Excess charged twice on Pet Insurance

[TimGS]

Hi,

 

I have a dog, who is insured, with a long term condition for which he is on medication.

 

He had a stroke last April and is on heart medication. Our insurance policy clearly states that they will pay out for no more than 12 months per condition - I have no dispute with this, the period of payment is coming to an end, but that's how it is. Similarly the excesses, although steep, are made very clear (a fixed 170 plus 30%).

 

I renew the policy every 12 months, in October, and have been with this company since we first got our dog.

 

What I didn't expect was to have the fixed excess applied twice. The table of excesses is prefixed by the text 'What you must pay during each period of insurance', and on a different page to the table of excesses, the policy defines a 'Period of Insurance' as the time for which they provide cover as described in the Schedule i.e. October of one year till October of the next year. Crucially, it appears to not include the 12 month period for which they will cover a condition.

 

This appears to mean that although they will payout for 12 months per condition, this period is defined as sitting within two periods of insurance, so we are stung twice for the fixed excess.

 

This seems nonsensical and counter-intuitive. If my dog had had his stroke in October, the clearly stated maximum 12 months of payout would fall within one 'Period of Insurance' and be subject to just one set of excesses. It is fairly unlikely though that an illness will coincide with the renewal date.

 

I realise that the large amount of small print is a legal necessity. However I would dispute how clear the situation is - and for any long term (12 months+) condition it is more likely than not you will be paying the fixed excess twice - which certainly is not made clear in the otherwise very clear table of excesses.

 

I don't think this is fair - but is it legal and does it amount to 'treating the customer fairly' ?

 

Thanks in advance for any advice.

 

-- Tim.

Edited April 24, 2013 by TimGS

[hightail]

I've never heard of this before. The insurer appears to be straddling the line between continuous cover and 12 month policies. I'm not quite sure if you're unlucky that they charge the excess twice or lucky that they will cover a condition beyond the renewal date. I can see the thinking, when you renew each October you are starting a new contract so it's a new excess. Who is the insurer?

[TimGS]

It's Paws Pet Insurance from Jardine Lloyd Thompson.

 

I've contacted the Ombudsman, and will be putting in a complaint.

 

thanks,

Tim.

[hightail]

Most insurers would charge an excess either per course of treatment or per period, not both. My gut instinct is that per course would be more normal but I think you should do a quick check with other insurers to see what they do.

[SallyHayward]

I have recently done extensive research covering most pet insurance policies in the UK. The excesses you mention are indeed very steep!! Not sure I have found another one that steep but have admit I have not come across Paws Pet Insurance. Most 12 month policies only charge the excess once per condition. However Animal Friends is an exception to this... their policy says "you are responsible for either the first £69 or the first £99 of each claim per condition per policy year depending on the excess level you have selected.

 

If your insurers did not make it clear when you purchased the policy (either in their Key Facts document or Policy Document) that you would have to pay the excess in each policy year then I suspect you might have a good case with the ombudsman as this is not generally the norm for this type of policy.

[BG1445]

May is ask how old your pet is. some insures apply a % at a certain age,

[TimGS]

Hi,

 

Our dog is about 15 years old, hence the large excesses.

 

The issue - as I see it - is that the documents do not make clear, nor has it been made clear at any point in the past, that the excess is per condition per policy year - on a first reading it looks like it is just per condition.

 

The wording before the excess tables is "What you must pay for each illness or injury that is treated during the period of insurance".

 

I would have expected the "period of insurance" to include the 12 month period during which I am eligible for payments from the insurer for each illness/condition.

 

I realise that in terms of the small print I may be wrong - but I certainly don't feel this amounts to fair treatment, and I do feel the documents do not make this clear.

 

-- Tim.

[bg5067]

Hi,

 

Our dog is about 15 years old, hence the large excesses.

 

The issue - as I see it - is that the documents do not make clear, nor has it been made clear at any point in the past, that the excess is per condition per policy year - on a first reading it looks like it is just per condition.

 

The wording before the excess tables is "What you must pay for each illness or injury that is treated during the period of insurance".

 

I would have expected the "period of insurance" to include the 12 month period during which I am eligible for payments from the insurer for each illness/condition.

 

I realise that in terms of the small print I may be wrong - but I certainly don't feel this amounts to fair treatment, and I do feel the documents do not make this clear.

 

-- Tim.

 

Hey Tim,

 

I actually work for a large pet insurance company, May i ask who it is you're insured with?

[TimGS]

Hi,

 

I'm with Thistle Insurance services, part of Jardine Lloyd Thompson, trading as PAWS pet insurance.

 

thanks,

-- Tim.

[bg5067]

I'm having trouble locating there website to look at T&C's. if you can provide them or a website i would like to look at them.

 

A lot of insurance companys that offer liftime cover with a flat xs will apply for each unrelated condition with that policy year and when the policy renews the xs will apply again for that year. If there's a % then that will usually apply to all claims regardless of continuation claim or not.

[TimGS]

@bg5067 - I'll try and find an electronic T&C, though I'm suspecting it doesn't exist online.

 

I complained to the Financial Ombudsman service, but it turns out that is useless in this case. Thistle acted as an intermediary for Alpha A/s in Denmark, which the FOS tell me means that it is not under their jurisdiction. I have to complain to the Danish equivalent.

 

This costs money unfortunately - not a lot, but I'm wondering how far it makes sense taking this.

 

Annoyingly Thistle themselves, in response to my complaint, directed me to the UK FOS as my next port of call. Evidently this has been nothing more than a waste of time.

 

-- Tim.