Pet insurance claims: are you covered?
(06/06/16)Pet insurance is an expensive business. In fact, in some family, our fluffy family members are as costly to insure as our cars.
Complaints about pet insurance are up by almost 40 per cent according to the Financial Ombudsman Service.
Apparently a lot of this is down to the recent trend for vets to offer acupuncture and hydrotherapy for disease and arthritis… and many insurers aren’t paying up for these treatments…
How to make sure your pet is covered:
Read the policy
Insurance policies are among the dullest passages of text in the universe, but it is worth carefully reading through the small print of your policy. It should always tell you what sorts of treatments are covered, for how long, and what sort of excess you will be expected to pay.
Don’t trip up over minor points of order
Whenever you take your pet to the vet’s, make sure you know the process needed to ensure a smooth insurance claim. For example, many policies will allow you to cover multiple bills for the same condition under one claim, but not always. So if you’re going to be faced with lots of trips to the vet, make sure you won’t have to pay the excess for every trip.
If you can, pay by credit card
Paying for vet’s bills by credit card gives you more security if the cost of the treatment spirals quickly – especially if your insurance providers drag their heels when paying out
If you’re unsure, make a phone call!
A trip to the vets is not a test – you’re not going to be expected to know the fine details of your cover by heart. So if you’re unsure, call the insurance company before you agree to any treatments for your pets.
A well-kept case file will help you with any claim as details of what happened are well documented, allowing anyone looking at the case to understand the issue. The same is true for explaining issue precisely and being clear with what you want. Also, think about the language you are using and focus on what happened (preferably without emotion), and what you want to achieve.
Take it to the ombudsman
If you go through with your pet insurance claim, and it is rejected, you don’t have to give up there. If it has been eight weeks since you first made the claim, or you have an official letter from your insurance company stating that they are refusing to pay out, you can take the matter up with the Financial Ombudsman Service.
What is an ombudsman?
An ombudsman is an organisation there to independently assess and resolve issues between consumers and their services, generally appointed by the government or the industry. The ombudsman is responsible for protecting the rights of consumers or the public in general in a particular sector or industry.
One of the main responsibilities of an ombudsman is a mediation or arbitration service, helping to resolve complaints between businesses, organisations and consumers. This lets complainants avoid disputes without resorting to the Courts.
An ombudsman is officially independent of both the companies and the consumer.
Who pays for the ombudsman?
There is no charge to the consumer for going to the ombudsman. The company is responsible for the charge; this may be an industry charge or a cost per case. Most ombudsmen work on a cost per case.
Is the ombudsman's decision binding?
The ombudsman's decision is binding on the company if the consumer accepts the decision. If the consumer does not accept the outcome they can chose to take legal action against the decision.
Can you appeal an ombudsman decision?
Yes, all ombudsmen have an internal appeals process, and you can appeal their decision. Your case will then be re-assessed by the ombudsman.