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Hi all,
My one year (at the time back in October) Beddlington was suffering from poor coat quality and thinning, so had the vets test him for Copper Storage disease. Poor coat quality is a symptom of canine hepatopathy and Bedlingtons are known for it - they agreed. Got him genetically tested and upon positive genetic test he then underwent biospy. Liver has massive amounts of copper, 10.3 times what is considered normal at 2300+ micrograms/g of dry weight liver. He's doing great now, he tolerates Penicillamine really well and it's a pretty cheap drug.
However, on the clinical notes that they wrote and sent to the insurers they have simply stated "owner requested genetic test" and "owner requested biopsy". This is what has made BoughtbyMany think that this was elective. The ****? Do I look like a vet to them? How am I qualified to request laparoscopy? Cue my insurers rejecting the insurance request as being "elective".
Vets refusing to change tune on "diagnosis" as they don't want to be seen changing records, but will state that his treatment isn't elective as the disease can either slowly kill dogs or kill them quickly depending whether it takes an acute or chronic course. I don't know what the insurance outcome will be, but fully expect BoughtbyMany to be arseholes about it.
Advice?
I'm pissed beyond words.
but will state that his treatment isn’t elective as the disease
Try this, if it works problem solved.
Yeah, it's also about the poor clinical notes as well - and lack of detail given/consent that these were elective procedures, if that's what the vets think when I squeeze some clarity out of them (I'd argue that it wasn't anyway).
I suggest it's the insurers being arseholes not vet. Vet will never mandate treatment - they'll give you options and up to you.
"You could do a genetic test to be sure and make treatment more effective"
"Yes please"
Owner has just requested genetic test. You can't blame the vet.
If not then https://www.financial-ombudsman.org.uk/businesses/complaints-deal/insurance/pet-insurance
Ok, so if the appeal doesn't work I have to try an internal complaints procedure first Fuzzy? Cheers for that!
Should I get mean with the vets on the informed consent side as well? Or hold onto my cards?
I don't think you should get mean with anybody at this stage.
Vets are under incredible pressure at the minute. Operating in vastly different ways to normal due to Covid. The stress levels in practises are through the roof and perhaps before you barge in there with the attitude that the vets are assholes maybe try to consider the human element and the difficult job they are doing.
I think maybe an attitude adjustment will get you better results in your dealings with the clinic on this occasion.
I hate this whole it's up to you thing that vets trot out whenever you take your dog there.
How the beep am I supposed to know?
That's what I pay you for.
Re your situation, OP, I'd try to be nice with the vets if you can especially if you are planning on staying with them. To be honest, I do think it sounds more like an insurance company thing too. Maybe think about changing them if you can. I have to get my dog insured and was thinking about BoughtbyMany. Maybe not now.
I might add, it took the insurers months to reject it the first time. Then within a few days of rejection, the vets shoved it to a collection agency without notice given. The last message I had from them was the initial invoice.
So I'm mildly annoyed about that as well and might be looking for an excuse to get mean.
Who are you insured with op?
BoughtbyMany
Sounds like insurance co problem to me.
My vet always discusses and gives options for non routine treatment. Seems sensible to me.
One reason we self insure our pets is to avoid dealing with insurance companies.
I hate this whole it’s up to you thing that vets trot out whenever you take your dog there.
How the beep am I supposed to know?
That’s what I pay you for.
I suspect if you had asshole clients threatening you with legal action or death threats ( https://www.telegraph.co.uk/news/2017/10/06/vets-threatened-regular-basis-pet-owners-angry-cost-treatment/) over treatment costs and potential mis-diagnoses (nobody gets everything right every time), leading to a massively high suicide rate ( https://www.vice.com/en/article/xyk4xd/why-is-the-suicide-rate-among-vets-so-high) you too would hesitate before being definite about a course of treatment, or potential options. Those of you calling vets assholes don't deserve them tbh, have a damn look at yourself ffs.
(Vet speaking here)
It should be pretty simple for your vet to tell the insurance company that the investigation and treatment was necessary. It doesn’t really matter whether you asked them to do it or not, it was an essential procedure that was required for the health of the dog. Unless it was specifically excluded on your policy they haven’t got a leg to stand on.
In my experience most insurance companies will back down on a firmly worded letter from me - failing that as others have said the insurance ombudsman is a free service to help you if you feel you have been let down by the insurance company.
We are under a lot of pressure and stress at the moment, and bear in mind your request for payment was after in your words the insurance took months before deciding, so the account with them has been outstanding for all of that time. There are not many other businesses that will happily tolerate unpaid bills for several months.
Sadly these days many insurance companies make a point of trawling through clinical notes in order to find an excuse to not pay out.
I thought this was going to about a specialist element of veterinary medicine.
Whereas I thought it was going to about mouthy over 40s racers.
It seems like your claim has just been bounced by the lowest tier of claims adjuster. Standard practice IME (cars, not dogs). I can't see how they could refuse this really. I don't think the vets need to doctor (ha!) their notes, but an additional letter to the insurer explaining that it's obviously not 'elective' would be helpful.
We are under a lot of pressure and stress at the moment, and bear in mind your request for payment was after in your words the insurance took months before deciding, so the account with them has been outstanding for all of that time. There are not many other businesses that will happily tolerate unpaid bills for several months.
Would have been happy to pay up front had they actually called or contacted me in any shape or form, even called in a number of times to give them status updates and see how things were. Will keep everything in writing next time instead.
The aggression of pressing the big red button and getting collections involved within a couple of weeks of the insurance company rejecting the claim, without contacting me - pissed me off hard.
It's not just vets under pressure during Covid, all of us who are in medical or healthcare aligned fields are.
(Vet speaking here)
It should be pretty simple for your vet to tell the insurance company that the investigation and treatment was necessary. It doesn’t really matter whether you asked them to do it or not, it was an essential procedure that was required for the health of the dog. Unless it was specifically excluded on your policy they haven’t got a leg to stand on.
Good to read.
Otherwise bloody everything's elective. Choosing to take your dog to the vet rather than let it die on your floor - "owner requested treatment"
I thought this was going to about a specialist element of veterinary medicine.
Nicely done.😁
Bloody 'Merkans
Asshole vets
Damn, thegeneralist beat me to it!
My quip was going to be along the lines of a 'specialism too far'.
oakleymuppet I agree lack of communication always causes problems - but didn't your insurance company tell you about the rejected claim? Usually they tell the client first, more often than not we hear from the client that a claim has been rejected - it's your policy so you should be their primary point of contact.
I also suggest you have a good read of your policy document. We tend to use the term elective to simply refer to routine neutering. However you could argue that any procedure that is planned in advance ie not an emergency can be described as elective or semi-elective. If an insurance company decided to not cover any elective procedures in their policy they could then decide not to cover any number of 'elective' procedures such as removing a benign tumour, TPLO surgery for cruciate rupture, patellar luxation surgery - essentially any pre-planned procedure that benefitted the health of the dog but wasn't an emergency. Actually investigating and treating copper toxicosis would pretty much not fit in that list as it can be extremely severe and sometimes fatal.
It does raise another issue that pet insurance is extremely variable, and there are definitely companies out there that try very hard to avoid paying. Bought by Many is a relatively recent addition to the insurance market and I'm not sure about them in that respect.
oakleymuppet I agree lack of communication always causes problems – but didn’t your insurance company tell you about the rejected claim?
This is partly the cause, I had one email buried in my junk folder from them - no letter through the post and no text message update like I usually get.
Arghh.
Do people/companies not get that email is dead and the cause various communication failures?
Damn, thegeneralist beat me to it!
Nope. Credit where it is due, @thegreatape was the man. I just quoted him.
@idiotdogbrain
And I suspect if your dog had been treated like mine was and you got the advice I did, you would understand when another forum member called their vet an asshole.
It's partly the nonchalant way they say it's up to you, like they couldn't give a shit.
And no, I haven't ever complained about charges, let alone threatened them with legal action or death threats, I mean, it's not going to bring her back is it? Or make her life on this earth any better.
I have also said in previous threads that I have had good experiences with vets.
So, how about, like me, you apply a little balance? And if you can't do that, wind your neck in.
Do people/companies not get that email is dead?
Eh?
Do you honestly expect important updates/communication from large corporates to be done just via email? None of my banks bother with it anymore, it's either they call/SMS you or you get a letter.
Emails just get buried in junk folders and under massive amounts of spam.
Do people/companies not get that email is dead?
Its the main form of communication, replacing letters...
Its the main form of communication, replacing letters…
Boomer.
Nahhh dude. Emails dead. It's all about apps and instant messaging services now. Haven't had a single email from my bank in three/four years.
Or my utilities either, all the bills are on the app in PDF form.
Do people/companies not get that email is dead and the cause various communication failures?
Oh dear, I can see why you are having problems now.
Oh dear, I can see why you are having problems now.
Honestly, I do mostly check it though.
But BoughtbyMany has an SMS service as well, which has seemingly stopped updating. "your vet we'll update you on how the claim is progressing via text message and email." so they aren't providing the service they claim to.
Ahem - others agree: