Court claim for vet bill! Help!!

[droddis]

Ok, so i took my dog to the local vet as he had a limp on his rear right leg. The my vet advised me he needed to go to the hosipital to see a consultant and asked if i had pet insurance. I did and they refered me to the hospital.

 

I had a consultation with the Vet and he said he needed to perform orthopedic surgery to repair the leg. and stated the bill would be between £2800 and £3500. The vet went ahead and did the surgery and the bill was settled by the insurance company for approx £3300.

 

The vet then booked him in for a follow up examination where he did an x-ray. He then added £600 for an xray to bill and £180 for the consulation to the bill. It was never explained that this was an additional cost and not included in the procedure.

 

My pet then developed the exact same problem on the other leg we took him to the local vet again and explained that the insurance only had an available balance of £700, they explained they could do an alternative procedure for £750 including all after care, and refered us to a different hospital, the procedure was done and the bill settled.

 

The first hospital is now pursuing the balance of the after care, which i believe had already been paid by the insurance in the origional payment of £3300.

 

My questions are follows.

 

Do i have a defence to being overcharged, or the additional cost not being clarified (or would this be considered a quasi-contract?)

 

Do I have a defence for negligence as they failed to offer alternative procedures (would this apply to my vet or the 1st hospital)

 

If not is there any defence?

 

The Particulars of claim are brief and as folllows:

 

* Unpaid treatment cost for pet after recieving orthopedic surgery on the following dates xx/xx/xx. xx/xx/xx.

* Efforts to contact clients with regards to payments of the invoice proved unsuccessful.

*total amount outstanding £800.

 

I can not afford to pay this bill as i am currently recieving income support and on a very low income.

[ScarletPimpernel]

As you mention Particulars of Claim, do we take it that they have issued proceedings in the County Court?

 

Either way:

 

- did you receive an itemised bill for the services that they are claiming for?

 

- did your insurer write to tell you what had been settled, and whether anything was outstanding?

 

- did the vet/hospital tell you what the charges for the x-ray and consultation would be beforehand? In other words, did you make an informed decision about whether to go ahead or not?

 

- have you received any previous letters from the hospital regarding this?

 

Finally, and more out of interest that anything else, I would be intrigued to know what sort of x-ray costs £600. A whole body x-ray of a human costs around £300, so I am struggling to understand how imaging of a dog's leg can be £600. As a guide, for humans a private x-ray of both hips would be £80-90.

 

If this is a court claim, don't worry. If you are on benefits you will probably be exempt court fees, and even if they win the court will only order affordable payments such as £1/month. Companies that rush to sue often find that the system can work against them!

[droddis]

Yes sorry, this is in the county court.

1. I cannot remember recieving a bill from the vet, there are no documents with the claim.

2. The insurer never wrote to say what has been settled but did inform me of my limit and explained i would be responsible for anything over the £4000 limit.

3. The Vet never informed of any additional cost, i was told the first consulation was £180 and the full procedure would be between £2800 - £3500.

4. In regards to the x-ray, afterwards i was informed I could of had the x-rays done at my local vet and they would of been about £180 each.

 

The second procedure was £750 including ALL x-rays, and the second vet said in his opinion the procedure was actually better than the first one carried out.

[droddis]

Does anyone know whether there is a defence to this?

[hightail]

http://www.rcvs.org.uk/Templates/PreviousNext.asp?NodeID=89721&int2ndParentNodeID=89717&int1stParentNodeID=89642

 

If the link I've posted works it may well be of help to you but you'll need to get an answer from those with more legal knowledge. Parts 1f-h of the vet's responsiblities to their client could be relevant. I don't know if it's a legal defence as such but you could put a complaint in to the RCVS and if it's upheld then they would have to drop the case against you.

[droddis]

Hightail, thank you for the response, I have briefly read the information provided, but will need to read into more detailed tommorrow. I have notice that the guidance sets out various responsibilities which i believe should have been followed.

 

My Query at the minute is I need further information from the claimant to determine exactly what he is claiming for, as part of the majority of the bill has been settled. Do I still need to file a defence as there is a time limit? how do i get this information??

 

Thanks Everyone!

[hightail]

You certainly need to send the papers back saying you will be defending if only to give yourself time to get more help. I know stuff about animals and vets not courts I'm afraid.

[buzby]

Noting the number of parties involved in the care, (You, Insurer, Hospital, Vet) these are too many variations for you as a defender to explain to the court the shortcomings and reject the liabilities. Apart from the stress of the action (and the possible financial ramifications) you may need specialist help to protect your interests, as you may be concentrating on issues irrelevant to the action, effectively wasting court time.

 

You MUST lodge your defences, BUT to do this without a consultation could be ill-advised as your defence notice is a useful tool to unsettle the pursuer/claimant, and if you waffle on irrelevances, they'll not think twice. You may also wish to involve your insurer as a notifiable party, and they could legitimately be involved. As for their 'cao' on the total costs, were you notified of this at any stage prior to your claim, or following it? This too, is relevant.

[hightail]

As for their 'cao' on the total costs, were you notified of this at any stage prior to your claim, or following it?

 

I'm guessing you mean 'cap' and it's a typo. The OP will have been notified well in advance as all animal insurance carries a limit either per condition or per year and would have been the very essence of the insurance policy.

[buzby]

Never assume. In many cases the vet prefers to deal directly with the insurer, and as such is not privy to limits that may have been agreed with the policyholder. Nevertheless, the question remains valid, as limits are not enforceable if disclosed following a claim.

[droddis]

We were aware of the cap before hand, but the vet was also aware we were on income support and couldnt afford to go over the limit. But with the quotation he gave this wouldn't of been a problem. He was paid for the the main part of the operation from the insurance as I said, which is why the insurance paid out on the second operation at the other hospital.

 

I have contacted the insurer and as far as they are concerned the matter is settled and aren't interested in pursing the difference in cost between the two procedures, and said I had to deal with the claim on my own.

 

I acknowledged the claim, stating that I intend to defend the claim. and the defence is due at the court on the 8th November.

 

I believe that i may have access to a free legal information service from lyons davidson, so i will attempt to contact them to find out. If not where is the best place to go to get advice, would I be best contacting a solicitor or going to the local C.A.B

[buzby]

Not CAB, as they mean well but will not be interested in representation, which I believe you do require. Legal information from LD is all very well, but To have a fair chance of winning, you'll need someone to speak for you (as I expect the claimant will have instructed someone). A local search for a solicitor or para-legal with an interest in arguing pet-related issues are not a must, but would be beneficial. You can have all the correct info but if you don't disclose what is required in the 2-3 minutes you have to explain why payment was not made, can leave you in dire straits.

 

However, taking someone to court that is on Income Support is usually a waste of time, as any order to repay will be at such a low level as to not make court action advisable.

[hightail]

In many cases the vet prefers to deal directly with the insurer, and as such is not privy to limits

 

Ah, I see what you mean. I thought you were asking the OP if they knew of the limit rather than if the vet knew. I have to say this is now striking me as very strange. The hospital settled the bill for £3300 direct with the insurer. Would they not have gone back to the insurer if there was more treatment? At that point if the other leg had already used up the rest of the limit wouldn't the insurer have sent the bill either back to the hospital or on to the OP?

[buzby]

Another thought, is that surely if the other leg started up, this is a fresh course of treatment and the clock restarts? A policy the limits the maximum exposure (that isn't expressed in millions, but a finite amount COULD be seen as being manifestly unfair, even if part of the documentation.

 

If I was in the OPs shoes, I'd be pushing the insurer to look at this cover, and if they do not agree get a deadlock letter and take it to the Ombudsman. Not only would this give the opportunity for a stay but put the insurer back In The frame, where they belong!

[hightail]

Some policies are £x per year Buzby and some are £x per condition.

 

Something else has made it's way into my befuddled brain as this goes on. I would like to know if this was a university vet hospital or one of the new private setups. 'Hospital' is now a term which any practice can use if it fulfills certain criteria such as 24 hour cover, certain equipment levels etc. etc. They are inevitably part of those vet chains and going back for a second bite of the cherry isn't exactly unheard of when it's an insured animal. They have some 'creative' ways of billing. It's one of my (many) bugbears that insurers do not question the charges so long as a vet has signed off the paperwork.

 

I'd like to know the timeline on this whole thing too. I really do wonder if they knew exactly what the limit was and got caught out because the other leg needed treatment and the owner went elsewhere.

[IdaInFife]

moved to legal issues

[droddis]

The second injury was classed as the same course of treatment by the insurer, as it was a bipolar condition, they sent me lots of jargon, but I couldnt understand any of it, it may as well of been in another language. The 1st Vet (the claimant) said the fee would be another £3300 but the insurance wouldnt cover it, all and was offered to do the treatment on my credit card!! which of course i couldn't afford, he was aware at this time i was on income support.

 

I then went back to my local vets, who had refered me to the private hospital. They said could I take my pet to a different hospital where they would do a similar procedure for £750. This was of course settled by the insurer as the balance was available. I am unaware if the claimant attempted to contact the insurer for the second payment.

 

I dont think they have sought legal advice, as there particulars of claim are extremely brief, no supporting documentation has been provided and the claim is in the vets name who perormed the surgery. There is also no claim for Solicitors fees.

 

I do not fully understand what the £800 is for, i think it is the second consulation, but the claim says just says for orthopedic surgery on the 3 dates the pet was in.

 

I will phone LD now, and see if they can help.

[buzby]

The claim for solicitors fees follows a win (by them). It is capped at £100 or so.

[hightail]

I am unaware if the claimant attempted to contact the insurer for the second payment.

 

It would be very strange if they didn't though. They'd been dealing direct with the insurers up to that point. How long ago did this all happen?

[ScarletPimpernel]

Was anything signed, such as a consent form, which might have included an agreement to pay any fees not covered by insurance? I am more familiar with human healthcare, but I imagine many of the procedures are the same - though the vet seems to have an immensely expensive x-ray set-up!

[hightail]

though the vet seems to have an immensely expensive x-ray set-up

 

Don't they just! I don't honestly think there's much can be done until a properly itemised bill is forthcoming. I'm fairly sure vets take a policy number up front if it's going to be an insurance job where they claim direct and check the cover is 'sufficient' before they start. It's why I'm just a touch suspicious at the amount being claimed, just enough to take it up to the limit and about the amount of an excess over.

[hightail]

Will be interesting to see if there are any other x-rays on the bill and what they were charged at.

[droddis]

Hi to everyone, and thanks for all your help.

 

Just to update everyone, it was decided that we can do with out the stress of another court case as we have been in and out over the last few months, with various thigns, and have just admitted the claim and offered payment of £20 per calender month, which was accepted!

 

David