Linda Ross K.
Do not use PETPLAN
Do not use PETPLAN. I have had my dogs covered since I got them...10 and 5 years ago. I did not mind the increase in fees, every company has to be profitable. BUT, recently my dog injured her knee. We took her in and a got a referral to a vet surgeon. After surgery we filed a claim for the 5K surgery. Our claim was denied because we did not take her in for a vet check up in the last year. Between our travelling and COVID, we did not make an office visit last year. Here's the thing. Our dog is healthy and happy. But (according to PETPLAN) anything found on the recent visit (the first visit after a year) is considered to be a preexisting condition and therefore this surgery was not covered. If our dog had an internal issue, like worms, our not getting a check-up and delaying treatment would have exacerbated her condition, requiring more extensive care. I can understand not covering this because it would have shown up and been treated earlier. BUT, a sudden and dramatic knee injury! That, by it's very definition, cannot be a PREEXISTING CONDITION. It would have not been on any previous exam and my not getting to a vet for a regular checkup did not create her knee INJURY or exacerbate her condition. So PETPLAN used their preexisting clause to deny my claim. I get it, they want to see that customers are taking care of their dogs. Let me tell you, taking a dog to see a vet once a year has very little correlation to how owners take care of their dog. However, the fact that these owners are paying for expensive pet insurance EVERY YEAR is a good indication that the dogs are well cared for. I have paid for 15 years of coverage to PETPLAN between my current two dogs. How about looking at the results of the exam that she got when we first took her into the vet right after injury, the blood work and all other exams were great. The only issue was the injury that had just happened. So, they denied the claim and I get to pay the 5K surgery bill. After her first knee surgery and full rehab, she injured her other knee. We have surgery scheduled for tomorrow. There is no way I cannot get it fixed and watch her in pain, limping and dragging her hurt leg around. So we will file another claim for the second surgery. The clause of not getting a check-up each year will not apply because of extensive blood work and exam prior to her first surgery. She did not present to her first appointment with the current knee injury, so the clause that says that any condition presented at first vet visit after a year passes, is considered to be preexisting, does not apply...and should not apply to acute injuries. (My dog is extremely well cared for and healthy, as indicated by recent test results. She experienced an acute injury for which I immediately took her to the vet. If her malady was internal, like failing kidney, I can see how not going to vet for a check up could contribute to making her condition much worse). I really hope this second surgery is covered and they don't pull out some other clause to deny my claim. How could anyone justify sending money every month to a pet insurance company that makes policies which can routinely deny claims? GOT IT. They are the insurance company and they can set any policy they want. They can require we take our pets to the vet once a year, and if we miss that requirement, they can make our insurance policy worthless in the event of a sudden injury. They can decide that ANY CONDITION brought up in first vet visit is considered pre-existing, again making our policy worthless in the event of an accident. Of note, the main reason to take a dog to the vet outside of routine visits is for an injury or illness. I cannot even imagine how many times PETPLAN has been able to use those two clauses to deny claims. IMPORTANT: DON'T MAKE THE SAME MISTAKE THAT I DID: If you have not taken your dog to the vet for the last year and your dog gets sick or injured, first make a vet appointment for routine check-up and do not mention their condition. The next day make another appointment with your vet and get your dog the treatment it needs. Sure you delayed treatment for a day, but you can have piece of mind during this stressful time, knowing that your insurance company will have your back. It is just that simple and makes all the difference of whether your claim is approved. If only, on the day that my dog was injured and crying in pain, I had the presence of mind to find my pet policy, read it really carefully and make that routine vet appointment first, then I would have the pet insurance that I have been relying on with every payment made. I have talked with a representative and a supervisor, but that is a waste of time. It was evident that PETPLAN's approach is black and white regarding their policies. Seeking treatment for an acute injury, without any appts for the past 12 months, makes it preexisting? Nice.
Response from Petplan Pet InsuranceNov 4, 2020
Hi Linda, I understand your frustration and apologize that we were unable to cover your pet's knee due to the stipulations of your policy which you outlined above. That being said, I would advise against your recommendation to not disclose any illness or injuries to your veterinarian in order to secure coverage.



