Author Topic: Claim rejected and skin condition exclusion put on policy !!!  (Read 2359 times)

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Offline c19unn

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Claim rejected and skin condition exclusion put on policy !!!
« on: October 03, 2011, 12:34:43 PM »
Hi Guys
Alot of you will know Diesels Story well concerning his supposed Skin Condition.
Well briefly Diesel had marks on his skin, The vets i was with stated on his records that he had possible skin conditions and basically 580.00 later with numerous bath stuff and sprays and specialists they advised that they had no idea what was wrong with him and it would cost another 500.00 to find out.
I took him to a second vets for a 2nd opinion, After an Antibiotic shot, and a frontline spray and a conclusion of harvest mites diesel cleared up and has never had any more issues.
A claim was put in to PetPlan for the 580, however the due to the vet putting in skin condition on the day i took out the policy - 1 day after i bought diesel, Pet plan have decided that it is a 'pre-existing condition' and have rejected the claim and have now put skin conditions exclusions on his policy for the next 2 years !!!! I understand that due to the fact he had the skin thing before the policy that they will not pay out but to put a skin condition exclusion on the policy when he infact Had HARVEST mites is RIDDICULOUS - He DOES NOT and NEVER HAS had a skin condition
What is the best course of action for me to take any advice anyone?

I am absolutely Mad about it to say the least and even more so at the poor wording in his records and treatment given from my prev vets !!! How can you mention skin condition in a report when it was not even investigated on that day.
My Mummy's name is Charlene
My name is Diesel



Diesel DOB:16-04-11

Offline Eve

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Re: Claim rejected and skin condition exclusion put on policy !!!
« Reply #1 on: October 03, 2011, 03:19:39 PM »
I would send a letter to the insurance company cc the ombudsman saying exactly what you have written here. If the first vet will not help, ask the second vet to write a confirmation letter that it was harvest mites and not a skin condition.

It may not get you anywhere but for the price of a stamp/email it could make all the difference.

Good luck.

Eve

Offline PennyB

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Re: Claim rejected and skin condition exclusion put on policy !!!
« Reply #2 on: October 03, 2011, 04:01:56 PM »
problem is your 1st vet treated him on the basis of a skin condition despite the fact that the other vet didn't and no doubt somewhere along the way this would've ended up on the insurance claim
Friends of Hailey Park
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Offline JaspersMum

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Re: Claim rejected and skin condition exclusion put on policy !!!
« Reply #3 on: October 03, 2011, 08:18:28 PM »
Do you have a copy of the original report from the vet, it could be down to nit-picking the wording - investigation of potential skin condition or treatment of a skin condition, for example!

Jenny - owned by Jasper, Ellie, Heidi, Louie & Charlie

Offline supergirl

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Re: Claim rejected and skin condition exclusion put on policy !!!
« Reply #4 on: October 04, 2011, 08:44:43 AM »
Get your vet to speak to them and explain that they are completely unrelated, what was thought might be a skin condition was actually harvest mites.
My vet did the same for me - I'd forgotten to disclose that Lexi had an eye infection when taking out a new policy and when I had to take her in for her eye again I was worried that they might not pay out (they never actually queried it at all), but vet spoke to them and told them that the 2nd treatment (a year later) was eye trauma and not an eye infection.
Misha, Ellie, Roly, Lexi (& Karen)

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Offline Christal

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Re: Claim rejected and skin condition exclusion put on policy !!!
« Reply #5 on: October 11, 2011, 03:20:23 PM »
What's happening about this Charlene?   
Hope it can get sorted out, it's disgraceful the way you've been treated. >:D

Offline c19unn

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Re: Claim rejected and skin condition exclusion put on policy !!!
« Reply #6 on: October 11, 2011, 03:41:42 PM »
Well i got the Pet plan rejection letter
It states that the claim was rejected due to 'dermatitis'  :huh: :huh: :huh:
So i have an appointment with the vets today (new vets that treated the harvest mites)
Going to get them to give him a health check and a skin check and to write an updated report on top of the other 2 to state that he DOES NOT have a skin condition and certainly not Dermatits and going to fax it to them tomoro so fingers crossed, i dont mind if they dont pay out on the claim due to the 'time' difference however i think its unfair to put a skin exclusion on his insurance due to a condition he does not have
Will keep you updated  :D
My Mummy's name is Charlene
My name is Diesel



Diesel DOB:16-04-11

Offline michelle123

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Re: Claim rejected and skin condition exclusion put on policy !!!
« Reply #7 on: October 12, 2011, 09:48:45 PM »
I'd actually agree with the Insurers.  In black & white terms it IS a pre existing condition.  If I am being totally honest, I think that you are doing well for them to lift the condition after 2 years - not many would budge on this type of exclusion  ph34r

Offline c19unn

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Re: Claim rejected and skin condition exclusion put on policy !!!
« Reply #8 on: October 13, 2011, 07:05:52 AM »
Yeah i understand that but to put a skin exclusion on for Harvest mites???
Harvest mites are not a skin condition, they are like head lice on a child ...
My Mummy's name is Charlene
My name is Diesel



Diesel DOB:16-04-11

Offline bajoleth

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Re: Claim rejected and skin condition exclusion put on policy !!!
« Reply #9 on: October 13, 2011, 07:08:51 AM »
This must be so frustrating for you, you are having to bear the brunt of a misdiagnosis from the first Vet. I agree Charlene in my view and what seems like common sense he had an infestation not a skin complaint. Good for you for keeping at it, I really hope this gets sorted for you ;)
Jo, Belle and Monty

Offline bluegirl

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Re: Claim rejected and skin condition exclusion put on policy !!!
« Reply #10 on: October 13, 2011, 08:11:15 AM »
I'd collect all your supporting information that its not a skin condition and never was and complain to the ombudsman.
Karen, Penny, Logan, Phoebe and Bronte.


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Offline c19unn

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Re: Claim rejected and skin condition exclusion put on policy !!!
« Reply #11 on: October 13, 2011, 09:47:59 AM »
Im building it all up just now, got his history from Prev vets then his history with current vet and the 2 reports that the new vet has written for him so just need to write a covering letter - Will send it all in to pet plan first so that they have the option of re-assessing the exclusion.
I wouldn have minded so much if he did have something wrong with his skin but i think a skin exclusion due to harvest mites is unfair
My Mummy's name is Charlene
My name is Diesel



Diesel DOB:16-04-11