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LV pet insurance wont pay out **WON**


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I just had my pet cat taken to the vet today as she was not being herself. She was diagnosed with various conditions and under vet supervision for 24 hours. I took out the insurance on 19th and the claim made is on 26/03/2011 since she started undergoing treatment. They are sending me a claim for but the advisor on the phone said that it was highly likely that the claim would get accepted as it is being made with in 14 days, she says its in the terms and conditions blah blah.

when i took out the cover this is the email i got which should state that i cannot claim for 14 days but on the contrary says Tily’s policy starts on 19/03/2011.

where do i go from here what are my chances any help would be appreciated

Your pet insurance policy reference-number:

 

Dear Mr

Thanks for choosing LV= Pet Insurance. Tily’s policy starts on 19/03/2011. Your policy documents will be sent in the post within three working days. You should read these carefully and keep them in a safe place.

Pet insured Tily Level of cover Essential Policy Start date 19/03/2011 Monthly premium £5.70 Payment method Monthly Your reference number

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Ah, what they are saying is that you cannot make a claim within 14 days from the start of the policy.

 

You took it out on the 19th March and attempted to make a claim on the 26th which is just 7 days. I think quite a few policies do this, especially where premiums are paid monthly.

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well tily is undergoing treatment and ive put all the cost of it on my credit card for now, her health comes first but its unbelievable how much of hypocrites they are i dont mind paying the policy in full if it comes to it. I mean why say it starts on the 19th it should be 14 days from the date bought and i do agree that they are protecting themselves from abuse but we humans can explain when things go wrong my kitten was fine one day and turned the other its just the way nature works, not according to these insurance companies.

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I think that you have to look at the overall sales pitch for the insurance and take that into account as well as their terms and conditions.

 

First all, I assume that somewhere in the process of signing up for the insurance online is a box which says that you have read and you agree to the terms and conditions. Is this right?

 

Either you ticked the box without reading – or you read the terms and conditions and then you ticked the box. Is that right?

 

Are you able to find the terms and conditions and confirm that they exclude claims made in the first 14 days of the cover?

 

Secondly, – and this is very important – do they advertise the policy as being 12 months? If so, then what is the termination date of the policy?

 

If the termination date is 18 March 2012, then it would be clear that the insurance policy has been misrepresented to you - because if you are prevented from reclaiming the first 14 days, the policy would only be 50 week policy and not a full year.

 

Let us know what you find – and then we can go from there. Please answer all the questions

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yes there were these box things i had to click though obviously it wouldn't let me go forward which explains the 14 days exclusion etc

it is also mentioned in the policy booklet.

now the important bit

period of cover =12 months how ever they did not give me a termination date yet as the policy schedule has not arrived through the post yet

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no, no need to see the T&Cs.

 

It seems to me that they are selling 12 month cover but only granting 50 weeks. You'll have to see when the schedule arrives.

 

The 14 day buffer is quite reasonable but clearly it should be worded to say that your cover will commence 14 days from XXX date and terminate on the same date 12 months later.

 

No what you have to do is to leverage this error on their part to "persuade" them to pay up.

They might equally say that they will merely extend the cover for another two seeks at the end of the policy.

 

Wait until you get the schedule and then write and complain. Tell them that you are prepared to go to the Insurance Ombudsman.

 

Don't be disappointed if you don't succeed.

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thanks you so much for your help, i will do as you say and will let you know what happens next but for now ill just have to wait for tily to get home healthy. If i dont succeed ill have you guys to thank and not regret that i did not do anything about it

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It seems to me that they are selling 12 month cover but only granting 50 weeks

 

Not quite true. If the cat had been hit by a car or fallen and broken a leg then the policy would pay out from the start. It's quite clear on all pet policies that illness will not be covered for an initial period - usually two weeks but some companies have three weeks as an initial incubation period for existing illness to show clinical signs and be diagnosed. A cat that has been diagnosed with 'various conditions' 7 days after taking out a policy will almost certainly have had something wrong already.

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Not quite true. If the cat had been hit by a car or fallen and broken a leg then the policy would pay out from the start. It's quite clear on all pet policies that illness will not be covered for an initial period - usually two weeks but some companies have three weeks as an initial incubation period for existing illness to show clinical signs and be diagnosed. A cat that has been diagnosed with 'various conditions' 7 days after taking out a policy will almost certainly have had something wrong already.

Good point

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Not quite true. If the cat had been hit by a car or fallen and broken a leg then the policy would pay out from the start. It's quite clear on all pet policies that illness will not be covered for an initial period - usually two weeks but some companies have three weeks as an initial incubation period for existing illness to show clinical signs and be diagnosed. A cat that has been diagnosed with 'various conditions' 7 days after taking out a policy will almost certainly have had something wrong already.

Good point

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  • 9 months later...
  • 5 months later...
Nearly a year now and good news FOS has ruled in my favour and asked LV to pay out thanks guys. The adjudicator was really helpful and awarded me full cost plus 8% interest

 

We're just about to lodge a complaint with the FOS against Direct Line as they have the same exclusion hidden away in the small print rather than making it clear in the policy summary.

 

Are you able to summarise the FOS ruling? We're very unhappy with having to pay a £500 vets bill for our dog, especially as he's been continuously insured since he was a puppy.

 

Thanks,

 

Steve

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The adjudicator said that since the insurance was taken out on the day the cat was bought home from the RSPCA rescue centre, and that the cat was given a full vet check up before they handed her over to us she would give us the benefit of doubt that the cat was not sick when bought home. The adjudicator did mention in the end that the claim according to the terms and condition was invalid but she believed it was made in good faith therefore asked LV to reconsider.

 

 

any more help let me know.

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