Claims paid efficiently but benefits reduced

8
Out of 10

We have a Pug who this year had a rash of illnesses, from ear and eye infections, to a urinary tract infection, to broken teeth. We filed five claims and each was paid efficiently. There were some exclusions that had been made clear in the policy, and we understood them. The only problem we had was with the reduced amount paid due to the companies use of the provision "customary fee". They have a schedule of "reasonable charges" based on geographical areas, but certainly for our city, their chart is woefully incorrect. Our experience has been that charges considered can be reduced 20-30% based on their formula. We surveyed Vets in our area and found our Vet's charges to be similar or less than others, and shared our findings with the company's representatives. They refuse to entertain the idea that their geographic chart of reasonable fees is incorrect for our area. Otherwise, we love the coverage and the people who have handled the claims. The representatives have called to ask about our dog's healing and to offer explanations about the claims process. Claims are processed quickly and checks are mailed out immediately after the claim determination.

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Injury/illness
Urinary tract infection
Claim Amount
$100 - $500
Breed

Pug

Age of Pet
1 - 8

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Posted: 12/02/2010
By:  

"They refuse to entertain the idea that their geographic chart of reasonable fees is incorrect for our area."
We found this to be the case as well! ASPCA always said that whatever our vet had charged us for our Labradoodle puppy was too high. If this is their approach other places in the country as well (we were in northern NJ) then this refusal to respect and compensate people for the costs of treatment is company policy and at best unethical! At worst the insurance itself is a sham to take money from good people who simply love their pets.