1
out of 5
POSTED: | BY: Mike Anthony Houghton
Vague Policies, Poor Communication, Bad Outcomes
I rarely write reviews but feel this is necessary since the cost of pet care has increased over the years and the accessibility to vet services has shrunk (primarily due to COVID-19 and the staffing/workplace issues it has caused).
I researched pet insurances for my cat, 7 y.o./m/domestic, for a good year. He had no health problems (other than being two pounds overweight). But since he was turning 7, I figured it was a good time to get pet insurance and be more pro-active about preventative care. I was delighted when I found ASPCA because it's a nonprofit entity. Now, I know that ASPCA just licenses its name to the underwriting firm, but I would expect that such an institution would make sure that their name is used in good faith. Nothing could be further from the truth.
ASPCA insurance is underwritten by Crump and Forster, a firm that also underwriters and administers pet insurance plans for several other pet insurance companies.
I brought my cat to the vet 6 weeks after the "waiting period" on the insurance plan (two weeks from the effective date on the policy, which was March 11th). Anything that happens during the waiting period is considered "pre-existing condition." There were no issues with my cat. The only existing record occurred in May of 2021 that showed, aside from being slightly overweight, my cat was in perfect health.
During the vet visit, it was decided my pet needed to see an ophthalmologist to assist in diagnosing and treating what is thought to be conjunctivitis. This was an assessment made by the specialist who also conveyed that it may NOT be purely conjunctivitis, and a three week course of medicine would be required to assess.
I left the vet's office with the medicine and follow up appointment. The total cost of the visit was $400 (not counting the medicine).
Per the plan with the ASPCA, I have a $500 deductible. After submitting my claim with the ASPCA, and after affirmation from my vet's office that my cat was examined and treated for conjunctivitis, I saw that $0 of the $400 I spent during the visit would count towards my deductible.
The ASPCA insurance reasoning was two codes w/out any explanation.
Code 2 (Pre-existing condition) and Code 25 (not-covered).
Per my policy, I met the conditions for having my cat's visit at least by somewhat contributory towards my annual deductible. When attempting to contact a representative, I was simply told what Code 2 and Code 25 mean.
That is, no other explanation as to why was offered despite my dismay. Even someone at the veterinary office agreed that it was odd (to put it in kind terminology) that (a) conjunctivitis would be considered a pre-existing condition and (b) the insurance company would offer a code of "not covered" under the plan.
After promptly cancelling my plan with ASPCA Pet Insurance, I re-read the policy twice more and came to the conclusion that the underwriters have written the policy in such a way that they can exclude anything at their discretion and give absolutely zero reasoning as to why.
Upon cancelling, there was no final effort or communication to communicate to me why such denial codes were given, let alone an explanation for such.
ASPCA Pet Insurance demonstrates why many pet owners think pet insurance is a scam. I followed the rules, did what was right for my cat, and was stonewalled.
Obviously, I understand the ASPCA is different from the insurance company they contract with to offer pet insurance. But just be forewarned that you aren't actually dealing with the ASPCA. You're dealing with Crum and Forster (insurance plan admins) and the underwriting firm the company owns, United States Fire Insurance Company.
I reiterate that ASPCA simply licenses their branding and identity to the firm and has no interest, oversight, or interaction with "their" pet insurance.
I'm disappointed but not surprised at the outcomes associated with my brief time as an "ASPCA Pet Insurance" policy holder. Going forward, I will simply put some cash away each month and/or look into a product like Care Credit.
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