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Its a long story, so bear with me!!
Our dog required surgery on his back leg - he had a condition called Left Hnd Medial Patella Luxation which required corrective surgery.
I contacted the insurance company (Virgin) and they said that as the cost was going to be over £500 it would need to be pre authorised. I had to fil in a claim form and then get the vet to fill in their bit with an itemised bill of what would need to be paid for (medication, tests, surgery etc).
The vets did this and Virgin wrote back agreeing to the claim of upto the cost of £1425.93 for the proposed treatment.
Jazzy was booked in for the op, but it turned out he had a serious infection and the sugery couldn't go ahead, instead he needed treatment for the infection. Jazzy was then booked in a 2nd time, another blood test was carried out to ensure that the infection was gone - but it wasn't so op was post poned.
On the 3rd attempt Jazzy was finally infection clear and the op went ahead.
I submitted a claim for the infection treatment and was paid in full by the insurance company (this was just under £300, but once excess was taken off they paid me £235)
The vets submitted the claim for the op to the insurance company - their bill was 1394.11, so less than the pre authorisation, especially as i had to pay £60 excess, so th figure claied was actually £1334.11. The insurance company has now refused to pay for the blood test stating that
Kindly note that as the terms of the policy do not extend to cover fees in respect of routine or preventative items, fees for pre op bloods have been ecluded as it is deemed by the underwritters t fall under this category. We would also note that 3 tests had previously been done in August 2009.
The vet checked the paperwork and the blood test was included in the pre authorisation paperwork and no mention was made in the acceptance letter that the blood tests would not be included, although it does say
We are pleased to confir that treatment may go ahead to the agreed esitimated sum, and that this wil be covered subject to the T&C of your policy.
The costs of the test is £55.30 and the blood test was absolutely neessary as the vet needed to be sure that the infection was completely out of Jazzy's system as it would have been dangerous for Jazzy to undergo the op.
What do you suggest i do - should i call the insurance company and explain this? If they rejet the bloods under the op claim, could i claim under the infection claim as it could be argued that the test was bnecessary to check the infection had cleared completely??
All/Any advice is very gratefully received!!!
Our dog required surgery on his back leg - he had a condition called Left Hnd Medial Patella Luxation which required corrective surgery.
I contacted the insurance company (Virgin) and they said that as the cost was going to be over £500 it would need to be pre authorised. I had to fil in a claim form and then get the vet to fill in their bit with an itemised bill of what would need to be paid for (medication, tests, surgery etc).
The vets did this and Virgin wrote back agreeing to the claim of upto the cost of £1425.93 for the proposed treatment.
Jazzy was booked in for the op, but it turned out he had a serious infection and the sugery couldn't go ahead, instead he needed treatment for the infection. Jazzy was then booked in a 2nd time, another blood test was carried out to ensure that the infection was gone - but it wasn't so op was post poned.
On the 3rd attempt Jazzy was finally infection clear and the op went ahead.
I submitted a claim for the infection treatment and was paid in full by the insurance company (this was just under £300, but once excess was taken off they paid me £235)
The vets submitted the claim for the op to the insurance company - their bill was 1394.11, so less than the pre authorisation, especially as i had to pay £60 excess, so th figure claied was actually £1334.11. The insurance company has now refused to pay for the blood test stating that
Kindly note that as the terms of the policy do not extend to cover fees in respect of routine or preventative items, fees for pre op bloods have been ecluded as it is deemed by the underwritters t fall under this category. We would also note that 3 tests had previously been done in August 2009.
The vet checked the paperwork and the blood test was included in the pre authorisation paperwork and no mention was made in the acceptance letter that the blood tests would not be included, although it does say
We are pleased to confir that treatment may go ahead to the agreed esitimated sum, and that this wil be covered subject to the T&C of your policy.
The costs of the test is £55.30 and the blood test was absolutely neessary as the vet needed to be sure that the infection was completely out of Jazzy's system as it would have been dangerous for Jazzy to undergo the op.
What do you suggest i do - should i call the insurance company and explain this? If they rejet the bloods under the op claim, could i claim under the infection claim as it could be argued that the test was bnecessary to check the infection had cleared completely??
All/Any advice is very gratefully received!!!
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