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RSPCA and AXA - Pet-Insurance - wont pay up ***Resolved***


Jules Street
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Hi I am hoping for some much-needed advice!

 

Last December our beloved cat suddenly became breathless. The vet diagnosed heart failure which he tried to treat with surgery and medications. Sadly after 2 days we had to have her put to sleep. I have RSPCA Gold Pet-insurance, underwritten at the time by AXA. I contacted them for a claim form which arrived and I completed it. As agreed I paid the Vet directly the £75 policy excess and left them with the claim-form for them to finalise and send to RSPCA Insurance. The total bill came to around £1000 I think.

 

I heard nothing more until 2 weeks ago when I received a letter from a Debt Collection agency on behalf of the Vet! (Also, the bill now appears to have increased to £1200). I ignored the Debt Collector and contacted RSPCA, who said they had never received the claim-form from the Vet. The Vet said they sent the claim, and maybe it was lost in the post. I requested a new form and filled it all in again and sent it off to the Vet for them to complete again. After a few days I checked the RSPCA had received it, which they had.

 

Yesterday I came home to a message on my answer-machine from RSPCA saying they had decided not to pay the claim and they would write to me with their "reasons". Back to square one.

 

It wouldn't be so bad if it were just a claim for a car or something, but it is so upsetting because I still haven't really got over the loss of my cat so I know I am not thinking as clearly. Before I go off like a rocket, can anyone please offer me any advice on the best way to go about sorting this mess out?

 

Thanks in advance,

Jules

x

 

:-x

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What you must start doing is putting everything in writing by recorded delivery. Don't discuss this in any phone calls with the Insurers or the Vets, as you won't have these to use in any future actions, unless you record the calls.

 

At the moment, you have a debt with the vets, which you must think of as separate to the Insurance claim, if it is not an insurance policy via the Vets. The Vets have passed the debt to a DCA to chase for payment, as I expect is their normal procedure. You may have to enter into a payment arrangement with the Vets practice and hopefully at some stage you will be able to get the Insurers to reimburse you. You need the Vets practice on your side, in your battle against the Insurance company, so anything you can do to assist with this may be helpful to you. Perhaps you should write to the Vets practice saying that you are currently in dispute with the Insurers about the claim submitted and realise that this has delayed the bill being paid. Offer them what you can afford over a period of time and make a first payment.

 

RSPCA are just the brand name. The Insurance company AXA will be the ones who left the message on your answerphone. They deal with the claim on behalf of RSPCA and will address all communications as if they are the RSPCA. There are no RSPCA staff involved. I think you know this, but I have clarified anyway.

 

You need the information from AXA as to why they have refused the claim and then you have to read the terms of the policy, to see how they have come to this conclusion. Without knowing this information, it is difficult to comment. Post back, once you have the information and I may be able to comment further. AXA will have a complaint procedure you need to follow and this will include referral to the FOS if necessary. The FOS could take a very long time to resolve, if you involved them, so you could look to use the courts instead, after getting legal advice.

We could do with some help from you.

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Thanks so much UncleBulgaria, you are very "calming". I am glad I didn't ring them now. Just to complicate the whole thing, our other cat has had to have an op recently which I am going to have to claim for as well. So it's probably doubly important that I don't go and upset everyone right away!

 

I will write to the Vets as I could probably manage to pay a tiny bit each month, and also I will find out from AXA what they are disputing.

 

It would be great if there were a Pets NHS which all pet owners paid into. £1200 is an astronomical sum for me, hence the insurance!

 

Will post back when I have some developments, and thanks again,

Jules

x

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Hi again, just reporting back developments with the above problem!

 

To clarify there are 2 vets involved:- I will call them Vet A (our usual vet) and Vet B (our usual vet referred us to Vet B when the cat was taken ill. This is the Vet who is now pursuing us for the debt).

 

I have now received a letter from RSPCA Pet Insurance stating they cannot pay my claim because our cat showed clinical signs of heart disease in Sep09, 6 months before cover commenced. I went off to our usual vet (Vet A) and obtained a copy of the medical records. There is an entry in Sept 09 made during the cat's annual examination which states "possible slight heart murmur RHS". I do remember Vet A mentioning this at the time but he said he wasn't sure if it was a murmur, and anyway it was quite likely just due to the stress of visiting the vet. Every annual exam since then, plus a thorough check prior to a anaesthetic for a tooth extraction in 2012, has stated "no abnormalities detected". Vet A is on holiday 'til Monday and his receptonist has suggested I go back and speak with him as he might be able to do a letter to the insurers for me.

 

Meanwhile I have offered (by recorded letter to Vet B) to pay £25 per month until I can potentially settle the dispute with the insurers. This is the amount I am saving per month (on insurance and flea/worming etc) since the cat was put to sleep, and is all I can afford. Vet B has left me a voicemail asking me to contact them. Their DCA have also left me a voicemail asking me to contact them "to set up a payment plan".

 

My question now, before I contact them, is can the vet insist I deal with the DCA? I didn't think they could just pass on my debt/details to a DCA. Would I have signed up for this when I paid the initial £75 to Vet B in December? If I did sign anything I can't remember, but I was very distressed at the time as the cat was seriously ill. Also, the first I heard of the bill not being settled by the insurers was by the DCA letter 3 months later. Vet B did not contact me at any stage to say the bill had not been paid, so can they just pass the problem to a DCA wthout even telling me?

 

Hope you can help,

Thanks in advance,

Jules

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It depends on the terms of the vet you signed up to. If the vet wants a DCA to collect payments, without any agreement terms signed by you that confirmed any collection fees being due to the DCA or vet, then the £25 a month (or whatever amount) would have to go towards the debt.

 

I would suggest paying the vet directly in the absence of them confirming that any payment made to a DCA, would not incur any additional charges. Some DCA's have been sneekily adding collection fees to debts, when these are not covered by the original agreement signed

 

As advised before keep everything in writing. Make a payment to the vets the debt is due to, with a letter confirming that you will pay them direct. You could add that if they want a DCA to deal with repayments, they will need to confirm this in writing and also confirm that no additional charges/fees or interest will be due.

 

Hope you can get the previous vet to confirm in writing the situation with the heart murmur issue and this resolves the problem with the Insurers. It might be a struggle, as Insurers tend to go by what is shown on the medical records. If there is nothing on record to say the cat was checked again before the policy start date and the heart was found to be ok, then Insurers may not be convinced there was a not a pre-existing heart condition.

We could do with some help from you.

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  • 2 weeks later...

Hi again,

 

Just to keep you all posted and thank you all again:-

 

DCA continue to ring me twice daily - I do not pick up.

 

Vet 2 has not replied to my letter asking for confirmation that they will accept my offer of £25 pcm and requesting written evidence that I agreed to deal with any DCA.

 

Vet 1 has rung RSPCA/AXA for me and also faxed them a letter telling them they are WRONG. As a direct result they have agreed to re-open the claim and look at it again!! This Vet is my HERO, he is the only person (apart from you good-guys at CAG of course) who has not tried to just stonewall me.

 

I will keep you up to date,

Jules

xxx

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Hi Jules

 

If the DCA calls are getting in the way of your day to day life/communications, it might be worth getting a 'Truecall', you type the DCA number in, it's blocks them, whilst allowing other calls through. There are also templates in the library that you can send regarding phone 'Harassment'.

 

Keep updating the thread.

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Hi again,

 

Just to keep you all posted and thank you all again:-

 

DCA continue to ring me twice daily - I do not pick up.

 

Vet 2 has not replied to my letter asking for confirmation that they will accept my offer of £25 pcm and requesting written evidence that I agreed to deal with any DCA.

 

Vet 1 has rung RSPCA/AXA for me and also faxed them a letter telling them they are WRONG. As a direct result they have agreed to re-open the claim and look at it again!! This Vet is my HERO, he is the only person (apart from you good-guys at CAG of course) who has not tried to just stonewall me.

 

I will keep you up to date,

Jules

xxx

 

 

Thanks for the update.

 

Have you put in an "Official Complaint" to your Insurers, if so the DCA should stop contacting you until the complaint is dealt with.

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  • 7 months later...
Thanks for the update.

 

Have you put in an "Official Complaint" to your Insurers, if so the DCA should stop contacting you until the complaint is dealt with.

 

Hi guys, finally last month RSPCA/AXA insurance actually gave in and paid up. Thanks so much for all your advice, it was really helpful and inspired me not to give up. Also prevented me from making mistakes when sending letters, etc. Cheers, I will make a donation x

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Hi guys, finally last month RSPCA/AXA insurance actually gave in and paid up. Thanks so much for all your advice, it was really helpful and inspired me not to give up. Also prevented me from making mistakes when sending letters, etc. Cheers, I will make a donation x

 

Glad you got it resolved. They do try it on, in the hope of saving money.

We could do with some help from you.

PLEASE HELP US TO KEEP THIS SITE RUNNING EVERY POUND DONATED WILL HELP US TO KEEP HELPING OTHERS

 

 Have we helped you ...?         Please Donate button to the Consumer Action Group

 

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