Spot | Pet Insurance Review

my only experience was enrolling which was easu

My experience was great . The operator was courtios and helpful. I would recommend spot to friends and family.

The admissions process was very easy.

It appears I have been wrongfully denied for reimbursement for a claim that was pre-approved. After contacting Spot multiple times regarding this issue, speaking to a number of customer service agents, as well as submitting an appeal, I have decided to escalate this issue and request assistance directly with leadership. On November 18, 2022, I submitted a claim (estimate) for services for my dog, Lola - Claim #3787215 for the amount of $2,765.54. On November 28, 2022, I received notification that I was approved for reimbursement in the amount of $2,340.90. The Explanation of Benefits (EOB) showed that I was approved for reimbursement for all "Professional Services" listed within the claim. The excluded items on this estimate - "Herbal Treatments", "Special Diets, Foods or Supplements", and "Tax/Medical waste" were all items/treatments that I chose not to follow through with, as I was told in advance, per this estimate, that they wouldn't be excluded. I did, however, pay for all items (all "Professional Services") that were approved on this estimate, as I knew Spot had fully approved these for reimbursement. On November 29, 2022, I submitted a claim (Claim #3804260) for all paid "Professional Services", which I provided a receipt for in the amount of $1,984.03. I noted in my claim that all services within the receipt provided had been fully approved beforehand (via Estimate/Claim #3787215). Much to my surprise, when this claim was completed on December 9, 2022, I was only reimbursed for $1,532.70. I checked the EOB for this claim and discovered that a Claims Adjustor had decided to list one of the recently approved "Professional Services" - "Rectal insufflation DISCOUNTED Ozone therapy 6 sessions" (at the price of $258.00), as an "Experimental Treatment", after it had already been approved. Not only was this treatment pre-approved, but I have been raised with the knowledge that, if you give your agreement/approval to reimburse for a product or service, you reimburse as fair policy. I received that approval via Claim #3787215. Additionally, nowhere was the Ozone Therapy listed as an "Experimental Therapy" on the EOB; nowhere was the Ozone Therapy listed as an exclusion at all on the EOB for the estimate (Claim #3787215). I thoroughly reviewed the EOB for Claim #3787215 prior to paying for these services, as I was well aware I didn't have the funds to pay for anything that wasn't approved, including the Ozone Therapy. Whether a SPOT representative mistakenly approved this treatment via Claim #3787215 or not, I consider this fully to be a fault/mistake of SPOT and hold SPOT 100% responsible for this error. I am requesting the issuance of payment that was initially agreed upon for the Ozone Therapy treatment, at 90% reimbursement for the amount of $258.00. I am a very hard-working individual with a great sense of integrity and responsibility. I am not at fault and believe I am entitled to this agreed-upon payment.

I like that I received a follow-up call from Spot. Those personal touches go a long way in this day and age where everything is done online or through an app. It's nice to hear a human voice.