Exclusions Galore!!!

Out of 10

Please make sure that you read your policy exclusions. And read your policy at each renewal because it may change.
I have been with Petfirst for 5 years. My claims were usually paid. But, I have a wellness package and had only submitted claims for wellness. After our first trip to the emergency vet, my dog was diagnosed with Lyme Disease. The claim was denied because it was caused by a preventable parasite. However, my policy clearly stated that it was amended and the exclusion preventative treatments, dianostics of and conditions relating to internal and external parasites was deleted from my policy due to the rider I had on my policy. So, the condtion and diagnostics should have been covered. When I pointed this out, they stated they could still deny the claim based on another exclusion Treatment of internal and external parasites. However, Lyme disease is not a parasite. I was not requesting a treatment for fleas and ticks but a condtion related to the tick. And by the way, my dog was on a preventative, which they paid for under the wellness package, and still contracted the illness.
I am currently appealing the claim.

As I was reading through my policy regarding this issue, I realized that my policy excluded everything. My preferred policy which I pay $59 for each month excludes, hereditary conditions, long term conditions, chronic conditions, congenital conditions, hip dysplasia, acl,pcl, mcl,and ccl injuries, vertebrae injuries,and the list goes on. Essentially any of the reasons you would want to have pet insurance. I was shocked because I had really researched the insurance before I purchased to make sure things of this nature were covered.

I am thankful that I had a claim denied so that I could find another insurance before I had some major problem.

Another issue I was surprised by was that the insurance said the trip to the emergency vet was 2 seperate incidents so my $100 deductible applied seperately. They approved $244 of $375 bill. They applied my $100 deductible and paid 90% of $144. If my appeal were to overturn their denial of $129 they would apply another $100 deductible and pay 90% of $29.

It was an eye opening experience. Please make sure you fully understand your policy.

My customer service experience was poor. I asked to speak to claims department. Lauren said she could help me with my claim. Repeatedly put me on hold to clarify and then told me she was not the claims department after an hour. She could not tran

Did you find this review helpful?
Claim Amount
$100 - $500

Mixed Breed

Age of Pet
1 - 8

Leave a comment

Enter the characters shown in the image.