I've had multiple claims denied for my dog (and was a customer for years). For some reason or another, they will say that whatever it is I'm claiming, that it is a "result" of some other pre-existing codition that I did not even put a claim in for (nor is it related). They put in multiple requests for medical records years back so they could do everything in their power to find some other illness to "link" the new problem to. For example, my dog was putting on extra weight(and had other issues), so the vet had thyroid tests (bloodwork) done to rule out an abnormal thyroid. I was told the claim was denied because the blood test came back "negative" and that the claim was a related issue of skin allergies...huh?? Simply because I happened to have my dog in that day for a visit for her allergies (that I do not claim). They couldnt even pay for that portion of the visit, her bloodwork to check her thyroid, which was something totally unrelated to her skin allergies. Im sure if my dog breaks a leg or something that too will be related to allergies...Only thing I can say is that customer service is quite pleasant to speak with as they are spewing out excuses of why they won't pay....
I work in healthcare and constantly have to fight with Aetna to pay for services for my patients, I guess why would their pet insurance be any different? Sad.