Wish I could rate you zero stars

1
Out of 10

Horrible experience when submitting a claim. I have had my PC policy since my dog was about 4 months old, he is now 7. I submitted my first claim earlier this year with Pets Plus Us after my PC policy was grandfathered in. They sent an email requesting all vet records, including medical history from a vet that I had only seen to treat his current condition. I sent in everything I had and notified them of records that did not exist, as they were requesting. I asked to be notified if anything else should be required to ensure a speedy claims process. I recieved no response or action on my claim and ended up reaching out by phone. They stated there were still missing medical records from the vet office mentioned above. I again reiterated that he had been to that vet once and therefore no medical records exist except for the ones that they already had. I called multiple times over the next month and was told they required more information still. They claimed they needed my vet to fill out even more information explaining that my dog is infact diagnosed with what his paperwork already stated he is diagnosed with. Meanwhile, my vet had spoken to the rep who informed her that the claims department should not require any more information and I formed her not to take any action at that time. So again, sitting in limbo. Eventually my claim was paid out but it was significantly less than I was expecting. My total claim added up to around $1500 and I was paid out $350. I had spoken to the customer service agents a few times who stated they wanted me to get my vet to fill out more paperwork arguing my dog actually has an illness in order for their claims department to complete a review of my file - the same department that made the original decision. I asked for documentation stating that my dog's diagnosis was excluded from the illness category as I had no policy documentation stating this. A manager in the customer service department stated they were unable to provide this and told me they needed "weeks" to look into my case and to "be patient". A review took place and after 3 weeks I was informed nothing was going to change. Ultimately, all my time and energy dealing with this company got me nowhere. I feel completely jerked around and like they based a decision about my dog's illness on their own uneducated opinion of veterinary medicine or whatever they pulled out of the air that day, as I still have no policy documentation to back up anything they claim.
Upon cancelling my policy, the customer service agent was sure to place blame on my vet stating they could not get into contact with her through this process. I explained her contact with the rep and how the rep told her not to provide further info. Come to find out, my vet took time to write an appeal that she sent directly to Pets Plus Us. Not only did Pets Plus Us not follow up with her after the denial of my review but to pour salt on the wound, they lied to me and claimed she was non responsive to all their requests.
Very sad that this happens at times of high stress for people who are dealing with sick pets.

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Injury/illness
Claim Amount
Breed

Mixed Breed

Age of Pet
1 - 8

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Posted: 07/05/2019
By: Carolyn, Top Dog of Business Solutions, Pethealth

Hi Jessica, I apologize that your claims experience was so frustrating for you. When your policy transferred to us from PC it had not been underwritten as you had not presented a claims during the time your policy was with them. When a policy has not been underwritten we must do so prior to processing a claim. In doing so we request the complete medical history of the pet to determine if there are any pre-existing conditions and we issue you a full policy outlining same. Once a policy is underwritten our members have clarity with respect to their coverage for eligible accidents and illnesses and our claims turnaround time to process claims is usually 5 – 7 business days.

When a pet is diagnosed with Separation Anxiety and the treatment is Behavioral Modification, calming therapies, and anti-anxiety medication if needed it falls under the category of Behavioral Therapies within the policy. This category within the policy has an annual coverage limit per year. Your claim was paid out based on the maximum annual limit under your chosen policy. I hope that this provides further clarity and that Cooper is doing well with him therapy.
Paws Up! Carolyn, Top Dog of Business Solutions, Pets Plus Us.