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Neil Faulkner

Pet insurance pitfalls to watch out for


The financial watchdog receives hundreds of complaints every year from animal lovers unhappy their pet insurer has rejected their claim. Here are some common issues and how to avoid them.

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The Financial Ombudsman Service (FOS) rules on complaints made by customers of banks, investment firms and insurers.

The FOS has recently published its rulings on a number of pet insurance complaints and the good news is that it has been upholding around six out of 10 cases.

We look at the complaints that were turned down by the ombudsman so you know what areas to watch out for when buying a pet insurance policy.

Pre-existing lumps

Mr V asked his insurer of two years to pay for his cat Florence to have a tumour removed.

The claim was rejected because the vet had found two lumps before Mr V bought the insurance.

Mr V argued the vet hadn't diagnosed the lumps and said the insurer should have contacted Florence's vet to investigate her medical history before agreeing the policy.

The ombudsman listened to the initial phone conversation between Mr V and his insurer and heard Mr V answer "No" when asked if there had been any signs of illness.

But the pet insurance policy terms clearly expressed that clinical signs of illness are excluded.

The ombudsman rejected Mr V's complaint.

Untreated, pre-existing problem still excluded

A further case concerned Mr L's dog Ivy, who needed treatment for a dislocated knee cap.

The insurer rejected the claim on the grounds that the problem had been diagnosed three years earlier.

Mr L argued the vet hadn't initially prescribed any treatment. The vet told the ombudsman that she hadn't treated it because she didn't expect it to become a problem.

Unfortunately for Mr L and Ivy, the problem existed previously, even if it hadn't been treated.

The ombudsman found the small print clearly defined pre-existing conditions as "any condition or symptoms or signs of injury, illness or disease, occurring or existing in any form prior to the start of this insurance".

It rejected Mr L's complaint.

Death benefits

Mr C's horse, Amber, suffered from a degenerative joint disease and she went lame. His vet put her down to end her pain.

Mr C claimed for a lump sum payout from the insurer, but this was rejected on the grounds the euthanasia did not meet the British Equine Veterinary Association's (BEVA) guidelines and he hadn't sought written consent from the insurer, as stipulated in the small print.

The ombudsman investigated.

Although BEVA guidelines were not explicitly mentioned in the policy document, it was clearly set out that the horse should only be put down if no other treatment was available.

The ombudsman found that Amber's condition was possibly treatable with anti-inflammatories and retirement to a paddock.

Mr C complained that he had received written consent from the insurer, but he had received a claim form only, stating the insurer would "need to receive a fully completed claim form, before we can consider the validity of your claim".

The ombudsman rejected the complaint.

The good news

The Financial Ombudsman Service says that other common pet cover complaints are either about an increase in premiums, particularly for lifetime policies, or about insurers turning down claims inside during the exclusion period at the start of the policy.

For example, Miss R's insurer was told to pay up for her dog Haversham, despite it having pre-existing lumps.

This is because the vet had concluded the lumps were insignificant, and because the new lumps, which Miss R was claiming for, were unrelated to the older ones.

Another customer, Mrs R, switched to a new insurer after her dog Bella had already started getting hip problems, because she believed her new insurer told her she would be covered.

The ombudsman ruled in her favour when the insurer couldn't supply a recording of the telephone conversation setting up the policy, and because it thought it unlikely Mrs R would have switched insurer if the new provider had made it clear that Bella's hip problem wouldn't be covered.


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