- Report: #765091
Complaint Review: Petfirst Healthcare
| Petfirst Healthcare
Internet United States of America |
|
Petfirst Healthcare Multiple refusals and extensive red tape, Internet
*Consumer Comment: Not upfront with policy
*UPDATE Employee: PetFirst Response
*Consumer Comment: Wouldn't it be better
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The forms have to be filled out correctly with a stamp and signature of the vet plus the stamp of the clinic. This in itself is a real pain as you have to remember to bring the claim for with you. If you forget a claim form, you have to contact the vet and beg them to fill out one for you, something which they don't do correctly most of the time.
Once I get the claim in, it is usually denied, and I then have to contact the clinic and have them send the dogs complete medical records. I submitted one for Lyme Disease treatment and was told that Lyme disease is preventable and so it wasn't covered.
I urge owners to avoid Petfirst and find another pet health insurance that is a reputable company.
This report was posted on Ripoff Report on 08/14/2011 03:35 PM and is a permanent record located here: http://www.ripoffreport.com/r/Petfirst-Healthcare/internet/Petfirst-Healthcare-Multiple-refusals-and-extensive-red-tape-Internet-765091. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year.
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Search Tips#1 Consumer Comment
Not upfront with policy
AUTHOR: Tim - (United States of America)
SUBMITTED: Wednesday, January 18, 2012
So I go to the website to review the policy first...No policy terms stated??
I call the toll free # and with much frustration I am told in salesman speak that I cannot review the policy until I actually send money first! WTF? Anyway I ask to speak to a supervisor and am told that they are on lunch.
One last note:Customer service person was about to hang up on me before I could find out the details.
Based on this experience, I will NOT be buying insurance from this company.
#2 UPDATE Employee
PetFirst Response
AUTHOR: PetFirst Healthcare - (United States of America)
SUBMITTED: Monday, November 21, 2011
Insurance contracts, claim payments, and all the associated administrative functions of pet insurance are regulated by the states in which policyholders live. Even though we consider our pets part of our family, they are actually defined by the states as personal property and are subject to the states laws regarding property insurance. The way we handle claims is regulated by your state Department of Insurance and they impose some specific requirements on us. For instance, all the coverage and exclusion language in your policy must be filed and approved with the Department of Insurance prior to our issuance of any policies. The Department reviews the language of the policy to make sure its readable, that there isnt any intentionally confusing or misleading language and that all the terms comply with state law. As a company we are then required follow the exact terms and conditions approved by the state or risk state sanctions. This means if the policy says certain items are included, or specifically excluded, we must follow the exact intent of the policy.
Also with claim payments the Department requires, by statute, that we complete a thorough investigation before we approve or deny claims. In order to meet that legal requirement, we must obtain a complete medical history on each pet to make sure that we have enough information to make a determination on what is covered and what isnt under the state approved terms of the policy. Failure to investigate a claim by requiring full medical records would be unfair to our policyholders and a violation of state law. We realize that the claims submission process seems like a lot of hoops to jump through; however it is a necessary process to ensure we have the information to fairly evaluate your claim. This includes looking at pre-existing conditions, preventable conditions, or any other items that are excluded under the state approved policy.
Finally, regarding your claims that have been denied; insurance, whether its coverage for our furry family members or your auto and home insurance is intended as a tool to mitigate loss. Insurance policies arent intended to cover every possible scenario of loss, which is why they have deductibles, co-payments, and excluded areas of coverage. Its a balance of trying to provide good comprehensive coverage at a reasonable cost. The cost of your policy is simply a function of a claims cost. If any policy (pet, auto, home) covered every conceivable loss scenario, none of us would be able to afford the premium for the coverage. Our policies provide an effective balance between the most common conditions and an affordable monthly or annual premium. We would recommend review of the policy terms and conditions in order to ensure there are no surprises the next time your pet requires treatment.
No hoops to jump through either.
Oh yeah, the "spca" is usually a scam too.

