Pet insurance claim being investigated

[BuntyCollocks]

Has anyone had any experience of being investigated following a claim? We had a horrible time literally the weekend before Christmas and were told on the Monday we’d either have to pay £8k plus to have our dog put through a potentially unsuccessful surgery, or £2k to have his leg amputated.

We had a literal Christmas miracle and he spontaneously regained the use of the leg. The vet essentially has said they think he has a congenital malformation to his legs which was undiagnosed, and which as he gets older now means he is dislocating his joints, they were thinking it was something far more serious and sinister.

However, the investigations etc were hundreds, so we put in a claim with our insurer.

I’ve now been contacted by a really arsey claims investigator, and today had a letter turn up with my name as Mrs ROR first name last name - ror being reservation of rights. Actually disgusted they think this is appropriate. This states I have made multiple changes to my policy as of this Monday - which I didn’t. But my insurer will no longer talk to me and refers me to this claim lady - who sent me an email last week saying I had to get in contact within 7 days. I then phoned her every day for 5 days and sent 2 emails before she actually spoke to me (!) at which point her attitude was terrible, telling me I should “get my facts straight” and ensure I had the full history from the vet.

I’m so stressed out about this it’s unreal. Never had an issue with insurance before and we’re talking about literally a couple of hundreds of pounds when we take off the excess they’d have to pay, not thousands.

I feel like I’m being called a liar and a cheat, when all we were doing was caring for our wee dog. Unreal.

I’m sorry, this is awful. Who is your insurer?

I wouldn’t speak to them. Everything in writing and sent registered. I'd also co tact the financial services ombudsman.

What is their actual problem with the claim that you’ve submitted as you have not said and did you fill in forms or did your vet do it ?

Tesco which is apparently royal sun alliance

Our vets filled in the forms and they’ve said the vets haven’t provided enough information - not quite sure what we can add given that neither of us are vets and we’re following vet recommendations etc!

Won’t try to give specific advice then as no experience of them, but so sorry you are going through this.

i definitely feel like doing this but am afraid of being blacklisted from insurance services!

It sounds like the vets could help by providing more detail. Can you maybe have a chat to your vet?

Very unusual from Tesco, I've dealt with them hundreds of times (both as a customer and a professional) and never had an issue.

What changes are they saying you made, you're saying you dispute making any?

I would take the letter and the email address / number to the vet on Monday and ask them to deal with it as the issue is obviously with them . I’m wondering if there’s been a balls up at the vets and they’ve submitted someone else’s claim .

This sounds normal to me as you've put a claim in for something the vets have said is congenital, and congenital conditions are not usually covered under pet insurance.

Then why haven’t the insurance company just refused to pay and told the OP that , it’s simple enough .

Are they just saying they need more information for the claim?

They won’t talk to me at all so I can’t even ask the question.

If that's the case you need to get them to tell you why they can't talk to you.
They should be able to tell you why they can't

Dog is in on Friday for his 6 month check so my husband is going to get the medical history and chat it over/ask the vets for more info

Will definitely be discussing with vet thank you

when i called today they said “it’s with a different department we can’t discuss anything with you, call this number” who is the claim investigator.

they said they need to clarify and gather information

It just sounds like they need more information about the claim to me and that they were telling you to speak to the claims department because the first number you rang wasn't dealing with it

Speak to your vet.

We had a different issue, where the underwriter tried to wriggle out of reinsuring our dog - we had made an enormous claim the year before - by saying that our dog was aggressive, based on him taking anti anxiety drugs on one visit to the vets! He was anxious, not aggressive.

I contacted our vet and they sorted it all out. It was the underwriter to blame.

Speak to the press

I really would do this

Round robin mail covering insurance, vet claim handler. Covering what you put in OP.

Say everything will need to be put in writing from now on and you will contact the ombudsman. Say you are going to speak to vet. Then put that conversation in writing

Also ask for a copy of their complaints policy as you are making a formal complaint

We had tesco investigate a large claim we made, we just needed the vet to send a more detailed explanation & it was fine. But very stressful at the time as the bill was quite large.

I’m with tesco too and they had someone calling me making it sound like I was committing fraud. The reason was that we’d only taken switched insurance companies a few weeks before. It was because the vet had documented that I’d said the issue had started weeks before rather than days so they adjusted the details to be accurate and then it was all sorted.