liverpool victoria/pet insurance not paying out

[hightail]

LV will only cover treatment of a condition or anything that is related for a period of up to 12 months from diagnosis

True for their essential cover. Their premier cover is £5000 per condition with no time limit.

[raydetinu]

If this is the case as explained above; why could not LV do that?

[hightail]

If this is the case as explained above; why could not LV do that?

Do you mean why could they not continue to pay out up to £5k? Simply because the premiums for continuing cover with no time limit are considerably higher. If a customer hasn't paid for the premier policy then they ain't covered for premier payouts.

[unclebulgaria67]

Because LV have never been the most switched on companies. If you speak to people in the industry they will tell you that LV have a long way to go in terms of building a company that is capable of delivering high customer service standards. They have in recent years put significant sums into developing their personal lines business, but in terms of operation matters including staff training they have a lot to do.

 

But LV are not alone in offering below par services. Some of the other big brands have diluted their standards, with staff no longer writing proper explanitory letters or phoning customers with proper explanations, because the staff do not feel they have the time, due to the targets. These days if you work in some offices, they even restrict the time you are allowed for such things as toilet breaks.

[postggj]

just an update

i can confirm they had

 

 

• Premier pet insurance - no time limit for treatment for each condition
  

and NOT

Essential pet insurance - up to 12 months treatment for each condition

[raydetinu]

No excuse then for not paying up then!

What say you LV!!

[unclebulgaria67]

No excuse then for not paying up then!

What say you LV!!

 

LV's stance is very odd then. What policy term are they using. I think they need to explain.

[postggj]

Right from the start i have been asking lvcares

 

please explain the letter and the logic behind it

 

no case history

 

just a brief explanaton

[unclebulgaria67]

They won't respond online, only to the Policyholder via complaint, which is what they are going to have to do. LV's MD does not appear to have treated the previous correspondence as a complaint, which is pretty poor.

[postggj]

lvcares

 

what a joke

 

they were quick to comment, but just faded away

 

no more than a publicity stunt

 

shame on you lvcares

[hightail]

If premier cover has been in place without a break since before the problems started with the first leg and the £5k limit has not been reached then they're just plain wrong.

[unclebulgaria67]

If premier cover has been in place without a break since before the problems started with the first leg and the £5k limit has not been reached then they're just plain wrong.

 

The other possibility is that the policy wording has changed. We are looking at the latest wording online, but it is possible the policyholder concerned has a policy with slightly different terms.

 

Where this happens the FOS would normally expect the Insurers to honour the latest terms, on the basis that loyal customers should not lose out to new customers, being offered the same product, but a different policy wording.

[hightail]

Fair enough but those have been standard terms in the pet insurance market for a long time. Postggj has confirmed that the owner does have premier cover and always has.

 

I have known one insurer play a very dirty game in a similar situation. After an expensive condition was diagnosed which was likely to recur they changed the dd payment date at renewal and then claimed there had been a break so the cover was not continuous.

[postggj]

I HAVE JUST DONE A ROUGH DRAFT OF A RESPONSE LETTER, PLEASE FEEL FREE TO ADD OR DELEATE BITS

 

 

 

Formal complaint as to your complaints procedure

Dear Sir

 

Thank you for your letter dated 22/07/2011 (copy enclosed) for which the comments have been noted.

 

From the beginning of this complaint, I consider your company to be in violation of the legislation contained within the Consumer Protection from Unfair Trading Regulations 2008.

 

I must inform you that if no adequate response is received into this dispute, then I will have no alternative but to address my complaint to the office of fair trading, financial services authority, and the financial ombudsman service for compliance.

 

I find your letter dated 22/07/2011 rather amateurish in its explanation as to why my claim is not being honoured. It fails to include also the financial ombudsman’s complaints procedure being it is a final response to the claim. I consider the response given to be no more than a template letter.

 

I will now dissect your response piece by piece.

 

You state the illness/injury showed clinical signs before the cover started, please be good enough by return any evidence to support that reasoning. (Reports by a veterinary surgeon are acceptable)

 

I must inform you that the insurance cover in place is the premier cover, not the essential cover. The premier cover has no time limit on the treatment for each condition.

 

If premier cover has been in place without a break since before the problems started with the first leg and the £5k limit has not been reached then Liverpool Victoria is just plain wrong on its decision. This claim is not subject to one maximum benefit of £5000

 

I must advise Liverpool Victoria to re-examine the merits of this claim. While a decision is being made, I require your company to contact my veterinary surgeon of this new development.

 

Failure to address this issue will result in me contemplating a claim in the small claims court.

 

Yours sincerely

Edited August 5, 2011 by postggj

[unclebulgaria67]

Good letter.

 

You could also include the relevant part from the FSA handbook. Comments about the promptness and fairness. Lack of guidance about the claim and lack of updates. And unreasonably rejecting the claim.

 

ICOBS 8.1.1 06/01/2008 1An insurer must: (1)handle claims promptly and fairly;

(2) provide reasonable guidance to help a policyholder make a claim and appropriate information on its progress;

(3) not unreasonably reject a claim (including by terminating or avoiding a policy); and

(4) settle claims promptly once settlement terms are agreed.