Insurance wont cover because of pre existing

[DownAndUnder]

I’ve just read my insurance policy as dog has a lump on on her leg. They will not pay out for tumours, cysts, growths, abcesses or warts. Dog previously had a lump, it was tested, a harmless cyst and went away. I understood they wouldn’t pay out for cysts but Im so worried it won’t cover for any tumours/cancer related treatments.

They won't pay out for tumours?! That sounds like a terrible insurance policy! Who's your insurer?

It’s pet plan. I’m honestly shocked, I so hope there’s nothing wrong with my girl, I pay £65 a month insurance and £10 for a vet package, I don’t have money for huge vet bills.

That’s really odd, I’ve had Petplan for years and all three dogs have had all manner of lumps and bumps dealt with, no issues on claims. Did you stop then restart the policy for some reason? That might explain why they now consider it ‘pre-existing’?

You are paying a lot in insurance if it is not covering tumours! Do you get lifetime policies?

Have they actually turned the claim down or is that your interpretation of the policy?
Usually pre-existing is specific. So if there had been a lump that was removed and that lump cake back it wouldn't be covered, any other lumps should be.

Call them and ask.

Usually, particularly with petplan, if you've had the previous lump identified and get the new one identified and it's something else, there wouldn't be a problem. If it comes back as the same type then no, it wouldnt be covered.

Speak to your surgery. Whoever does their insurance claims should be able to speak to petplan on your behalf with your permission (you'll need to speak to PP and give permission for "name of vet practice" to discuss details and hopefully they can get an answer for you.

I'd get your vet to try and speak to them and argue your case. Petplan told me once that if you go two years without the problem happening again the exclusion drops off.

I've just had Pet Plan refuse to pay out for £500 worth of surgery because of pre existing conditions. My dog is 10 and they insisted on having every single piece of his medical history which was a nightmare, when in reality the last three years gave them enough info for them to say no on the grounds that they have. I pay £60 a month, very tempted to cancel and put money in a bank account for my eldest...My dog has had other problems that they should have put exclusions on for after seeing his history that they have not. Don't trust them at all...

Also in terms of pre existing being specific, mine are 'resulting from or connected to all disorders of the ear' and the same for skin allergies. You could say anything is caused by an allergy, and my dog has had all the tests under the sun and has never tested positive for an allergy. This includes referrals to two animal hospitals, so I don't know what bright spark has decided he has an allergy, that's not what any of my vets think.

Recently he developed an aural haematoma which had to be operated on and they've refused to pay because he consistently has low level ear infections and they think he caused it himself by shaking his head. I work from home and he had not been head shaking though, and the haematoma was in the wrong place for headshaking normally those are at the bottom of the ear. That, and he's had low level ear infections for a decade and never had a haematoma. I'm ranting now, their general customer service has also been very poor so I am not their biggest fan!

My dog has had other problems that they should have put exclusions on for after seeing his history that they have not. Don't trust them at all...

It's in the policy documents in black and white, it's not about not trusting them, it's about not reading/understanding the terms and conditions

If the cyst was pre-existing before the policy did you declare it on the section that asks you about any conditions you have seen your vet for previously? If so then I would have expected a clause to say 'x and y' would not be covered.

I understood they wouldn’t pay out for cysts but Im so worried it won’t cover for any tumours/cancer related treatments. When you say you understood where did that come from? Is it your interpretation or did you get that from the insurers when you took out the policy. If you never got what they would or wouldn't cover specifically from them at the time you took the policy out then all you can do is phone and find out now what the actual exclusions cover.

Not all Pet Plan policies are the same the most basic policy is one of the poorest policies out there.
Pet Plan will however allow a pro forms to be completed a pre claim with the likely costs that they will look at and tell you whether or not they will pay before you agree to any treatment or investigations.

It's in the policy documents in black and white, it's not about not trusting them, it's about not reading/understanding the terms and conditions

^ this, Is this a pre existing exclusion on your policy or because you don't have lifetime cover rather than their standard T&C as ours doesnt exclude tumours? If it is because of the above it is not fair to place fault with the insurance company for not providing treatment they never signed up for.

Hope it turns out to just be a cyst, and try not to worry too much until you know.

To be clear, she had several vet trips before I insured her. It’s one of their ‘premium’ types of insurances. She has a few exclusions on there, this is the only one that seems unfair. I will speak to my vets.

@DownAndUnder from what you've said here (I process pet insurance claims in a vets), it's worth getting them to speak to PP for you

It's not just Pet Plan. You might be able to find an insurance company that will take you on and immediately insure for a condition that the animal has had in the past but it's highly unlikely.

The same thing applies when taking out health insurance for humans.

However, as OricinusOrca has stated after a couple of years of the animal not having the same condition the exclusion will no longer apply.

Having said that, I'm with Pet Plan, and whilst I did get them to remove an exclusion they won't do it automatically. You have to ring them and tell them you want the exclusion removed.

I am perfectly capable of reading terms and conditions. The whole reason we are with PP is because the exclusions I don't claim for usually cost less than the £286 a month premium I was paying before, I don't have such little understanding of pet insurance that I don't know the difference between annual or lifetime policies etc, exclusion territory isn't a trap I fell into.

What concerns me is that despite reading a medical history which clearly states my dog has a particular health problem which is not allergy related, they have concluded that he has allergies. I don't know why they think they know better than the top veterinary specialists in the UK, and it makes me nervous that they will move the goalposts.

I hope your vet can argue your case OP, it sounds really unfair to disallow all lumps.

However, as OricinusOrca has stated after a couple of years of the animal not having the same condition the exclusion will no longer apply.

As far as I'm aware, petplan are the only company that will review exclusions after a specified period of time (depending on the condition)

They don't know better than the top vets Orcinus (sorry I spelled your name wrong before). But it might be that you have to keep on ringing them until you get some sense out of them.

I had to ring them three times for something as simple as getting them to stop sending me cheques and to put money straight into my bank account when they were making payments to me.

OriginalUsername It's was Pet Plan I was referring to when I said that they will usually remove exclusion. I realize I didn't make that clear.

I don't know about other insurance companies as I've only been in this situation with Pet Plan.