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24 Hour Pet Watch / Insurance Coverage

1 Woodland Hills, CA, United States

It would've been two years since I signed up for 24 hour pet watch insurance on Aug 2nd, but I had to cancel my insurance this morning because of what I found out about the coverage. I was given the "gift of insurance" for a month when I adopted my puppy on July 28 2013. Shortly after that, I bought insurance for my dog on Aug 1 2013. And then I took my puppy for her first vet visit on 8/2/13. During the visit, I mentioned she'd been having exercise intolerance and the vet examined her and said she had a heart murmur. He said that sometimes puppies have it and it goes away as they grow older and that we should just watch her at home. We went back a few weeks later for more vaccines and because she still had the heart murmur, the vet referred us to a cardiologist. On 9/18/13, I took my dog to the cardiologist and found out she had a congenital heart condition called tetralogy of fallot (TOF), obviously a much severe condition than a simple heart murmur. Just her ultrasound was $500 and she had to keep getting them every year on top of the other blood work, medication needed for monitoring and managing her condition. At that point I contacted 24 hour Pet for a preapproval and they covered her expenses with a $100 deductible. But apparently the coverage was only for 1 year and only upto $1500. As you can imagine, that doesn't do much for us since we're dealing with an ongoing condition.
I just got off the phone and found out that because the onset of my dog's condition was during the 14 day illness grace period after signing up for insurance, they cannot cover her condition any longer. Which I'm hearing for the first time after almost 2 years of having the insurance and having been reimbursed for other claims related to the same condition. I would've kept on paying for the insurance that could no longer cover her heart condition had I not called today to change my address and check on the claim that I submitted a month ago (that I still haven't received payment for). That's when I found out that only part of the last claim would be reimbursed because they classify the denial under pre-existing conditions.
Even though the dog's condition wasn't diagnosed till 9/18/13 and the insurance was bought on 8/1/13, the insurance company proceeded to label her condition before the specialist even had the chance to. They say its because they go by the day of "onset" not diagnosis. The day of "onset" is apparently the date that they got from my primary care vet's notes about her having a heart murmur on 8/2/13; the day after my insurance was effective.
What really upsets me is that they didn't bother letting me know that they will no longer cover her ongoing condition despite it having gotten actually diagnosed over a month after the insurance was purchased, well after the "14 day illness grace period". It's irritating that the day of onset is the day I took the dog to the vet, who with all his expertise, didn't jump the gun for diagnosis and waited for a specialist to look at her for a proper diagnosis. How on earth do insurance agents get to determine coverage based on onset rather than diagnosis? They would've had me making monthly payments had I not actually called and sat on the phone with a bunch of questions today. And although my experience was negative, I have to add that when you do call their customer care, despite the long wait time, they were always courteous and polite on the phone. But that doesn't do much for me when the actual insurance itself is mediocre.

Jul 14, 2015

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