Question - what constitutes a pre exisiting condition in insurance terms

[cockahoot]

I lost the younger of my lovely girls at the beginning of December, very suddenly and supposedly to cancer.  We didn't have her insured and in a week ran up a bill of over £3,000.  Her mum was pining terribly and so we decided to get her a puppy sooner rather than later and collected Izzy straight after Christmas.  When I collected her I noticed there was some pink staining below her eyes, but put this down to newspaper die.  A week later I took her to my vets for her 2nd inoculation and just happened to mention that her eyes were a bit runny, I know this can be a symptom of teething.  He commented that it could be ingrown eye lashes but just to keep an eye on them and bathe them to prevent the skin getting sore.  At no time did he suggest any treatment or follow up appointment. I didn't even think he had made a note of it on his computer.  At the time we had the standard 6wk free insurance with pet plan, and still feeling the pinch from our latest vet bills we decided to continue to insure Izzy but opted to go with another insurer, it didn't occur to me to mention the runny eyes.  Concerned with the staining caused by her runny eyes because I would like to show Izzy,  I took her back to the vets suggesting that they test her for a blocked tear duct.  He has now refferred her to a specialist but advised me that I won't be able to claim on my insurance because this is a pre-existing condition.  How can it be when the cause of her runny eyes hasn't been determined and she has not received any prior treatment?  Does anyone have any similar experience or advice?

[PennyB]

All insurance companies vary and so only they will be able to determine if it is or not.

However, the condition seems like it appeared while you had the free insurance with petplan and possibly if you'd stayed with them you would be able to claim. Your vet would have possibly noted the runny eyes and taken that into consideration as part of the reason why you're being referred to a specialist --- everything that the vet notes is often put on your dog's record whether its relevant to the future or not

[scjmk]

We had a similar problem with Dylan last month. 

He always had weepy eyes (which were also baggy, you can see a pic of the eyes on this thread http://www.cockersonline.co.uk/discuss/index.php?topic=24583.30) and when he went for his 5 month check up he was perscribed eye drops just in case it was conjunctivitis.  When he went in to get his dangly bits off last month I also asked them to have another look at his eyes and the vet thought that the the eyelid turned in wards and could damage the eye.  He had the lids tightened up but I was worried that the insurance company (which like yours had been changed since they first looked at his eyes) may not cover it, but I'm glad to say they have even though the treatment for conjunctivitis had been mentioned when I took out the policy.

Hope Izzy's problem is sorted out soon!

[julesd]

Teddy had an attempt to unblock his tear duct last year (it failed) The excess was covered by his insurance but we had kept with the breeder's insurance company. He saw an eye specialist at Christmas for an unrelated eye problem in the other eye who said that he would like a go at the blocked tear duct (it's a bit unnactractive) He said if ever Teddy needs to go under anaesthetic again it would be great if we could do it on the day he comes to the surgery so that he could have a go at the tear duct at the same time.

I hope there is a way round this for you. Just in excess we have spent a fortune on Teddy and he's only 18 months.

[cockahoot]

Izzy saw the eye specialist today, bearing in mind she is usually evil she was so well behaved this morning.  It transpires that her weepy eyes are due to her tear ducts not being formed properly or at all and the drooping of the eyes which has just developed is due to a build up of tears.  So she has to have an op poor girl.  Despite feeling a bit foolish for not staying with Petplan, I am very angry at my vet who obviously thought that a fleeting comment followed up by no examination or suggested treatment warranted such detailed notes on his system which have meant we are not covered  by our new insurance.   Has anyone else had any experience of cockers with missing or badly formed tear ducts which have been operated on and if so how successful?  I guess this means I can't show her?

[Annette]

I would be a bit mad too. Might be worth checking with your insurers to see if they will pay.

Don't know about showing, but we very occasionally meet another cocker who had this problem. I met them recently and they told me that the surgery had been totally successful (and quite expensive, though I don't know how much). I'm afraid I know almost nothing else about her, not even where she went for the op.

hth anyway. And hope it works out ok for you.

[shonajoy]

That's why I hate Petplans *free* insurance. I work in a v ets and we have had a few cases where pups had colitis or diah, then petplan call it a pre existing condition, meaning the owner has to stay with them for ever, or lose coverage of any condition that they deem similar.

It depends how your vet worded it, but petplan will have asked for a summary of the records and if he said it could be entropion, they won't pay.

[PennyB]

That's why I hate Petplans *free* insurance. I work in a v ets and we have had a few cases where pups had colitis or diah, then petplan call it a pre existing condition, meaning the owner has to stay with them for ever, or lose coverage of any condition that they deem similar.

It depends how your vet worded it, but petplan will have asked for a summary of the records and if he said it could be entropion, they won't pay.

But if people are taking out insurance with another insurer once the free petplan insurance ran out surely its not petplans fault (especially if they never claimed under petplan) --- I would've thought the new insurer would want a summary of the records in this case (I know M&S do in some if not all cases).

I can't move from petplan becuase of all the claims I've made under them but then that would be the same whichever insurer I was with

As you say though sometimes it does depend on the skill of your vet re how they word things

[Jeeves]

Aha - step into my office.....

Having had the mother of all battles over a so called "pre-existing" condition, I think I'm quite well qualified to comment here!!! 

Cockahoot, you may not be aware of my mammoth battle with Tesco pet insurance over an enormous bill which they refused to pay because of a so-called "pre-existing" condition, but believe me, I've been there and not only got, but hand woven the t shirt!! 

The down side here is that any treatment your dog has had so far (prior to the tear-duct diagnosis) has not been successful.  This makes any attempt to argue that she has a "new" condition pretty hard to prove.  However, all is not lost!  Although your new insurer is telling you to take a running jump, you MAY be able to claim under the original Pet Plan policy.  Provided the condition did not manifest itself within the first 2 weeks of the cover, then you should find that in the small print, they are liable for any claim that STARTED within the time that their policy was active.  This is well worth looking into, especially when trips to the specialist are involved.

If you want, please PM me and I'll tell you all about my battle royal and my successful outcome  and I will happily share with you any crumbs of advice I can from what I've gleaned so far.

Don't despair, all may not be lost.......

[DennyK]

I had exactly the same problem with Paddy.  He got diarrhoea at ten weeks - vet said it "might" be colitis.  I moved from PetPlan to M&S after the six week period.  Turned out that Paddy has recurring colitis (now stable thanks to raw feeding and Penel's homeopathic vet) but that simple "might be" comment meant that it was uninsured.

To answer your question "what defines it as "pre-existing"?", it's exactly that - that the symptoms (even if not the diagnosis or treatment) appeared before the date on which your insurance policy took effect.  Since Paddy's diarrhoea appeared at ten weeks - it's deemed to have been the onset of the colitis and therefore he "had" colitis before we went to the M&S policy.

You need to be really careful on some of the internet applications for policies as well.  Some of them give you  a list of problems/injuries/illnesses your dog has had and you have to tick those that apply.  I ticked "eye infection" on one "get a quote" programme, and it popped up with a warning that "no eye infection will be covered as it's a pre-existing condition".  On the next "get a quote" programme, I noticed conjunctivitis was an option (which was what Paddy had suffered from), ticked that and there was no exclusion.  Went back to the original programme - conjunctivitis was an option on that list too but I hadn't noticed it first time scrolling down - ticked that, unticked the "eye infections" - bingo, no exclusions - and the premium went down.

Denise

[shonajoy]

That's why I hate Petplans *free* insurance. I work in a v ets and we have had a few cases where pups had colitis or diah, then petplan call it a pre existing condition, meaning the owner has to stay with them for ever, or lose coverage of any condition that they deem similar.

It depends how your vet worded it, but petplan will have asked for a summary of the records and if he said it could be entropion, they won't pay.

But if people are taking out insurance with another insurer once the free petplan insurance ran out surely its not petplans fault (especially if they never claimed under petplan) --- I would've thought the new insurer would want a summary of the records in this case (I know M&S do in some if not all cases).

I can't move from petplan becuase of all the claims I've made under them but then that would be the same whichever insurer I was with

As you say though sometimes it does depend on the skill of your vet re how they word things

It's not Petplan's *fault* no, but often because people take out the free insurance, they risk being clients of petplan for the life of the pet. Just marketing.

[cockahoot]

Thanks for all the advice.

Izzy had her tear ducts created yesterday, had none in the left eye at all poor thing.  Anyhow, I got in contact with my insurers prior to her op and laid my cards on the table.  They said not to worry, submit the claim as it might be something they would cover. They also pointed out that as there was no gap between my insurance with them and my original insurance with Petplan this would help.   Fingers crossed - perhaps they will look at my nectar card rewards and decide I'm worth looking after!

Izzy doesn't seem to be phased by the ordeal and is enjoying the additional attention.  Already her eyes are not so runny and hopefully the pink staining will fade in time. 

If ever a dog was created to tug at your heart strings it has to be a spaniel.

[DennyK]

Does Izzy have pale/white fur around her eyes? I ask because you refer to the pink staining.  One longer term tip I saw on here ages ago was to make some barley water (not the Robinsons stuff!) by adding an ounce of pearl barley to a litre of water in a pan, heat it till it's on a rolling boil, then let it cool.  Use the barley water mixed into their ordinary drinking water and over time, the round-eye staining lessens because the barley water changes the pH of the tears.

Has anyone used this method successfully?

[cockahoot]

Yes Izzy has a white freckled blaze running down her face which has become quite pink and looks as if she has been wearing a head collar which has rubbed her.  I saw somewhere on the internet that mixing a teaspoon of unrefined cider vinegar in her drinking water helps to reduce staining, but she wasn't over keen on the taste and I didn't want to put her off drinking.  I will try the barley water though, and see what happens. 

Thanks