liverpool victoria/pet insurance not paying out

[postggj]

 

 

STAY WITH ME ON THIS ONE

 

THIS IS NOT MY PET, A GIRL AT WORK HAS ASKED FOR HELP

 

 

TWO YEARS AGO THERE DOG HAD MUSCULAR SKELETAL PROBLEMS WITH THERE RIGHT LEG, VET TREATED AND INSURANCE PAID OUT

 

ROLL ON TWO YEARS AND DOG HAS DIFFEENT MUSCULAR SKELETAL PROBLEMS ON THE OTHER LEG

 

INSURANCE ARE REFUSING TO PAY OUT STATING PRE EXSISTING CONDITION EVEN THOUGH DIFFERENT LEGS

 

SUGESTIONS???

Edited July 27, 2011 by postggj

[postggj]

quote from letter

 

disapointed with our decision

 

cant help any further

 

now you state you can challenge the decision

 

why was that not put in the letter

 

i thank you for looking in and hope to enhance your customer service reputation but that just seems a sod off letter to me

 

(excuse my french)

Edited July 27, 2011 by postggj

[postggj]

Just a quck bump

[postggj]

It seems lvcares did not come back to this thread

 

what is annoying me is that after the ppi scandel of misselling by banks, and no doubt insurance companies were well aware of it,

 

are such things as the mass explosion in pet insurance companies trying to fill the void as no one will ever trust ppi again

[raydetinu]

If the original problem was under an LV policy then how can they refuse; however if it was with a different company then I understand their position.

[Mark&Janice]

postggi

 

Is this second injury with the same insurer or a new insurer?

[raydetinu]

Note what you say LV, however it would help if you explianed your position so others could make up their mind whether you are being fair in this respect.

there must be a reason why you have taken this stance which does not sound very positive.

why are you on this site, then if you cannot be specific and perhaps provide guidance to others that may have a problem!

[unclebulgaria67]

For what it is worth the stance taken by LV appears to be correct i.e there was a pre existing condition issue.

 

As the LV rep says, this is obviously fairly complicated and cannot be gone into on a public forum for the reasons stated.

 

Suggest that the Policyholder concerns uses the LV claims complaints process and takes this to the FOS if they want to.

 

In future my advice would be to work with local vets, when arranging suitable Insurance.

[postggj]

same insurer L.V.

 

thats why i am mad

 

AND LVCARES

 

WE ARE NOT TALKING ON A SPECIFIC CASE AS SUCH

 

AS ALLWAYS BIG COMPANIES BEING ECONOMICAL WITH THE TRUTH

 

JUST ANSWER THIS

 

IF I HAD AN OPERATION ON MY LEFT KNEE LAST YEAR

 

AND ANOTHER OPERATION ON MY OTHER KNEE THREE YEARS LATER

 

HOW CAN THEY BE CONNECTED BEING DIFFERENT PARTS OF THE BODY

 

THATS A GENERAL QUESTION, CAN BE ANY PART OF THE BODY

 

ANSWER THAT AND I WILL GO AWAY

 

I REPEAT

 

TWO DIFFERENT PARTS OF THE BODY, HOW CAN THEY BE CONNECTED AND TREATED AS THE SAME INJURY

 

PLEASE DEFINE PRE EXSISTING CONDITION

 

A PET HAS AN ACCIDENT

 

HOW IS THAT RELATED TO ANOTHER PART OF THE BODY THREE YEARS LATER

[raydetinu]

Well I hope LV address the problem satisfactorily for you but does not sound as if they are going to play ball or act fairly.

If as you say they were the orignal insurer you should be covered.

[postggj]

if they do not play ball then it will be either

 

C.P.U.T.R.

 

OR

 

AN N1 CLAIM

[unclebulgaria67]

If you have maintained continous cover with LV and they covered the first condition, then according to their policy they will cover recurring conditions. I would think the two issues experienced can be related, as to my knowledge the type of issue MUSCULAR SKELETAL PROBLEMS, would not just soley affect one leg. I am not a qualified vet, but I think a vet will depending on the exact problem confirm that they can be related.

 

I am not sure where they are coming from in regard to pre existing condition. This normally means before LV are on cover. If you have had a policy lapse for a period and have taken a new policy with LV, the pre existing condition will apply to the new policy, because you have not had continuous cover with them.

[postggj]

I am not sure where they are coming from in regard to pre existing condition. This normally means before LV are on cover. If you have had a policy lapse for a period and have taken a new policy with LV, the pre existing condition will apply to the new policy, because you have not had continuous cover with them.

 

 

THAT IS WHAT IS ANNOYING ME AT THE MOMENT

 

ITS THE OLD BS FACTOR AGAIN

[unclebulgaria67]

THAT IS WHAT IS ANNOYING ME AT THE MOMENT

 

ITS THE OLD BS FACTOR AGAIN

 

So you have had continuous cover with LV throughout, they covered one leg due to the condition mentioned, but they won't cover the other leg.

 

What LV appear to be saying is that the conditon existed ever before they dealt with the first claim and certainly before the policy was taken out.

 

What information have LV received from a vet to say that you would have been aware of a pre existing condition before the policy was taken out ? I think you need to dig away and find out what information they are relying on to form their judgement.

 

The letter from LV's MD is pretty poor. He should know that if the letter is supposed to be a final letter of refusal to deal with a claim, that it should have included details about the FOS complaints procedure and attached a copy of the FOS leaflet. I would suggest that the LV rep who is responding makes sure the MD's staff are correctly including the FOS bits, as otherwise they risk getting a slap from the FSA.

[postggj]

Agreed

 

i am now drafting a formal response

[hightail]

I've had a quick look at LV's website and the first question is whether you had their essential or premier cover.

 

If it was the lower (essential) cover then they are correct in what they say about the second leg as each year you are starting from new. The first time you renewed after the year in which this problem first showed in one leg it became a pre-existing condition and was therefore not covered.

 

If you had the premier cover throughout then it's an argument about the money. From what I can see they have a £5000 per condition limit which is not time limited. If the treatment for the first leg cost less than £5000 then you still have cover up to that amount as they are (rightly) saying it's the same, or a related, condition.

 

I would say that there was no reason whatsoever for the spokesman from LV not to explain the difference in their two levels of cover though I'm not surprised. I think their website is misleading. Both essential and premier cover give the same £5000 figure and the only explanation they give is that it can be claimed over a longer period if you take the higher cover - with presumably higher premiums. Many (if not most) consumers would in my opinion see that headline figure of £5000 cover and opt for lower premiums. They simply wouldn't realise the difference. If I could get the pdf policy document to open I'd check further - but I can't.

[raydetinu]

LV are not doing themselves any favours here, and are normally quite reasonable and fair; will now have to rethink about continuing to use them ( not pet related ).

HIGHTAIL are you saying that when renewing you must declare a condition that they have already paid out for in previous years? that cant be right as they already know about it; you dont do that when renewing car insurance, you only declare stuff when you change companies!

Edited August 2, 2011 by raydetinu

[Mark&Janice]

As we explained in our last post it's not possible to explain our stance on a claim without going into specifics. Every claim is different, with its own unique set of circumstances.

As to why we posted on the forum, we regularly engage with the key blogs and are often able to help customers with their problems. While we couldn't talk about a specific claim publicly, we suggested a possible next course of action with the limited information that was available. Again, if any policyholder wants to discuss details of a claim with us then they contact us directly. Thank you.

 

LVCares? too funny, what is your purpose of being here? just to snoop?

[raydetinu]

LV here is your opportunity to reply to the specifics of this case and to help the OP, thats what we are here for,

As said above whats your reason for being on here then?

[unclebulgaria67]

Ok. This is what I think is happening here (my theory). The policyholder only took out the Essential cover which only covers up to 12 months treatment for each condition. LV believe that the other leg problem is related to the previous condition and as the latest leg problem is beyond 12 months, they won't deal with it.

 

If this is the case which the Policholder should check with LV, then they should obtain an other independent Vets opinion, as to whether the latest leg problem is related to the previous condition or whether it is totally new. If the opinion is that it is a new condition, then LV should settle the Vets bill. If the opinion is that it is related, then LV would not be liable.

 

 

• Essential pet insurance - up to 12 months treatment for each condition
  
• Premier pet insurance - no time limit for treatment for each condition
  

[hightail]

Unclebulgaria has explained it in a nutshell. How they confuse people is that no matter which policy you take out you still get £5000 cover. How the majority of pet owners are meant to work it out I really don't know. If you look at essential cover it seems you get £5000 in one year and for the premier you're paying higher premiums for £5000 cover spread over many years. They do state that the essential cover is a 12 month policy but I don't think it's made clear enough what that really means. To most people £5k cover is £5k cover and many will not realise the implications of taking out the cheaper policy.

[postggj]

They do state that the essential cover is a 12 month policy

 

but the premiums have been collected by lv for the last three years

[hightail]

HIGHTAIL are you saying that when renewing you must declare a condition that they have already paid out for in previous years?

You don't need to because they know. These pet insurance companies call it 'renewing' every year which is another thing causing confusion. There is no indication in renewal documents to let the customer know if they have a continuous policy. All policies are taken out for periods of 12 months at a time so referring to one type as a 12 month policy isn't exactly a helpful definition.

[hightail]

They do state that the essential cover is a 12 month policy

 

but the premiums have been collected by lv for the last three years

 

With the essential policy you are starting from scratch each year which means on each renewal date any condition which has gone into the vet records becomes a pre-existing condition and excluded.

[unclebulgaria67]

12 month policies and being renewable is missing the point.

 

LV will only cover treatment of a condition or anything that is related for a period of up to 12 months from diagnosis, with the maximum cost being restricted to £5k.

 

So if you had a policy that ran from 1/1/11 to 31/12/11 and your dog suffered from a condition on 1/7/11, LV would cover the Vets bills until 30/6/12. After 30/6/12, they would stop funding any Vets bills.