Business ProfileforPTZ Insurance Agency, Ltd.

Re: Policy Number: A6790211 Claim Number: ******* In December 2023, my dog suffered CCL tear while playing catch in the back yard grass, she was seen by her veterinarian and underwent TPLO surgery and had her joint repaired. My dog is an otherwise healthy and young 4 year old dog; she has seizure disorder that is well controlled on medication and seizure free for more than two years. She has annual physical and blood work by her veterinarian clinic, which knows her well. In fact, my dog had completely normal physical exam and blood work less than 2 months prior to the occurrence of injury.When I filed for reimbursement of services related to this injury, including initial office visit after the injury, orthopedic surgeon consultation, pre-op visit, operation, post-op visit, my claim was denied and when I appealed, it was denied again. Of note, the insurance policy does not exclude coverage of ligamentous injury if not a pre-existing condition and the mechanism of my dogs injury falls within the definition of accident as stated in the policy itself "a sudden, unexpected or unintended action or event with a specific time and place which results in injury."My issue with the denial of my claim is that while as owner and the veterinarian are well aware that my dog is young and healthy without any pre-existing joint illness, the insurance company is attempting to build a narrative that her injury is classified as illness in order to avoid to be held accountable in reimbursement. It is unreasonable for the insurance company to issue denial without any evidence that my dog actual had prior ligamentous illness, only able to make such an assumption based on literature that it was not able to provide. It is shameful and reprehensible that while my dogs injury was completely accidental, the insurance company is portraying this accident as the result of pre-existing condition to avoid their responsibility to a paying customer.