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Insurance Claim


poodlesrule
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I've just got to have a vent. Petplan insurance have refused to pay out on a claim for milk fever on the grounds that it relates to "Treatment for Pregnancy & Birth". Never mind that she got it when the puppies were nearly three weeks old, how long do they think that "birthing" lasts for, and it has taken them five weeks to tell me. :mad

Not happy!

Hopefully the letter I have written to the underwriter will be successful.

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But it is related to you breeding her. If you hadnt bred her she wouldnt have milk fever. If I remember correctly in the policy book it says something about not covering breeding and issues that arise from breeding. I think thats fair enough, otherwise it would cost them a whole lot of money. I am a breeder too and it would be very nice to have coverage for breeding related problems but not one company will ocver it and I think thats understandable.

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But it is related to you breeding her. If you hadnt bred her she wouldnt have milk fever. If I remember correctly in the policy book it says something about not covering breeding and issues that arise from breeding. I think thats fair enough, otherwise it would cost them a whole lot of money. I am a breeder too and it would be very nice to have coverage for breeding related problems but not one company will ocver it and I think thats understandable.

What they don't pay out on is caesarians, miscarriages etc relating to pregancy and birth.

This is the Terms & Condition that they stated for not paying the claim "The cost of killing and controlling fleas, general health improvers and any Treatment in connection with pregnancy or giving birth"

My argument is the pregnancy and birth has finished (after the last placenta has been passed).

They also paid out last year for mastitis, so I can't see why this would be any different.

Edited by poodlesrule
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I think the key words here are "in connection with". There is a connection between milk fever and pregnancy and birth. If she wasnt pregnant and didnt have pups she wouldnt have milk fever. As for paying for mastitis last year, I dont know the details or why they would pay for that unless it was a phantom pregnancy and she developed mastitis??

Edited for typos

Edited by Kaffy Magee
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Mastitis happened when the pups were around 5 weeks and being weaned.

In this case with eclampsia, it wasn't related to pregnancy or giving birth, but due to heavy lactaction and nine puppies (see below for definition)

Eclampsia (hypocalcemia or puerperal tetany) is an emergency medical condition associated with a life-threatening drop in blood calcium levels that occurs in nursing mothers. Eclampsia occurs most commonly when the puppies are one to five weeks of age and the mother is producing the most milk. Eclampsia is not due to an overall lack of calcium; it merely indicates that the nursing female cannot mobilize sufficient supplies of stored calcium quickly enough to meet her metabolic needs. Females that are particularly good mothers, especially attentive to their puppies, seem to be more likely to develop eclampsia.

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Good luck to you for trying, I think personally that milk fever is related to pregnancy and birth. Due to the fact that if there was no pregnancy or birth your bitch would not have developed milk fever.

I would say that the fact they paid out for mastitis was an oversight on their behalf. Though I support your challenge in every way and wish you luck I think its a very fine line.

Out of curiosity are their Pet Insur. that will pay for breeding/pregnancy related things?

I am with Petplan also and only every claimed for treatment and diagnosis of a phantom pregnancy.

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Good luck to you for trying, I think personally that milk fever is related to pregnancy and birth. Due to the fact that if there was no pregnancy or birth your bitch would not have developed milk fever.

I would say that the fact they paid out for mastitis was an oversight on their behalf. Though I support your challenge in every way and wish you luck I think its a very fine line.

Out of curiosity are their Pet Insur. that will pay for breeding/pregnancy related things?

I am with Petplan also and only every claimed for treatment and diagnosis of a phantom pregnancy.

I gave up ages ago trying to find a company that does, no one will cover anything to do with pregnancy - wouldn't it be wonderful to be able to claim something back. :laugh:

Very interested if there is such a company though :D

Edited by Andisa
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I agree with the Insurance Company, it was your choice to breed her, so as an owner/breeder you have to accept responsibility for any costs related to this.

Why should any insurance company compensate something that was technically an "Elective" treatment...sure it would be nice to be reimbursed when these costs come to light :)

Yes I understand that the treatment of the current issue is not "elective" and most definately requires treatment, but breeding her is :)

All in all, I hope your girl is better soon :)

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I agree with the Insurance Company, it was your choice to breed her, so as an owner/breeder you have to accept responsibility for any costs related to this.

Why should any insurance company compensate something that was technically an "Elective" treatment...sure it would be nice to be reimbursed when these costs come to light :)

Yes I understand that the treatment of the current issue is not "elective" and most definately requires treatment, but breeding her is :)

All in all, I hope your girl is better soon :)

Yes she is better, thanks.

Here are a couple of hypotheticals though:

1. A bitch has a phantom pregnancy (not mated), lactates and is give a litter to foster and then gets milk fever. Technically she has never been pregnant or given birth.

2. A bitch has a litter and all of her pups die and she fosters a litter and gets milk fever.

Should they pay out for either of these?

My arguement with them, not anyone on here, is that the pregnancy and birth didn't cause the milk fever (it wasn't present during either) it was the feeding of a large litter three weeks later. :)

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I agree with them, I don't think it should be covered.

My arguement with them, not anyone on here, is that the pregnancy and birth didn't cause the milk fever (it wasn't present during either) it was the feeding of a large litter three weeks later. :)

Yes, the litter she whelped - which is the key part.

Even if she fostered a litter, it should not be covered.

If the bitch was desexed there would be no puppies, false pregnancies, milk fever etc All can be avoided with desexing.

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I agree with the Insurance Company, it was your choice to breed her, so as an owner/breeder you have to accept responsibility for any costs related to this.

Why should any insurance company compensate something that was technically an "Elective" treatment...sure it would be nice to be reimbursed when these costs come to light :)

Yes I understand that the treatment of the current issue is not "elective" and most definately requires treatment, but breeding her is :)

All in all, I hope your girl is better soon :)

Yes she is better, thanks.

Here are a couple of hypotheticals though:

1. A bitch has a phantom pregnancy (not mated), lactates and is give a litter to foster and then gets milk fever. Technically she has never been pregnant or given birth.

2. A bitch has a litter and all of her pups die and she fosters a litter and gets milk fever.

Should they pay out for either of these?

My arguement with them, not anyone on here, is that the pregnancy and birth didn't cause the milk fever (it wasn't present during either) it was the feeding of a large litter three weeks later. :)

IMO they would cover hypothetical 1 because it is not required for the bitch to be desexed. Hypothetical 2- the costs should be paid by the person who owns the pups.

I think the intent behind the statement is that they do not cover anything during or cause by the process of breeding the bitch, but they have said pregnancy and birth which this technically isnt- so a bit of a stuff up on their end. Not sure if they can get away with not paying based on the 'intent' of their policy.

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I really think that to stop any confusion, the Insurance companies should have a more defined list of exclusions.

As it is written then, if you keep a puppy from a litter and it does some sort of damage to the dam, whether it be in six weeks or six years time, what is stopping them from saying it was related to pregnancy or birth because you happened to breed the bitch and caused her to become pregnant and give birth to the pup? Just a thought.

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I really think that to stop any confusion, the Insurance companies should have a more defined list of exclusions.

As it is written then, if you keep a puppy from a litter and it does some sort of damage to the dam, whether it be in six weeks or six years time, what is stopping them from saying it was related to pregnancy or birth because you happened to breed the bitch and caused her to become pregnant and give birth to the pup? Just a thought.

Because they are saying that they do not want to cover the increased risk associated with breeding ie from the time she is mated to the time pups are weaned. So conjunctivitis during the pregnancy would be covered, or a broken leg, or a bite from another dog- be it a bite from her own pup or a strange dog. But the dont want to cover progesterone supplementation, Sections etc that are all physical or physiological risks associated with pregnancy/breedjng.

So no I cant see them saying that damage caused by a pup would not be covered if it has nothing to do with a regular complication of breeding- nor do I think that it is inferred by how it is written.

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I have my dogs on my home and contents policy - the company has covered 2 c-sections with no problems. You need to hunt around. I don't agree that they shouldn't cover your costs. If you have full private health isurance you are covered for pregnancy etc so why shouldn't the same apply for pet insurance?

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I have my dogs on my home and contents policy - the company has covered 2 c-sections with no problems. You need to hunt around. I don't agree that they shouldn't cover your costs. If you have full private health isurance you are covered for pregnancy etc so why shouldn't the same apply for pet insurance?

I never thought about home and contents insurance.

I did mention to the person from Petplan that it may be beneficial for them to put specific conditions in the policy and maybe a definition of pregnancy and birth to stop any confusion.

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Insurance companies cannot possibly continue to cover some of the things currently offered, let alone any breeding issues. Especially when they seem to offer claims of up to $10,000 each year when they charge $400 or so.... I suspect we shall see premiums rise significantly and the number of exclusions raised. We already have vets who ask whether you have insurance before they work out the cost for an operation.

If the company doesnt make a profit, they will not continue.

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So where exactly do you suggest they draw the line?

No claims on working, agility or show dogs as they were not being "usual or typical" dogs?

No claims on injuries incurred outside of the house?

No claims on skin treatment if they have flea allergies as fleas could be prevented?

No claims on gastro blockages as bones are evil?

Where does it end?

I don't understand people not willing to claim on their insurance (unless it is absolutely piddling and not even worth the no claim bonus) - why bother to have it in the first place?

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