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Thread: Pet plan--ccl injury restrictions

  1. #1
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    Default Pet plan--ccl injury restrictions

    I have added insurance recently on my dogs. I was discussing hypotheticals with them over the phone. I'm told that because Juice has a ccl injury to his right leg there is a 12 month waiting period for the other leg to be covered. I ask 12 months from when, she does not know as its an underwriting decision. I ask 12 months from the date of injury or surgery. She now thinks it may be -2 months from some point during the rehab but can't tell me for sure because it's underwritings decision. I have yet to receive a policy booklet to review. I asked what documentation I needed to send in so they could have a timeline on file. I let them know I wanted to get something in writing stating when coverage for the good knee kicked in. She told me there was no need to send in anything unless I wanted underwriting to review. Has anyone who uses this company dealt with them in this issue? They way they won't answer basic questions with any specificity makes it tough to have much confidence in them.

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    Senior Member Ted Shih's Avatar
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    I have had no problems with Pet Plan. But I generally get coverage for puppies. I had an adult with one bad knee, which was pre-insurance, other I think was 6 months after surgery. They covered second knee. Had puppy with two bad knees. They paid for both.
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    They told me the second knee would have a 12 month waiting period from an unknown point in time. Was this recently Ted? Im curious to know that if you had both knees done when only one was injured would the uninjured knee now be considered as having pre existing injury therefore excluded from coverage.

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    Senior Member Ted Shih's Avatar
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    this was done several years ago. I told you in previous post that if you do two at once, there would probably be no coverage. I did first knee on my nickel. Second blew afterwards. Pet Plan paid for second
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    I'm not talking about coverage on either knee right now but in the future. It's obvious neither would be covered at this point. Will the good knee that was operated on for the sake of beating it to the punch so to speak have coverage down the road assuming it is injured after surgery/rehab. Or would it be excluded. I plan to call about this tomorrow.

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    If operating on a good knee, or one that has not yet had an issue excludes it from ccl coverage in the future. That's the question i have. The answer to that would determine whether or not it is worth to have both done at once IMO.

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    Senior Member Ted Shih's Avatar
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    Quote Originally Posted by claimsadj View Post
    If operating on a good knee, or one that has not yet had an issue excludes it from ccl coverage in the future. That's the question i have. The answer to that would determine whether or not it is worth to have both done at once IMO.

    You are not making any sense. The insurance covers injury.

    You buy insurance. Knee 1 has a partial tear before you buy insurance, or that develops during waiting period. Insurance does not pay for knee 1 because the injury is a pre-existing injury.

    Knee 2 is ok at moment. If you decide to fix knee 2 at the same time as knee 1, for reasons of economy and expediency, insurance will not pay for either. It will not pay for knee 1 because it is a pre-existing injury. It will not pay for knee 2 because there is no injury.

    If knee 2 develops a partial tear during the waiting period - whatever it is - you are out of luck.
    If knee 2 develops a partial tear after the waiting period - whatever it is - you are covered at your insured rate - whatever that is.

    As I mentioned, I have a dog, which developed a problem with knee A prior to Pet Plan insurance. I paid as it was a pre-existing injury. It developed issues with knee B after waiting period (I believe it was 6 months at the time, but it could have been 12). Pet Plan paid at 80% rate with $200 deductible, which is my plan. Problems developed one year later with knee B, and surgery needed to be done again. Pet Plan paid at 80% rate with $200 deductible.

    To avoid future insurability issues, I ensure my puppies when I purchase them so that the waiting period becomes a non-issue.

    I think I have written all I care to on the issues of ACL and insurance at this time.

    However, Pet Plan has been very good to me.
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    It would usually be 12 months from the date of purchase of insurance policy. I can not say for sure, since we are dealing with something that I am unfamiliar with, but I know when I got my plan, the policy waiting period was from the date plan was purchased.

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    I've had Petplan for years on multiple dogs. Though I haven't had to use it for CCL repair (thankfully), I do put mine on as puppies. If I had an older one, I'd do the exam to avoid the waiting period. The policy documents can be accessed online through one's account. This is what mine says about cruciate injury, under exclusions:

    Any treatment associated with damage or rupture of cruciate
    ligaments, or defects of the patella during the first six (6) months
    that the policy is in effect. Except coverage is provided if a
    certificate of health is obtained stating that your pet has been
    examined during the first 30 days (beginning on the effective
    date of the policy) and stating that there are not any preexisting
    conditions relating to the pet’s cruciates or patellas.

    If your pet has received treatment for a cruciate injury to one
    leg then the other leg is automatically excluded from coverage
    for a period of twelve (12) months from the date of treatment.
    Kim Pfister, Rainmaker Labs

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    For what it's worth, here in Canada, I phoned several pet insurance companies about 1 year ago and was told that if there had been an acl tear in one leg then the other leg would be excluded from coverage.

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