Having medical insurance for pets is a great convenience to owners. Insurance policies for pets are not as complicated and much easier to understand that those for people. Some of the clauses and requirements may not be clear – it is up to the buyer to get clarifications on coverage. If you have insurance in place and filed a claim, some reasons for denial of a claim could be:
Every insurance provider has a process in place so that disputes can be resolved amicably. Look for the information in your insurance policy or claims section to determine what steps have to be taken and the information needed. Talk to an agent at the company for a review of the claim or how to dispute denial.
The reasons for denial should be very clearly given in a letter from the insurance carrier. Details could be offered in the form of exclusions, prior healthy conditions, ineligibility etc. are some of the reasons.
Insurance companies don’t usually turn down claims. If you are not happy and believe your claim was turned down unfairly, then filing a complaint with the State Insurance Department is an option. This is usually free and the State will intervene. Investigators will talk to the insurance company, gather information about the claim, get copies of the policy and other records and make a decision.
If you are not happy with the results after approaching the insurance company or the state, you have the choice of filing a lawsuit to get reimbursed. Winning in court could help you win legal costs as well.