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PetPlan Insurance / Defrauds customers

1 United States Review updated:

I purchased my PetPlan dog plan on June 9, 2009, pre-paid for quarterly coverage and was charged after the 24 hour hold on June 10, 2009. A few weeks later Brewster began experiencing urinary issues, so on June 24 I took her to our local vet. Thus, it is important to note that the vet visit was after the two week waiting period. It was simply coincidental that the vet visit was on the day after the plan went into effect. The vet diagnosed Brewster with a mild bladder infection and prescribed some meds. Given the fee was only $70 we didn’t bother submitting it to PetPlan.

After two weeks, Brewster still wasn’t well so we returned to the vet, who issued a different prescription. After another three weeks, she still wasn’t improving, so we returned to the vet who advised we begin costly testing. After checking with PetPlan, who told me specifically the procedures were covered, we moved forward with the testing to determine what was wrong. The tests ultimately showed Brewster had a stone in her bladder that had to be surgically removed.

At this point we had spent around $800 with the surgery estimated to cost more than $1000. We submitted a claim for the $800 for the initial fees incurred, and I again called and spoke with PetPlan to confirm the next surgical procedure would be covered.

Brewster went into surgery on August 31 at 7 a.m. When I got home from work, I received a letter from PetPlan saying that they were denying my claim and subsequently would not be covering the surgery we had performed today. I then called PetPlan immediately and was informed that they were considering it a pre-existing condition – because even though I enrolled on June 9 and paid the same day, my plan “mysteriously” was not activated until June 15, which meant the first vet visit occurred during the two week wait period. However, I did open my plan on June 9, technically in effect on June 10 due to the 24 hour hold, which would mean the June 24 vet visit would fall after the wait period had ended.

I did not enroll and pay for a service and then knowingly consent to the plan not being activated for five additional days. At this point, we have not received any further response/communication/resolution from PetPlan and are currently responsible for nearly $2, 000 in vet fees, despite Pet Plan incorrectly activating our plan five days after we enrolled and paid in full.

My dog means the world to me, which is why I was so thorough in my plan selection. Working in the insurance industry, I know how insurance companies work and often wrongly deny claims, which I fear is the case in my situation. I am glad my dog has now received the proper course of treatment, but there is still a large vet bill that needs to be resolved. We choose PetPlan to be protected, not defrauded.

Don’t choose PetPlan!

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  • Ma
      17th of Nov, 2009
    0 Votes

    I am having problems with PetPlan too - I have had exclusion backdated onto the policy recently to when I took it out - they suddenly decide that characteristics of certain dogs are now a condition - I can't get the vet to fight for me - surprisingly 9 out of 10 vets recommend PetPlan - think they are all in cahoots

    It is now under investigation by their complaints departs and the Financial Ombudsman - but if you look through google you will see that this seems to be a common occurrence with this organisation

    Be wary of PetPlan

  • Su
      5th of Apr, 2010
    0 Votes

    I have three policies with Pet Plan. I have not had to use them but enrolling my dogs was easy and reasonably priced per year so I referred my girlfriend and she enrolled her two dogs. That was back in January. Pet Plan promises that they will pay you a referral fee yet they don't, and have not paid me yet for the referral. I have reached out to them three times and once they promised me my referral fee by March 13, 2010. I have contacted them twice since March 13th and they won't respond. That's got me wondering about this insurance. What's it going to be like getting a claim paid. If it's anything like getting the referral fee I am convinced that the success stories on their site and in their magazine are the exception and not the rule. They took over $600+ annual premiums from me very quickly yet they wont' pay out a referral fee of $50.00. Once my policies expire I will NOT be renewing with them.

  • Po
      13th of Apr, 2010
    0 Votes

    I paid PetPlan for over a year before filing my first claim. I took my dog to an emergency clinic on a Sunday because she suddenly became lame in one of her front legs. I had a policy with a $200 deductible and 100% coverage afterward. The bill came to $397.00.
    A month later, I received a check for $77.90. I was told that since I took her to a "specialist" (an emergency vet because nothing else was open on Sunday) they would only cover 70% of the fee. They deducted 70% which left $277.00 and then deducted my deductible from that, leaving me $77.90, which is less than I pay them each month for my three Pomeranians. I thought this was bogus, so I cancelled and now I have to wait to be refunded what they deducted from my bank account yesterday which will be "pro-rated."
    I understood that they did not cover routine care and such, but I thought I would receive a check for $197.00.
    Go elsewhere for your pet insurance!

  • Jp
      19th of Nov, 2011
    0 Votes

    I have had similar experiences with PetPlan. It seems the common theme is that they have no problem collecting premiums but find every excuse not to pay claims. I renewed my 2nd year hoping that they would finally be useful, and my dog did become sick because of allergies. He had an ear, skin and bronchial infection all because of the same allergic reaction. Despite that this was all diagnosed in one visit, over $400 later Petplan denied my claim because they considered it 3 different problems. Really?? I would definitely stay clear of this company and I have cancelled my plan. We will see how soon they actually issue a refund on my 10 months of unused premiums.

  • Tk
      9th of Feb, 2012
    0 Votes

    I have had petplan for almost 2 years, and in those two years I have NEVER had any luck getting a claim approved. They will use EVERY POSSIBLE detail that the vet writes to deny claims. They have put in place so many roadblocks to getting claims process as possible. Never in my life have I experienced such difficulty with an insurance company! First, they require at leas 2 years medical history for every pet, and it MUST come from a veterinarian. If you don't have it, than you're screwed. Every claim is auto-rejected. NO OTHER PET INSURANCE COMPANY REQUIRES THIS.

    Their favorite excuse is "pre-existing" symptoms. Sorry, just because a dog has has bladder problems before, does not mean all bladder problems are automatically related.

    When there is no grounds for labeling it pre-existing, they simply tell you that the claim exceeds the allowed amount for treatment. They lure customers in offering 100% reimbursement, but then reject every claim. And what good is 100% reimbursement when limits are put on how much expenses can be.

    They also like to tell you "You could avoid this by getting pre-authorized every claim."

    I'm sorry, when my dog is requiring urgent medical care, I do NOT have the time to submit pre-authorization forms and wait days for a response just to see if the insurance will cover it. Also, in emergencies (where this usually becomes a problem) I do not have time to compare or worry about whether the fees my emergency vet is charging me will exceed the limits of the policy.

    Also, I've TRIED the pre-auth route... It should be called Pre-Reject, because that's all the process is for.

    I have regretted switching insurance companies since day 1. I have wasted THOUSANDS of dollars on this company, for NOTHING. The ONLY reason I haven't switched back is because my dogs currently have some medical issues that would not be covered on new policies because of waiting periods, and I cannot risk that.

  • Co
      12th of Mar, 2012
    0 Votes

    I am having problems with PetPlan, too.

    I have faxed all the required documents to them twice and they keep putting a status that I have not sent in the
    1. claim form
    2. release form
    3. invoice

    It has been 2 months now.

    This seems like a stall.

    Then, I bet, what will happen after the stall is they will find that 4/5's of the bill is not covered.

    They have done this before and pay a mere fraction of the total bill.

    Does anyone know of a reputable pet insurance company?

    So far, everyone has been a scam. This pet insurance industry is in serious need of regulation.

  • De
      19th of Jul, 2012
    0 Votes

    We are going through major grief with petplan right now for our 3 bassets...1 of which has been diagnosed with cancer and she is terminal. we have submitted thousands of dollars worth of claims which were initially denied because our balance was not yet paid in full. we have now put ourselves into a huge debt, taking a chance and paying our remaining large balance with a credit card. just resubmitted all claims, plus additional new ones, and this morning 7/19/12 got 2 emails (so far) that claims cannot be processed any further due to missing or incomplete medical records. we already sent them all the medical history our vet gave us when we signed up with them. we are so distraught at this time, expecting more denials and at our wit's end! what the hell do we do now?!!!

  • Dm
      28th of Aug, 2012
    0 Votes

    Pet Plan is bad on more than one level... They will be joining with H$U$ and donating $30 per policy to H$U$...
    HSUS will now have legal access to people's private pet status info...
    If someone wants to ensure more pets than the legal limit for their community,
    or wants to ensure their intact pets, or their Bully breed, and on and on...
    Sneaky, evil and Petplan needs to hear from pet owners how they would rather
    go with ANY other pet insurance than help Petplan finance anything for HSUS...

  • Ba
      6th of Oct, 2012
    -3 Votes

    The pit bull breed should be eliminated.

  • An
      31st of Oct, 2012
    0 Votes

    Pet insurance is regulated. Pets are considered personal property, insuring your pet is considered insuring personal property. Personal property insurance falls under Property and Casualty insurance and is regulated by your states Department of Insurance. If you have a complaint, look up your states Department of Insurance phone number and call to complain!!! Pet plan needs to know that what they are doing is wrong and they cannot get away with it!

  • Re
      14th of Nov, 2012
    +1 Votes

    Petplan are a bunch of rapacious ### that should be prevented from trading. The more complaints to the Ombudsman and more poor reviews on product review websites the better off we will all be.

  • Sh
      7th of Mar, 2013
    0 Votes

    A friend of mine has 3 labs had just been through a couple of years of chemo for one of her "babies" and said there is no way she could have afforded it without insurance. I decided to purchase 2 policies for my labs (Otis then 3 & Amos then 6) in early October 2011. In February 2012, 4 months after obtaining the policies, Amos tore his ACL while playing in the snow and needed surgery. During his 6+ years of life at that time, there had never been any indication of any issues with the only vet he had seen since he was a puppy. Be warned - Pet Plan has fine print and asterisks throughout their policies that basically have everything covered to determine it pre-existing or something else to allow them to deny claims. When I submitted my claim, I was told that in order to have my dogs knees covered (because it was such a common occurrence), I would have had to have their knees "certified" by a veterinarian within 4 weeks of purchasing the policy. When I mentioned this to our regular vet, and the surgical vet, neither had ever heard of "certifying" knees and usually the medical records were all that was required. The claim rep also said that for all they knew my dog had the injury either before I purchased the policy or shortly thereafter before the waiting period so that's why they require the certification by the vet. I care far too much for my dogs to let either one of them suffer for months and was very insulted at the accusation that I was being fraudulent.

    Otis did have some lameness in his right rear leg prior to obtaining the insurance. The vet evaluated him saying that his right rear leg appeared to have a lot of drawer and the xrays showed he has signs of ACL issues. In the same notes, he said the left rear leg shows no signs of lameness or drawer but he "suspects" bilateral issues. He sent us on our way with Meloxicam saying that some dogs live like this for years and never need surgery, but we'll know when and if the day comes that he needs surgery. We are 1 year 4 months into our policies and Otis started bobbing his head and seemed to be in pain, so I contacted the vet to have him evaluated and potentially have surgery. The vet submitted pre-authorization to do surgery on the right rear leg prior to our appointment assuming that it was his right leg causing the issue. The pre-authorization was denied due to pre-existing condition...not surprising but worth submitting. When the vet actually evaluated our dog, he determined that the left leg was actually a bit worse than the right, so we went ahead with surgery on the left. After submitting our claim, it took them over 7 weeks to determine it to be pre-existing and denied the claim because the vet "suspected" bilateral issues. One year 4 months, 2 claims and 1 pre-authorization all denied and $800 in premiums, and so far $6, 400 in surgeries. I would have preferred to have the $800 to put towards one of the surgeries. Pet Plan is a complete waste of money and as I said previously - they have every base covered with the fine print and asterisks in their policies allowing them to deny most claims. I've cancelled both policies and want to be sure to share my story so no one else can be scammed into thinking that they care about your pets. Also, there is no such thing as congenital or genetic because once either is noted in a vet's notes, it is then considered pre-existing, so logistically you can get a policy for a new puppy at 8 weeks that has never seen a vet, wait until you've met the waiting period before seeing a vet to ensure those genetic and congenital issues MIGHT be covered. It's a complete joke!

  • Ca
      3rd of Jun, 2013
    0 Votes

    We purchased pet plan 2 years ago. Our English Bulldog got sick in March of 2013. He came down with a bad cold/cough, took him to our vet he put him on antibiotics and he referred us to a specialist for soft palate surgery. We had been told about the soft palate in the past, but chose not to have surgery because he was fine at our home, he would only become stressed when we took him for vet visits, otherwise breathing was no issue. Thus this was noted in his file about respiratory distress. The charges ended up being over $5, 500. He is still doctoring for his pneumonia and bronchitis (he never had theses diagnoses before). However the entire claim is denied because they say it is "pre-existing" because the vet noted respiratory distress. Our vets have tried to help with our appeal. The customer service at pet plan is terrible, you never get the same answer, they always say a form wasn't received, when you call they say you will be receiving the letter in the mail and won't give you any information - THUS IT HAS BEEN DENIED. Pet Plan is worthless!!! Don't you them - they are a joke! Someone mentioned a class act lawsuit on another complaint page - hope this get started!!!

  • Gl
      27th of Jun, 2013
    0 Votes

    I would interested in Class Action lawsuit. I've had my dog insured for 11 yrs. with PetPlan. Have only filed one claim last year for boarding reimbursement because I was in the hospital 7 days. Couldn't believe what they required just for that. They actually wanted my medical history and entire hospital bill before they would reimburse. I refused to give my personal health records. After pulling teeth, 3 months later I got my check. My policy is up for renewal now,
    Any one have suggestions for pet insurance with another company. Appreciate any suggestions.

  • Ca
      10th of May, 2018
    0 Votes

    @Glynece I am persueing legal action towards pet plan for denieing a claim. I Would like to start a class action suit for defrauding customers

  • Ca
      10th of May, 2018
    0 Votes

    @carolyn kane I am trying to get others to Perdue the. class action suit

  • Ta
      15th of Aug, 2013
    0 Votes

    Im going through the same problem with pet plan as we pay monthly hes insured for 12months then it gets renewd few weeks before his insurance ends. my dog was poorly beginning of june13 this is still continuing and we have spend £500 on him after sending a claims form pet plan rejected as they said it was on going from 2010, in 2010 he swolled a bone and it got stuck since june13 he struggles to get his poo out and then gets blocked causes blood the vets wanted to x-ray him to see if there was any tumors etc thats stopping this where petplan rejected again! as i contacted pet plan to equire the reasons for this they couldnt be bothered to explain and then asking me to ask the vets for a letter to say these two were not connected the vets have rang 4 times wrote 2 letters and i still get on the same story they not looked at the form blah blah... im still paying for my dog to get better which is costing more money i dont understand why we pay for insurance as there happy to take the money but will not pay us back when we claim. i have took legal advise which ive been told pet plan are breaking my contract when ive told them this on the phone they just say take it further in a cocky attitude ive asked to speak to someone higher they say they cannot do this! ive been with pet plan since 2008 and think its disgusting how they have treated me.

  • Tw
      25th of Nov, 2013
    0 Votes

    My experience with insurance companies in general has taught me a few things. An attempt is made to engender loyalty by selling a service important to many policy owners. Once a new buyer has subscribed, the insurer is responsible only to the corporate principals and that fiduciary responsibility will never vary. Any service rendered to a subscriber is purely coincidental. That said, my experience with Pet Plan is on par with my experiences at any other insurance company. They will confuse charges, ignore attending veterinarian statements, laboratory results and biopsies, require endless and duplicate submissions of claims substantiation, etc. It is a game. It is legal and some very well-paid attorneys have seen to it that their employer is protected. Nonetheless, persistence will pay off. They will get tired of dealing with a claim using delays and "lack of documentation" as excuses. Do NOT let them wear you down. If they do, it amounts to you giving up an entitlement that you paid for. I speak from personal experience with Pet Plan. They might speak nicely to you on the phone but that does nothing to satisfy the contract that Pet Plan (or Blue Cross, Sentry, et al) has offered for sale. You must keep EVERY bit of documentation to fight the battle. You can bet the insurer does.

  • La
      10th of Feb, 2014
    0 Votes

    I would recommend to everyone Who has purchased this scam-CANCEL NOW. Put your premiums in an account and I bet you'll have more in your account in a yr, then you'll ever get out of this company. This insurance is a huge scam and I'm embarrassed I ever purchased it!

  • Je
      31st of Mar, 2014
    0 Votes

    Absolutely agree! This company is terrible.
    Does anyone know of a group lawsuit against this scam of a company?

  • Ti
      8th of Jul, 2014
    0 Votes

    DONT DO IT!!! This company is a JOKE!

    My vet had a pet plan brochure which I took.. The front of the brochure shouted "4 weeks free insurance" The fine print said only applies to new policies. NO problem as I will be a new customer.
    I joined up on line Feb 2014. In April I noticed that they had taken a payment out every month- no month was FREE. When I spoke to someone on the 1300 738 225 number, I was told I should have let them know it was one month free when I joined!!! After much discussion I was told they wouldn't take May's payment.. I also let them know that I had received nothing in the mail yet so I had no policy/insurance certificate- nothing at all.-Nothing arrived. Ist July i sent an email to say I still hadn't received my paperwork and by now had forgotten which account they were taking the premiums from to check if the $44 for May had been waived - No reply! 7th July I phoned 10am- no answer. I phoned back at 4.20pm and waited over 10mins to speak to someone. I went over the situation and she asked if I had it in writing that May would be waived!!!- OMG. :Painful. I also told her I had no paperwork. She was useless so I asked to speak to the manager. I was put on hold 10mins until my patience wore out & I hung up. I then immediately sent another email explaining that I was trying to speak to someone and explained the situation- By now, I have lost all confidence in this company that cant fulfill simple commitments so the email also asked for full refund & cancellation or I will go to Office of Fair Trading-NO REPLY. I did however get sent an invoice with my policy number on it but no other comments or acknowledgement of my call or May's fee.. I have now called OFT who advised to call Insurance OMBUDSMAN. I called OMBUDSMAN who will help me and also suggested I inform ASIC but first said to call Petplan disputes department. I called the dept but no one ever answered. It would ring & then it seemed as if the receiver hung up the call. I will now be contacting ASIC. This company seems so unprofessional & now that I look at the number of complaints against them, I can se they have a very lax attitude toward customer retention. They will take your money- give bad service, dont care that you will tell everyone you know how bad they are & wont renew with them. Finding loyal customers is the hard part so it makes more sense to endeavor to retain the ones you have by keeping your word & offering GOOD customer service- Its not hard- Bloody idiots!

  • To
      15th of Jul, 2014
    0 Votes

    Wow, has PetPlan changed. We've been with them for our three pets for several years. Within the last year, PetPlan went from paying reasonable claims in a timely manner to fighting and denying everything. Claims used to be processed in about a week. We now have claims that are nearly two months old that haven't been processed. When questioned, meaning you have to call them, it seems that somehow at the six-week mark, PetPlan decides they need more information. But they don't do anything about it. They don't bother to tell you. PetPlan doesn't bother to contact your vet, either. You have to follow up vigilantly and multiple times. PetPlan must make money that way by exhausting customers to give up on a claim or PetPlan counts on a certain percentage of customers to not follow up. In the last year, the records that our vet has to hassle to fax them get inexplicably but conveniently lost. Maybe part of it is gross incompetence, but whatever the reasons why PetPlan fails to do the one thing you pay them to do, it's really unacceptable.

    We actually just experienced two phone representatives outright lying about why a claim was denied. It was easy to prove because they lied about what was on the vet's notes, which was to explain away why they were denying a very straightforward claim. So we got a copy of the vet's notes and armed with that, I called back again and asked why it was denied. The woman said that the vet's notes said it was the right paw, which was a separate issue (totally untrue). I had her read the vet's notes verbatim, alerting her that any omissions constitute fraud. And magically, the vet's note now read "left paw, " (which would be covered). Why telephone reps would lie for their underwriters is beyond me unless there's some nasty commission for "saving" the company money by denying legitimate claims. So, that's one for the State Insurance Board to investigate.

    I believe pet insurance is crucial, as it prevents having to make terrible decisions based on whether you can afford a necessary or even life-saving procedure. But sadly, PetPlan is not a pet insurance company that can be trusted.

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