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Persistence paid off for Calgary couple who fought pet insurance claim rejection

CALGARY – A Calgary couple wouldn’t take no for an answer after a $5,000 surgery bill for their pet dog was rejected by an insurance company.

Chris and Shelley McCoy have a three-year-old Terrier-Rottweiler cross.

A year ago, Oakley needed unexpected knee surgery and they made a claim with 24 Pet Watch.

“They had said, ‘go ahead with the procedure.’ It would be at least at face value covered, and when the surgery was done, [they said to] send them the receipts for repayment,” said Chris McCoy.
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But McCoy said the claim was denied because a past medical report from their veterinarian indicated the dog had a knee problem before they bought the insurance.

“He was limping because he was in pain (from swallowing a foreign object) so then they said it must have been pre-existing because he was limping before,” said Shelley McCoy.

Despite a letter from their vet saying there was no previous injury, the claim was denied again.

The McCoys didn’t give up, and after fighting for a year, finally reached a senior manager who reversed the decision. The experience left them questioning the insurance system.

“That’s what really frustrated us, and we’re thinking, ‘well is this how they all are? Is there something better?’ Just a very frustrating process.”

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Doctor Drew Van Niekirk said in his opinion, most of his veterinary clients are happy with their pet insurance policies.

As with any type of insurance, there are going to be exceptions, he said. Pre-existing medical conditions are the most common reasons claims are denied.

“There are instances where policies change along the way, and those are always frustrating to people, because nobody wants to have a change to something they agreed upon,” said Van Niekerk.

He said when choosing a pet policy it’s important to understand the fine print, and if a policy is right for you and your animal.

“Certainly specific breeds have higher risk than others,” he said. “And individual activities, [such as] what you do with your pet, really do determine whether you should be getting coverage or not.”

Before you decide on pet insurance, here are some questions to ask:

  • Are there coverage restrictions on the age of animal?
  • Is there ever a maximum payout?
  • How much do you pay per claim and does that ever increase?
  • What isn’t covered?

The McCoys still believe in pet insurance and haven’t cancelled their policy, but advise anyone in a similar situation not to give up if a claim is questioned.

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