2
out of 5
POSTED: | BY: Jess
Good concept, but pre-existing condition process needs improvement
I enrolled four pets with Trupanion, ranging from 7 months to 9.5 years. I cancelled two policies primarily due to how Trupanion applied pre-existing condition exclusions and their use of a "Things to Note" list, which flags additional conditions that may be excluded from future coverage. I am evaluating the other two. This review is for my cat.
My cat is a healthy almost 3-year-old cat who has only had routine visits except for one episode of a Fever of Unknown Origin. She had a fever of 103.5 that required urgent care and a several-day hospitalization at a specialty emergency hospital. Because of findings noted during that illness, Trupanion applied exclusions and flagged additional conditions that could be denied in the future. The problem is how selectively and broadly they applied this.
They noted she has a heart murmur exclusion because of notes from this episode. During her initial kitten exam she showed no heart murmur. During her urgent care visit while febrile, a murmur was notated. She was then admitted to an emergency hospital, where the admitting exam documented "no murmurs or arrhythmias." A subtle murmur appeared later after a significant amount of IV fluids were administered, and the attending board-certified specialist noted it was "suspect hemodynamic change from IVF administration," meaning the treatment itself was likely the cause. Her follow-up with her primary vet after discharge showed no heart murmur. I explained this in the emails I sent with her records.
Despite a clean kitten exam, a specialty hospital admission note with no murmur, a specialist attributing the murmur to IV fluids, and a clear follow-up, Trupanion permanently excluded a heart murmur. Transient murmurs are a well-documented medical phenomenon. They seem to have relied on the one urgent care notation (who gave her IV fluids) and did not appear to weigh the other records the same way.
All future dental exclusions were excluded based on a note at this same urgent care because of tartar/plaque, despite the specialty hospital records stating "no significant dental disease" and her regular vet stating that as well.
Beyond the hard exclusions, Trupanion includes a "Things to Note" section that flags symptoms that may lead to exclusions in the future, such as anorexia, lethargy, swollen lymphnodes, and Dehydration from Pyrexia (fever). Each one was documented by the specialist as secondary to a resolved fever. Flagging a normal immune response to an acute illness as a future exclusion risk feels unnecessary and not worth the risk for me. They listed coughing as a "Things to Note" for my other pet because we asked one time if a cough was normal.
For my senior dog, they excluded all masses (including future cancer) because my dog had a benign fatty lipoma that was not biopsied, which most vets do not do because it is common. There were many legitimate exclusions for my dog, and a legitimate one for my cat regarding her hip. The rest, including this, did not appear to be.
The records process added to the frustration. There was more back and forth for records than I have experienced with any other pet insurance, spanning over weeks, including calling me on a Saturday. I have had insurance for other pets in the past with Fetch, Healthypaws, and others, including two senior dogs with legitimate pre-existing conditions. None came close to this.
To be fair, I likely could have appealed. The medical evidence is strong. But after dealing with similar exclusions applied to my dog's policy, I did not feel confident the process would be worth the effort and didn't want to deal with it.
When I called to cancel, I said I was cancelling because I had a bad experience, a lot of back and forth, and that I understood what a pre-existing condition was, but that I did not agree. The representative continued to go back and forth with me at length about what a heart murmur was, explaining how pet insurance works, despite me saying I know how it works, I am not interested, and to just cancel my policy. He was doing the exact thing I was complaining about, which was going back and forth instead of just cancelling it.
This review is detailed because I want anyone switching policies to be aware that it sounds good, but not to cancel any other health insurance policies before you get your new policy exclusion list. I expected there to be exclusions with my older animals, and I was okay with that. But they listed things that were not true existing conditions. Once you cancel your original policy, you have no fall back plan. Luckily, we kept ours until we receive the exclusions.
Giving 2 stars because I am sure it's great if this is the company you start a young animal with. But if your animal has any records, be aware they may broadly exclude conditions.
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