4
out of 5
POSTED: | BY: Joe
The Fine Print
It's really unfortunate my pet became ill shortly after I switched insurance providers, essentially disqualifying him from all future claims. I'm mainly to blame for not reading the fine print and keeping my old policy during the waiting period (if that's allowed), but here's what I could have reasonably expected.
1. A shorter review period: It took over two weeks to hear back when the date alone should have resulted in a denial of the claim in an automated way.
2. Clearer disclosure of terms: The policy effective date isn't when policy coverage actually starts. It starts 15 days following. For joint related issues it starts 6 months following. I put in a lot of time to put the claim documentation together and didn't expect to be over 4000 dollars behind after waiting. Ideally the portal shouldn't have even let me submit. There should also be an initial option selection for joint health related claims when filing within 6 months of signup where the portal automatically denies the claim. At the very least that information should be presented in a clear way upon sign-up.
Given their response to my inquiry, any clinical symptom during the waiting period can be associated with any later health condition, disqualifying coverage. In my case, my pet having an upset stomach and potential immune condition or arthritis got grouped into a health condition that can overlap with just about anything later.
"A pre-existing condition is any medical condition which first occurred or showed clinical signs before the effective date of your policy or during the 15-day waiting period. (By "clinical signs," we mean any changes in your pet's normal healthy state, bodily functions or behavior.)"
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