appealed to the co.?

i have had the same pet insurance for 8 years. ln feb 2004 my lab had a smal nosebleed. took him to the vet and was told dogs can get nosebleeds and appeared healthy. Had a couple of episodes of reverse sneezing. called the vet and was told most likely allergies. his insurance policy is from july to july. In september he had a large nosebleed and after many tests was diagnosed with nasal cancer. the insurance company refused to pay stating his iinitial symptoms began in the previous policy period and therefore not covered. No where in his medical record does it state he had cancer. I feel as if I've always done the best for my lab, securing lhealth insurance and taking him to the vet for any unusual symptoms and I feel i've been let down by both.


Could the vet have diagnosed him earlier or should the pet health insurance co take responsibilty and pay the medical cost i have incurred for his treatment. Who can i go to for advice. Is there time limitation in persuing action. thanksHow can i get legal advice regarding a pet health insurance company who denied a claim. I appealed to the co.?
Talk to your vet. He should write a letter to the insurance company and give them a time-line for the cancer diganosis. You should also have the records of your dogs vet exams. You can make copies and send them to the insurance co., highlighting the dates of exams. Have the vet office make you a copy. If they refuse call the Veterinary Medical Board in your state. By law they are required to make you a copy or a written summary of the records. The only other thing is go to an attorney....but that will probably cost you more that the vet bill. Good Luck and God BlessHow can i get legal advice regarding a pet health insurance company who denied a claim. I appealed to the co.?
It seems it might work to get your vet office to write a short note that the initial symptoms were first discovered in the current policy and sign the note, because they didn't diagnose it as cancer before.





I would read the policy itself because this seems like an awkward argument since you had insurance from the same company in the previous policy as well.





Maybe your vet's office or other dog owners can tell you about a better insurance option that you might consider in the future.
Not sure you have a basis for a legal claim. Don't spend money on a lawyer yet.





The best initial thing you can do is to contact your State's Insurance Commission and request info on what you can do in regards to a dispute about a claim that is being denied by that insurance company. Many times the state commission will have several claim disputes and it sometimes boils down to the invividual adjuster who is being ridiculous in favor of his company or it may be that company's operating policies. Sometimes the state will step in and help out the consumer.





Check it out.
I have a feeling I know who this company is and am just disgusted by some of the stories I've been hearing like this. I don't have any real advice, just sympathy, and am hoping that the advice you've already been given will prove beneficial.





Does your company have a dispute process? (I've heard that term kicked around but thankfully haven't had to use it.) It seems like there *must* be some kind of governing body (like the one previously suggested) that could hold a company accountable. I'm sure that if it's in the fine print of their policies that there may not be recourse, but it's just a shame, and hopefully word-of-mouth could help make it right. I've found some good information on complaints.com and would suggest at the very least that you warn other people about the company.





You have absolutely done the right thing for your lab, and I am so sorry to hear that you're having to go through this. Best of luck.
thats a boring case

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