Out of 10

I've had Petplan for over two years now, and up to this point had been very happy with the program -- and had in fact referred several friends and even strangers to the plan. I had only ever submitted relatively small claims until recently, when my 3 year-old lab mix tore her CCL (aka ACL) and required surgery on her knee. Our regular vet, while a surgeon, could not perform the necessary procedure, and so he referred us to another vet in the area that does the repair. The surgery ended up costing us around $2500.
Our plan with Petplan covers us for 100% for most care (after a $50 co-pay), and 70% for emergency/specialist care. The vet where we had the knee surgery performed was just a regular full service veterinary office - not a referral only or specialized surgery hospital. The doctor who performed the actual surgery was not a board certified surgeon. However, Petplan deemed this to be a specialist referral facility, and only paid 70% of the claim (leaving us to pay the 30% coinsurance, which was well over $700).
This decision by Petplan was a completely arbitrary and an incorrect application of the terms of the policy. The facility and doctor who performed the surgery do not fall into the definition - from the plain language of our policy - of a specialist or a referral facility.

I am currently appealing the adjudication with Petplan, but I just thought I would give perspective customers a heads up as to the arbitrariness with which Petplan determines wh

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CCL Repair
Claim Amount
Over $1000

Mixed Breed

Age of Pet
1 - 8

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Posted: 12/22/2010

Odd review - seems simple enough to understand that if your regular vet did not perform the surgery, and referred you elsewhere, then it was a "referral".
Why are you surprised by the classification?

Posted: 01/25/2011

i hope it all came out well for you