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Thread: Petplan - a HUGE THUMBS DOWN!

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    Senior Member J. Walker's Avatar
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    Default Petplan - a HUGE THUMBS DOWN!

    Well, I filed a claim with them recently when my dog suddenly started vomiting every 30 minutes and became partially paralyzed a couple of hours later. After a barrage of tests, the vet found nothing. He had no fever, his blood cell count was fine, everything was negative in the cytology, etc. My dog had immune mediated arthropathy over a year and a half ago (before the insurance) as a result of a Lyme infection. There's the magic word: arthropathy. Petplan focused on that word and now, despite what the actual clinical symptoms and test results were, they have denied the claim for the vet calling any type of lameness by the clinical term. There is absolutely nothing to indicate the second incident is linked to the first. Despite all of the previous records being provided indicating the symptoms, definitive diagnosis, and treatment, I'm getting royally screwed over by Petplan. I've had to go back to my vet and have him spend his valuable time to further explain what the records already show just because Petplan decided that if the same general symptom ever showed up again, it was automatically a pre-existing condition. They couldn't be bothered with details like actual clinical documentation.
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  2. #2
    Senior Member JusticeDog's Avatar
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    Quote Originally Posted by J. Walker View Post
    Well, I filed a claim with them recently when my dog suddenly started vomiting every 30 minutes and became partially paralyzed a couple of hours later. After a barrage of tests, the vet found nothing. He had no fever, his blood cell count was fine, everything was negative in the cytology, etc. My dog had immune mediated arthropathy over a year and a half ago (before the insurance) as a result of a Lyme infection. There's the magic word: arthropathy. Petplan focused on that word and now, despite what the actual clinical symptoms and test results were, they have denied the claim for the vet calling any type of lameness by the clinical term. There is absolutely nothing to indicate the second incident is linked to the first. Despite all of the previous records being provided indicating the symptoms, definitive diagnosis, and treatment, I'm getting royally screwed over by Petplan. I've had to go back to my vet and have him spend his valuable time to further explain what the records already show just because Petplan decided that if the same general symptom ever showed up again, it was automatically a pre-existing condition. They couldn't be bothered with details like actual clinical documentation.
    I can't even begin to count how many letters I have had my vet write to pet plan. I have also sent into to their head vet, and gotten resolution. Your story is exactly what I have continually experienced with them. Sorry you are going through it.

    They recently paid a surgical claim without an issue, and solicited a recommendation. I just laughed.
    Last edited by JusticeDog; 12-26-2012 at 07:00 PM.
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    Senior Member Rainmaker's Avatar
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    Gosh, that's too bad. Guess it happens, sounds like our human health insurance, never have had a straight claim without issue. I've only had good experience with Petplan though and sure is simpler. Hopefully, you can get yours straightened out.
    Kim Pfister, Rainmaker Labs

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    Senior Member hotel4dogs's Avatar
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    I'm sorry...but mostly I hope your dog is okay.

    Barb Gibson
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  5. #5

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    Yikes! Scary symptoms. Hope your dog is okay. At the clinic I worked at most of the claims with them were a PAIN. paperwork and employee time and didnt cover much.
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    Senior Member Rainmaker's Avatar
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    Quote Originally Posted by mountaindogs View Post
    Yikes! Scary symptoms. Hope your dog is okay. At the clinic I worked at most of the claims with them were a PAIN. paperwork and employee time and didnt cover much.
    They've covered everything for me and it was simply a matter of faxing the records and making sure the claims form, which is quite simple, was complete. Was hardly a big deal. Now, when I worked for a vet, VPI was a royal pain of an insurer when it came to paperwork and they were the ones paid very little and argued over every little detail. But, comes down to it, I'd just be happy with my dog being healthy and sound at the end of any illness or accident. If the bill's reimbursed at all, that's gravy.
    Kim Pfister, Rainmaker Labs

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    Senior Member Ted Shih's Avatar
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    I just submitted a claim for peridontal disease for one of my dogs. Claim processed. Check on its way.

    My experience with Pet Plan has been excellent
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    Senior Member Cindy B's Avatar
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    PetPlan came highly recommended to me. The program was a five star program where this person was concerned. I purchased the plan and six months later had to use it. My Bailey is a hard charging, grab the duck on the run, kind of dog. In grabbing the duck from the ground on a retrieve, he broke his jaw. Not knowing what the problem was, we visited the vet. Bailey's mouth couldn't be opened wide enough for a full exam, but it was assumed that it could be a dental problem. Being cost concious, I brought him home for the night to return the following morning for his sedation for the full exam and dental cleaning (he was sedated ... why not?) . Well, it wasn't a dental problem, so x-rays were ordered where they found the fracture. Long story short ... office visit not covered because it was under the deductable. Procedure was questioned (dental), which I agreed that the dental should not be covered, however, the visit, the x-ray and meds should have been. Nope. The initial visit was on one day and the procedure on the next. I sent them a scathing letter, which I'm sure was promptly thrown in the trash, and canceled policies on all five of my dogs.
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  9. #9
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    I've only had one claim, thank goodness, but PetPlan paid off like a slot machine for a TPLO and rehab at Gulf Coast in Houston. I considered myself one of the luckiest people in town to have taken out the insurance. All my dogs are insured with PetPlan now.

    Sorry you are having difficulty. Keep your cool and keep appealing and submitting documentation. The squeaky wheel gets the grease.

    Don't know what your relationship is with your vet, but if he/she won't help with documentation, I would look for another vet. He/She is selling a service and he/she should make sure you want to keep buying his/her service.
    Last edited by Tom Watson; 12-27-2012 at 05:29 AM.

  10. #10
    Senior Member wheelhorse's Avatar
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    Quote Originally Posted by J. Walker View Post
    I'm getting royally screwed over by Petplan.
    Welcome to the world of pet health insurance. It will only get worse and end up as bad as human health insurance.
    Kathleen

    "Before you diagnose yourself with depression or low self-esteem, first make sure that you're not, in fact, just surrounded by a**holes" -William Gibson

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