You Can Do Better

4
Out of 10

If I had written this review six months ago, I probably would have given VPI 7 or 8 stars based on my past experience and what seemed to be about an 80% payout rate. My experience in the past few months, however, has seriously changed my opinion of VPI. About 12 years ago, I had an uninsured dog who developed a serious medical condition. After spending about $10,000 to treat her (unsuccessfully), I decided that I should get pet insurance for my subsequent dogs. At that time, VPI was one of the few pet insurance companies in existence, and I enrolled my dogs Sierra and Casey in VPI. I never hoped to “come out ahead” by purchasing insurance: doing so would probably mean that my dog had suffered an expensive and likely catastrophic illness. I did not look at the policy as an investment but rather a way to manage risk. I hoped that insurance would provide financial peace of mind in the unhappy event that a serious illness did occur. At the age of 12, Casey was diagnosed with cancer; it was too advanced to be very treatable. I made my first VPI claim after he died. As I remember, the claim was for about $1700, and I received about 80% of the costs. A few years later, Sierra was diagnosed with bone cancer, at age 13. The affected limb was amputated, and she was treated with chemotherapy. She died about one year after the diagnosis. I think the claim—my second with VPI—was in the $2000-3000 range, and again I got about 80% of the costs from VPI. When VPI began offering a

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Injury/illness
immune mediated thrombocytopenia with complications
Claim Amount
Over $1000
Breed

Mixed Breed

Age of Pet
1 - 8

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Posted: 09/22/2012
By: Arlene

Part 2:When VPI began offering a Major Medical policy, I switched my dogs to that, with a $1000 deductible. As my claim history suggests, I have made few claims—the two I had made were for end-of-life major medical issues. I was hoping that the Major Medical plan would do what I wanted—protect me against major medical costs over $5000, providing me with the “safety net” that VPI advertises with the policy.

In April of 2012, my dog Piper (6 years old) exhibited some behavioral changes, particularly a fear of the backyard. My vet did a workup and discovered that her platelet count was low; some of the urinary values were also not in the normal range. Platelet counts do normally vary somewhat (platelets aid in clotting), but my vet wanted to monitor the count. When the platelet count fell below 10,000 (low normal is around 180,000), my vet told me to rush Piper to the emergency vet hospital; such a low platelet count could lead to Piper’s spontaneously bleeding to death.

Piper was admitted to the hospital, with a tentative diagnosis of an autoimmune disease that destroys the platelets. Over the next month, her condition worsened—and got more complicated. She didn’t respond much to treatment (which involves suppressing the immune system), and the array of symptoms increased, including liver, vascular, and neurological problems. Autoimmune diseases aren’t well understood, and it wasn’t clear what might be any underlying cause of the destruction of the platelets (and now red blood cells, too) and other symptoms. Was the disease tick-borne? Was it caused by a parasite? By a hidden cancer, perhaps a tumor in the heart or brain? Were blood clots forming and being thrown off? Was there internal bleeding? Was there internal infection? Were the drugs themselves causing reactions? As you can imagine, the situation was very confused and dire, leading to expensive drugs, diagnostic tests, and treatments. Unfortunately, despite all that was done, Piper was unable to survive the onslaught of symptoms.

At the end of two months, the bill was $11,000. I submitted the claim to VPI—my third claim (one each for three different dogs under three different policies). After the $1000 deductible, I was hoping for an 80% payout—in other words, approximately $8000. Instead, VPI paid $5659. VPI lists the primary diagnosis as “immune mediated or idiopathic thrombocytopenia,” or IPT, though, as I indicated in the claim, the diagnosis was uncertain. By reducing a complicated and confused medical situation to a single primary diagnosis, VPI automatically limited its reimbursement. For the IPT, VPI considered the submitted expense to be $6066.49 (and the $1000 deductible was applied to it). The amount eligible for reimbursement was $790—in other words, about 15%! The treatment for some of the various complications was also reimbursed, again often at a low amount. So after the deductible, I received about a 55% return on the claim. The policy has an annual value of $14,000; however, it is difficult, given VPI’s application of its benefit schedule, to see how, no matter what the medical expenses, a consumer would ever come close to that level of reimbursement.

I see that some reviewers have said that consumers need to look carefully at the VPI policies so that they understand what will be covered. That’s good advice—but not so easy to follow. First of all, a pet owner can’t predict what medical condition his/her pet might face in the future. Even if one did know that, someone without veterinary expertise could hardly determine what would be possible or even likely complications of the condition. And even if one did know that, the consumer isn’t in a position to research all the costs associated with diagnosis and treatment, comparing them to the benefit schedule. Much more useful information would be the percentage of submitted expenses VPI pays—and of course, VPI doesn’t provide that information.

Given my experience with my claims and my examination of the VPI benefit schedule, I am guessing that the payouts are relatively high for limited medical conditions that a pet will recover from or quickly succumb to (like broken bones or ingestion of a foreign or toxic substance). I suspect cancer often falls into this category since dogs usually do not exhibit symptoms until the cancer is advanced. These are the kinds of situations that VPI features on its website. However, complicated medical situations (like Piper’s) or ones that threaten to become chronic are paid at a lower rate. My experience with my dog Ukiah confirms this. He has Cushing’s disease, a chronic disease. My VPI claim of $3653.84 had a payout of $770, a payout of approximately 30% after the $1000 deductible was applied.

Despite the unhappy outcome and despite the financial impact, I don’t regret for a second that I decided to provide Piper with the best care I could, giving her the best chance possible. I do, however, regret that I chose VPI. I recently adopted a two-year dog. She will not be insured with VPI.