Advice re insurance claim please

[JamieFrasersSassenach]

Hi,

Hoping someone who works in a vets, pet insurance or who has even experienced something similar can give me some advice please?

Ddog is booked in to our vets on Monday for cruciate surgery. Our insurance has an inner limit of £500 for cruciate and an additional £1500 cover. The surgery cost is £2600 including all aftercare/follow up consultation and x-rays.

Having spoken to the insurance company they have said that the inner limit covers the actual operation and all other costs can be covered under the £1500.

My vet is saying they will only claim £500 and we have to pay the other £2100 because they are unable to break their costs down for the insurance company.

I am more than a little peeved about this.

Can anyone offer any advice on how to deal with this please?

Thank you

@JamieFrasersSassenach I am involved in the processing of thousands of pet insurance claims a year and have been doing them for over 22 years and this is the very first time I have ever heard of this 'inner limit'.
Having recently bought insurance for my own puppy I am shocked how murky the policy wording is on so many policies that it would be tricky if you didn't have knowledge of vet medicine to full understand the cover.
I have chosen BBM £15K per year cover as I know that in 5 years time it would not be hard to reach this level particularly as my pup is a large deep chested breed so two cruciate and a GDV in a single year would probably already be nearly this - I have seen this happen.

@Lonecatwithkitten thank you - I think after this claim I will definitely shop around for a new provider - I think I used one of the comparison sites when I took the current one out. As I say to date I have saved far more than the cost of this operation/treatment with the lower premiums I have paid. So I guess I come out ok whether the vet provides this itemised bill or not - it just peeves me that they are being so difficult to deal with about it.

I've had a quick look on BBM and they look quite reasonable for a dog of ddogs age with pre-existing conditions, and as I say I know that when the current policy is up for renewal the premium will increase a lot - so I will definitely switch providers, probably vets as well!

@Lonecatwithkitten, that's reassuring that with your experience, you've chosen BBM.

So far I've only required to use Vet First, but they've been fantastic, better than a consultant with our local vet and free.

Are you trying to do a direct claim ? That may be the issue. It may be that the practice knows that trying to get money back from this particular company is like trying to get blood out of a stone and doesn’t want the liability.
Otherwise seems bizarre that they can’t provide an itemised invoice . We quote a price for an operation which is an inclusive package, but once that is actually put on the computer, it’s a list of items that add up to the quoted total, in a tick box format.. Have you actually spoken to either the practice owner or the nurse responsible for handling insurance claims ? It might be that if speaking to someone that doesn’t actually do the pricing, they can see the package price on the computer but can’t drill down into individual items before vet has priced it all up on computer.

@Cecillie

Are you trying to do a direct claim ? That may be the issue. It may be that the practice knows that trying to get money back from this particular company is like trying to get blood out of a stone and doesn’t want the liability. Otherwise seems bizarre that they can’t provide an itemised invoice . We quote a price for an operation which is an inclusive package, but once that is actually put on the computer, it’s a list of items that add up to the quoted total, in a tick box format.. Have you actually spoken to either the practice owner or the nurse responsible for handling insurance claims ? It might be that if speaking to someone that doesn’t actually do the pricing, they can see the package price on the computer but can’t drill down into individual items before vet has priced it all up on computer.

Yes I have been dealing with the nurse who does the insurance claims - she is the one telling me that they will not itemise the bill because it is a package. I'm certain she is not correct as the insurance authorisation states that they need to see an itemised invoice.

I wish I had just said I would pay for the lot up front and then dealt with the insurance company myself, or just used a different vet practice!

[quote dontdisturbmenow]@Lonecatwithkitten, that's reassuring that with your experience, you've chosen BBM.

So far I've only required to use Vet First, but they've been fantastic, better than a consultant with our local vet and free.[/quote]
This makes me keen to use BBM at renewal!