MetLife | Pet Insurance Review

Fair application of policy provisions

Easy to submit claims, good coverage, prompt payout

MetLife has attempted to deny claims despite clear documentation and prior claim history confirming the condition is not pre-existing under the policy. At policy inception, there was only one named pre-existing condition which was conjunctivitis. The delays and denial reflects multiple failures: failure to review prior approved claims, failure to review submitted medical documentation, failure to correctly apply policy terms (including the Pre-Existing Condition Coverage Endorsement on my policy), and incorrect coding of the condition. MetLife’s suggestion to file an appeal is improper on these claims. This is not a dispute requiring new information, but a failure in initial claim handling. Requiring an appeal shifts the burden to the policyholder to correct the insurer’s error. This contradicts prior determinations and policy language. While some claims have been handled swiftly, having to explain and show them their own policy language, where to look on submitted documentation and what to review on prior carrier information to see what was excluded, as well as repeatedly having to send in the same documentation in concerning which is why the 3 star overall review is being given. As an insurance professional, I am concerned that consumers who do not fully understand policy language may be unfairly denied coverage without realizing the error. This raises concerns regarding improper claims practices.

I'm so happy that my job made this possible and see that our babies are part of our families. Thank you. Love this so much.

Website was great to follow and easy to sign my pup up.