Pet insurance refusal to honour preauthorisation. Help desperately needed.

[Lhg]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

Hi, just noticed that if it's a lifetime cover - would that make any difference? Qudos refer to it in the letter saying that if he has lifetime cover then it should be covered by Elite? Really, cannot wait to leave this company...

[des8]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

The certificate is different to the schedule.
Can you check the dates in post 14 as the last dates show the policy going backwards...... presumably a typo!

[Lhg]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

Sorry, that was a typo! No I only have a schedule for 2014, nothing for the previous year. Still having trouble editing it, so bit wary of posting my personal details (and the dog!).

Yes, I also have big concerns!

[des8]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

Hi, just noticed that if it's a lifetime cover - would that make any difference? Qudos refer to it in the letter saying that if he has lifetime cover then it should be covered by Elite? Really, cannot wait to leave this company...

That's one of the reasons I need to see the schedule.
They refer to it as an annually renewable policy (which means continuation of cover with no break) and make reference to "start date" &
"first start date". So what are these different start dates in a lifetime policy that should be continuous?
I can guess, as I've seen it before. I don't think it's fair, but I would like to see the complete picture before advising you on how to proceed.

[Lhg]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

Right. Interestingly on the schedule 2014 - it states: First start date (nothing written) and underneath:Period of insurance From 15/03/2014
To 14/03/2015
12.01 a.m. both days

I've also checked on the email about the renewal it states "

"The pet insurance policy x-2014 for Archie is due on the 15-03-2014.

We are delighted to advise you that the VetsMediCover policy is now underwritten by Elite Insurance Company Ltd. The cover continues to offer:..."

So implies that this is lifetime not just a renewal of a yearly policy. However, Qudos were stressing that I took the policy out with them and that was only a year's policy. However, they had also previously refused to agree to a preauthorisation for dental treatment which took months of madness for them to finally agree (should have been a warning) so I don't exactly trust them.

Ok, although I'm desperate for reassurance (!) I think it's best if I print out what I have and find a scanner tomorrow and post it, rather than you trying to guess what it says.

[Lhg]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

Sorry - should have included that under the "continues to cover it then states: Lifetime cover". So I assume that confirms it. Hope that helps.

[des8]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

Look forward to seeing the documentation,

[des8]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

Have continued tinking:


I would in the first instance make aformal complaint to Vetsmedicover.


Firstly,....the policy is described aslifetime cover so one would not expect a break in cover(as will bedescribed below)
Secondly..... they state “we willrenew your policy”


If a policy is renewed the covercontinues without a break.(I wanted to see the policy wordings to seeif this was so...it isn't)


What they have done is to allow your2013/2014 policy to lapse and then replace it with a new policy for2014/2015. That is not renewal of an existing policy.


The break occurs in cover because the2013/14 policy only pays for veterinary costs incurred & received during thepolicy period, whilst the new policy will not pay for treatment costsfor injuries 'conditions occurring prior to the policy commencementor illness occurring in the first thirty days of cover.


Although you had received priorapproval to have “Fido” treated, this was by the first company,who have acted in accordance with the policy wording.. Similarly thesecond company have acted in accordance with their policy wording indeclining your claim.
A broker/ intermediary who allows hisclients to be uncovered without drawing this to their attention isnegligent.
As your renewal was due shortly afteryou obtained authorisation for your dog's treatment Medicover shouldIMO have advised you of the time constraints.


I think you will have to complain againformally to Vetsmedicover. Not to their complaints dept but to theirowner( they are a private limited company)If they are any good theyshould be able to negotiate a solution with the insurers.
However I doubt that will happen asboth insurers are overseas companies and there probably is nopersonal relationship there.
Also I am concerned about the ethics ofVetsmedicover, if they can be so misleading about renewals
as not to warn their clients about thegap in cover.


Eventually I'm afraid you may have to sue them for the losses caused by their negligence.

Others here might have other advice.

[Lhg]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

Dear Des8,

Probably a stupid question - but is the broker the owner? If so he keeps telling me that the first insurers are refusing to pay as they are no longer the insurers and I can't get him to approach the new insurers.

I have copied and uploaded the schedule just in case that helps.

All in all this sounds like terrible news. However, I do appreciate your thoughts on this situation.

[des8]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

The broker or intermediary is the private limited company "vetsmedicover". They are privately owned.

The first insurers refuse to pay because the vets costs were not incurred during their period of insurance.
The second insurers won't pay as the dog's problems arose before they were insuring you.

You have fallen between two stools due to the negligence of the broker, who is supposed to be acting in your interests.
Bad or deficient advice from a professional amounts to negligence, which is actionable.

The schedule confirms you have no, or only very limited cover for the first two weeks.

[Lhg]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

Gosh. Thanks for that explanation. So it looks like I have no option but to complain/threaten legal action.

I have to say I am pretty shocked but I do appreciate your clarification and time spent looking at the documents.

[des8]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

Complain first, try and negotiate a settlement.
Legal action can be stressful, especially if it's your first time

Don't threaten legal action unless you intend to carry it through

[Lhg]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

Here's hoping there will be a settlement...

Thanks so much for your advice.

[des8]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

You're welcome.
Don't hesitate to ask if you need assistance and it would be good to know how it works out.
It may help someone else.

[Lhg]

Re: Pet insurance refusal to honour preauthorisation. Help desperately needed.

Hi, Just wanted to give an update. After a letter was sent by the Financial Ombudsman Qudos immediately paid the dental treatment. To be fair VetsMediCover had offered to pay the bill if Qudos refused. Very relieved that this crazy saga has been resolved. Thanks for your advice Des8.