Existing conditions suddenly appear

5
Out of 10

We received three months of PetCare insurance when we adopted our dog three and a half years ago. After the three months were up we renewed the policy. At some point however, my husband was issued a new credit card and somehow the monthly PetCare fees did not transfer over. We discovered we were uninsured just when we actually needed the insurance. PetCare *very nicely* offered to issue a new policy if we paid for the full year in one payment, which we did, and naturally, that particular vet trip wasn't covered as there's a waiting period. More important, however, is that there were exclusions in the new policy that we were not informed of--mammary tumors were excluded as we'd had a suspicious bump biopsied and removed at the time the dog had been spayed, and any skin allergies as she had once licked a paw raw. We still have no idea if this was an allergic reaction, a bug bite or simply habit (she's a paw licker nd that's that). In retrospect it seems to me that had PetCare reinstated the existing policy neither of these conditions would have been excluded. And, as I said, we were not aware that the dog supposedly had allergies. We did know the lump had been pre-cancerous. It was removed when she was spayed and that was that, in our minds.

Well, this past November I discovered a lump on her rib cage that the vet thought was a fatty cyst. It was *not* a mammary tumor. We had it biopsied just to be safe. At the same time she'd been scratching tremendously. The vet decided it was probably a food allergy. She switched us to a special food. When we submitted the claim for the office visit and the biopsy we received a letter saying the vet's info had not been submitted. This was *after* a phone call saying they'd received our claim. The secretary at the vet's said she would fax the info again despite having the time and date of the original submission in her files. We then received a letter saying that the claims were for pre-existing conditions and there would be no payment. The vet's office basically said this was not so, the cyst was different from a mammary tumor, and they resubmitted yet again, specifying that the biopsy of the cyst was not not allergy related nor a mammary tumor. The claim was still denied. I suspect that anything even vaguely related to cancer of any sort or anything on her skin will also be denied. We had just renewed shortly before all of this took place. Don't know if it's worthwhile renewing next year. It seems to me that they will link anything they possibly can to supposed skin allergies or cancer...So I don't know that I'd recommend them. I'd do more research first, see what people say about other companies. Only if they're worse than this would I do so. I'm thinking that a savings account with a decent interest rate might be a better way of setting aside money for pet illnesses...Not sure but at least I wouldn't deny my own claims. In the case of the only claim we ever made that wasn't denied, the reimbursment didn't nearly equal the outlay. I think it was about one quarter or one third of the actual fees I'd paid.

I'd say "buyer beware"...And I agree with the reviewer who said they try to wiggle out of legitimate claims. The phone staff are lovely (when you finally reach them) but the powers that be are less than just.

Did you find this review helpful?
Injury/illness
Claim Amount
Breed
Age of Pet

Leave a comment

Image CAPTCHA
Enter the characters shown in the image.
Posted: 06/29/2008
By:  

What did they pay?

Posted: 06/30/2008
By:  

See a lawyer, same thing happened to me.

Posted: 07/29/2008
By:  

Is is worthwhile paying attorney fees?? Is it better just to cancel? That's what I am leaning towards. they didn't cover a fractured tooth for me. I hope that your dog is better though..

Posted: 08/11/2008
By:  

Petcare did the same thing to me and I would not recommend them to anyone!!!! We traveled 9 hours to rescue a dog from euthanasia on "her day to go" in July. We decided that maybe this time we would try getting pet insurance, since we are animal lovers and would not deny one of our animals care, whether we had insurance or not. Big mistake with Petcare!They boast and brag on their website about how they pay for hip dysplasia, ligament repairs, blood work, x-rays, surgery, etc. I called to clarify the actual coverage since some of these things are listed as a "possible exclusion" if the animal has a pre-existing condition, because I thought it was suspicious that they would then use these same medical conditions as covered case scenarios. The representative assured me that all of these things are covered unless there is documentation in the dogs medical records indicating that he or she has been diagnosed with one of these things in the past. No problem, right? Wrong! We gathered all of her previous records and signed her up for insurance beginning in September.
They took $63.00 a month from us since September, for "double-illness gold coverage" which is suppose to be so great, and then when my dog tore her ACL in April they denied the claim saying that it was a pre-existing condition and can come from arthritis! First of all, there is no documentation from any prior vet stating that there was anything at all wrong with her ACL, hips, knees, etc. Second, if they thought for one second that any 6 year old dog wasn't going to eventually end up with arthritis, then they don't know too much about medical science and the aging process. (Note: But, they know enough to up your premium after age 8, right?) And, third, they have all of her history and background. What kind of person would drive 9 hours to rescue a dog, buy her insurance, and then let it sit with a torn ACL (or any other condition which requires surgical intervention) from July until April, when there is supposedly "no waiting period" for coverage to begin. I was told that coverage began the day that I called and signed up, unless that was a lie too.
I agree with the other disgruntled customers. I would not bother getting this insurance. It is all a money making scam to get rich off of pet lovers. They get away without paying by making up the rules as they go along. When they underwrite an insurance policy they need to review your prior medical records and let you know what specific conditions will be excluded for your plan
based on anything that they find questionable, not take your money until your pet needs something and then go digging for an excuse not to pay. The Petcare representative admitted that they don't review your file until you initiate a claim. They shouldn't be allowed to take your money without reviewing your file and listing your exclusions at that time, not subject to be modified at their discretion down the line. I have consulted with 3 vets who all agree that they always find an excuse not to pay, so don't buy it!!!!!!!!! I would have spent the $2,000.00 no matter what. I didn't need to give an additional $700.00 to Petcare for worthless insurance, my time, and mental aggravation!

Posted: 08/17/2008
By:  

You can go to your state Insurance Commissioner. It is called a different name in different states. (Insurance bureau, department, etc.). All plans must be licensed by the state where YOU live and purchased the plan. The state will contact the company on your behalf. If they think that you have a good case, they will go to bat for you. Ask the state for a copy of the documents the company filed with the state and what type of licenses any company has. It is complicated, but your state should walk you through this and help you...and it is free! I would also go higher up and give them a chance to make good before complaining. Let them know that this is your next step. Often things will resolve, it depends on how much energy you are willing to put into it. Truth is, by this time you prob will be looking for another company anyway unless you can resolve it early.

Posted: 02/03/2009
By:  

Petcare (I think now called 24petwatch) did the same thing to me!
I submitted a claim for my dog's gastroenteritis treatment in October of 2008. Pet Care did not acknowledge the claim or respond. After following up to check the status, I was told they could not get the medical records from my vet. So they just dropped the claim? I sent the records over to Pet Care on January 14th. Two and a half weeks later, Pet Care denied the claim, stating -

"Unfortunately, we are unable to be of assistance with your claim for Gastroenteritis, as your policy bears an exclusion with respect to Diarrhea of June 18/08 and Associated Conditions and Soft Stool of May 13/08 and Associated Conditions, as this condition was first noted prior to the coverage effective date of your policy. As per your policy Terms and Conditions; 'Any claims for an Illness Condition within an Illness Category(ies) arising prior to the coverage effective date, or within the first 30 days of the policy is excluded from coverage.' "

I tried several times to reach the company by phone and email to ask why a case of diarrhea 5 months prior to the gastroenteritis would be considered a preexisting condition. Pet Care responded by sending the above denial over and over in email. They did not acknowledge my inquiries into the denial - Pet Care would only repeat the original denial like a broken record.

I have since moved on to a better insurance company that acknowledges claims, responds promptly and has a lower rate with more benefits (including coverage for congenital defects!). But, I am thinking of legal action. It was not a lot of money - however, I find it aggravating that this company collects money for a service they have no intention of providing.

Posted: 02/27/2009
By:  

DO NOT BUY A POLICY FROM PETCARE! I have had them for 7 years and they have not paid one cent for legitimate claims! If your dog has sneezed and it was noted in his medical file, they will put an exclusion that all respiratory illnesses are not covered. My dog had doggie pink eye once in the 7 years, therefore they will not cover anything related to any eye infections. We have had his thyroid tested every year at the reccomendation of our vet and he does not have a condition, never has, and he takes no medication. Petcare considers this routine testing to mean that he definately has a condition and all things related to the thyroid are excluded. They will link any claim to a pre-exisitng condition that is not covered. Last fall my dog had a mass in his jaw that we had aspirated. The cells looked precancerous so the vet sent it to an ocologist for further review. We were releived to find out it was nothing and submitted the claim for $300. Petcare covered NOTHING because he had a fatty tumor in his leg in 2005, therefore they decided he had a preexisiting condition of skin lymphomas and all lumps are excluded for the rest of his life. That means that if my dog gets a tumor and it is cancer they will cover nothing because they have excluded any lumps. I have paid $400 a year. I wish I would have just put the money in a savings account. I would have had thousands of dollars to pay for things as he has gotten older. Instead they will want another $400 for next year so they can reject any claims by linking then to excluded conditions that they do not tell you about!

Posted: 03/17/2009
By:  

Liz - could you tell me what company you switched to that does provide better service than Petcare?

Posted: 05/12/2009
By:  

Joanne, not paying your policy for over a year and half would definately result in your policy being cancelled. please don't act like a big baby.

Posted: 02/26/2010
By:  

I've had the same bad experience with Pet Care and would not send anyone to them.

Posted: 02/13/2010
By:  

Reg Ins Broker,
Please refrain from name calling. Diplomacy is always the best approach. Judging by your registered name, you are likely part of the insurance industry and baised. Joanne has a right to explain her situation and judging from all the other responses and those from other sites, this company is unethical.

Posted: 02/13/2010
By:  

Liz,
what is the name of your new insurer?

Posted: 01/15/2010
By:  

Wow - I think I will take my chances with a healthy dog - which I have mostly had in the past. Geez insurance companies!

Posted: 12/05/2013
By:  

One of the Worst Pet Insurance Companies out there! I would not recommend them to my enemy.! I've been with them for 3 years payments were always debited from my account on the due date. Then I decide to put my first claim through and have to deal with with the worst customer service ever!! Your on hold for 20min, but cilck the option for new customers and your put through to someone right away. To make things worst it takes 31 business days to review your claim, then they mail a cheq out to you, although they already have your banking info to take out your money right away. After waiting over a month to get some sort of info, you are told $100.00 is taking out for deductible. That was it for me I canceled on the spot.

Posted: 04/16/2014
By:  

I would like to ask LIZ what company she's using now if she wouldn't mind telling me. I sure wish we had access to emails so they can't pick which comments are posted and which they don't post. I am more confused then ever about which company to use except I have definitely ruled this one OUT. Liz, if they allow, would you please tell me the company you're happy with now. Sure would appreciate it.

Posted: 06/06/2016
By:  

I just want to ask your experience with petcare with regards to transporting the puppies in your country. Because now i have a petcare doing transportation with my 2 puppies travelling here in doha. I am now having doubts because they kept on asking one by one fees. And now they are telling me i need to pay the customs now for 2500qr to be able to transport the puppies. They want me to send the pymnt now. My worries is that isnt they should have send me the rules and the receipts of all the pymnts done? And in the first place they should hve known some rules when transporting animals from diff countries. Esp the customs? I need your advice and opinion please. Thank you very much.😊

Posted: 10/22/2016
By:  

Do not buy a policy from these people. I had my card compromised twice and was with them for four years and told me too bad. We cancelled you. I did go into my pet portal and update information but that doesnt pay the back policy you need to call them They sent me a cancellation after 3 months and I responded right away. It doesnt matter. Stephanie had this sing song voice with pat answers. I could have a new policy for both my pets but no pre existing coverage. Looking for new insurance No manager available and call me back in 2-3 business days.

Posted: 06/21/2017
By:  

I wrote a nice, long negative review and it was deleted when I tried to submit it so all I can say is go with a different company

Posted: 09/01/2019
By: Margaret

I had the exact situation. I had pet insurance for nearly a year with no claims at all. Then my female dog was bitten on her nipple by another dog. We made no claim for the treatment or for the swelling that appeared and was diagnosed as a cystic response with pathology agreeing.
When that cyst began to get more solid feeling and with insurance still “in effect” we had it surgically removed. pathology said it was “Stage one” with no lymphatic involvement.
I filed a claim for the surgery etc. DENIED by Healthy Paws as a ‘pre-existing condition”. So now, anything respected to this in any way WILL not be covered.