Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:02/29/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Policy: ********* Policyholder: ***************************** Pet Name: ********** number: ******* My claim for my pet was wrongly denied. **** got sick due to ingesting a foreign substance on 6/28/2023. I had him treated at Oceans Ave Vet. It was an accident. The cost of the treatment was ****** USD. It should be covered by my Pets Best Policy purchased. ******* (Ocean Avenue Pet Hospitals assessment, and other health records attached. Thank you,

  

  Business Response

  Date: 03/04/2024

  Dear Better Business Bureau,
  We are in receipt of the complaint filed by ************************************* with your office. Thank you for the opportunity to respond to the concerns regarding the coverage and claim outcome. We empathize with the frustration felt by the consumer. 
  We are unable to provide specific information regarding the claim outcome as we are prohibited by law from releasing personal information without a signed release. Pets Best offers 1st and 2nd Levels of internal appeal. The 1st Level Appeal process includes a thorough review of the complaint, claim, and all of the pet's associated medical records by an Appeal Specialist. Appeal Specialists are individuals who are not involved in making the initial claim determination, nor are they familiar with the case. 2nd Level Appeals are reviewed by an Independent Third-Party Veterinarian. 
  Unfortunately, once these two levels of appeal have been exhausted, there is no additional review or resolution for Pets Best to provide directly, however, policyholders have the option to file a complaint with their state's Department of Insurance.
  Thank you for the opportunity to respond to this matter.
  Sincerely,
  Pets Best Insurance

• Initial Complaint

  Date:02/07/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I have been a Pet's Best customer since 2020 for my cat ******* and had no issues until this year. Starting in November 2023, the company started denying to pay claims, classifying many things as "wellness" that they had not in the past. On January 16, ****, ****** had an anesthetic dental procedure to check her teeth for periodontal disease as part of an ongoing condition she has been treated for for the life of the policy. In the past, these have always been classified as illness, since they are related to her ongoing care for the condition. However, the company suddenly and without warning denied the majority of the claims, misclassifying them as "wellness" to say they are not covered or over the coverage limit. At the same time, ****** was also having digestive issues, and the vet did blood work and gave extra antibiotics during the procedure and to be given at home to attempt to resolve the digestive issues. Much of this was also misclassified as "wellness." The claims related were #******* (dental procedure including x-rays, bloodwork, and anesthesia) #******* (medications administered during the procedure), and #******* (medications and parasite testing). The amount in these claims that should have been covered but was not comes to $1,109.06. With the 80% reimbursement rate of my policy, I should have been reimbursed $887.25. I am requesting the reimbursement of that amount ($887.25) in line with prior claim processing.I have called twice now requesting a detailed explanation regarding the sudden change in the way these are classified and appeal form to appeal the claim, but have never been provided such form. The representatives have been intentionally unhelpful and refused to assist, including suddenly demanding I give them a new address (while my current one is correct) before assisting. There is no way to email or request the appeal besides calling the line, where the reps do not assist.

  

  Business Response

  Date: 02/12/2024

  Dear Better Business Bureau,
  We are in receipt of the complaint filed by ************************* with your office. Thank you for the opportunity to respond to the concerns regarding the Wellness Endorsement benefits and coverage concerns. We empathize with the frustration felt by the consumer and regret to hear that the experience was less than positive. We have responded to ************************* directly via email as we are prohibited by law from releasing personal information without a signed release.
  If anything further is required, we are happy to assist. 
  Sincerely,
  Pets Best

  Customer Answer

  Date: 02/12/2024

   
  I am rejecting this response because:
  While they did email me separately, they have not resolved the issue or issued a reimbursement for the dental procedure or related costs. There was no information or justification given that was any different from the *** statement I received. There has been no attempt to resolve the issue, only explain it away and avoid reimbursing for the previously covered services.

  

  Business Response

  Date: 02/15/2024

  Dear Better Business Bureau,

  Pets Best feels we have accurately addressed the member's concerns in our direct email response which included the next steps available to dispute the claim(s) in question. We have provided an open line of communication to address any remaining questions or concerns directly as we are prohibited by law from releasing personal information. 

  Thank you,

  Pets Best

  Customer Answer

  Date: 02/18/2024

   
  I am rejecting this response because:
  They have not resolved the issue at all. They have provided no reimbursement or valid reasoning why the charges are suddenly excluded from the policy. While they did finally provide an appeal form, this is not a resolution, only another hurdle I will need to jump through in an attempt to have this issue solved. Given the refusal to address the issues or resolve the situation, I highly doubt they will process the appeal and reimburse me for the charges that should be covered. In fact, they are now even trying to backtrack and say that the previously covered charges were "accidentally" covered in order to justify this fraudulent denial of my claims. This is NOT resolved at all.

  

  Business Response

  Date: 02/22/2024

  Dear Better Business Bureau,
  Pets Best feels we have accurately addressed the member's concerns in our previous response and direct email replies. 
  While we understand the frustration and concern about inconsistent claim handling, we have thoroughly explained the exclusions and policy provisions applied to each of the denied services and provided **************** with an option to dispute the outcome. Pets Best has made every effort to aid in an understanding of the policy provisions, including referencing these within the Explanation of Benefits provided with the initial claim determination. We have also discussed the policy provisions over the phone when discussing the claim outcome with **************** and in emails sent to **************** with screen shots and references to these policy provisions. 
  The coverage is outlined in the policy documents clearly and understandably, and there have been no changes to the policy coverage. A copy of the policy has been included, for reference, and in an attempt to provide all information to the best of our ability as we are limited in the information we are able to share with the BBB for privacy reasons. 
  Thank you, 
  Pets Best 

• Initial Complaint

  Date:02/02/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  When I got my rescue dog Huck 7 yrs ago, I bought insurance through pets best. At that time it was under $50. Each time I've made a claim my rates have gone up with an explanation that it related to increased usage in my area (not my specific use). Last year it went up to $109/m and I challenged this and complained to the company. I just got a note stating my insurance will go up to $174.15/month They moved my renewal up two months from 3/27/24 to 1/22/24.. I think they are charging me a higher rate for using my insurance. When I went online to see what a new policy for my dog would be, the rate came up as a maximum of $51 for their highest policy.

  

  Business Response

  Date: 02/08/2024

  Dear Better Business Bureau,
  We are in receipt of the complaint filed by *********************** with your office. Thank you for the opportunity to respond to the concerns regarding the premium increase and Underwriter pricing differences. We empathize with the frustration felt by **************** and understand the concerns about affordable coverage. 
  Premium increases happen at the annual policy renewal. The premium at renewal is not based on the claims submitted, but it is based on the enrolled pets age, breed, and the cost of veterinary care in the policyholder's local zip code area. As pets age, their odds of needing medical care increase, as do the odds this care will be more expensive. Premium changes can occur annually at renewal to balance these age-related health risks with rising medical care needs. 
  The policies being offered at this time (as referenced in the images provided by the consumer) are underwritten by a different underwriter than was offered by Pets Best previously. It's important to understand that the coverage under each policy is also different and that this impacts the cost of the policy, resulting in a different quoted price. 
  In addition to this response, we have responded to **************** directly via email to provide additional and more specific information as we are prohibited by law from releasing personal information without a signed release. If anything further is required, we are happy to assist.
  Sincerely,
  Pets Best

• Initial Complaint

  Date:01/31/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I have been a long time customer of Pets Best Health **********************. I have been pleased with low premiums and I specifically chose them because they offered direct reimbursement to my vet upon approval. On September 10, my dog CC was admitted to *********************** for a vascular accident. Pets Best preapproved the direct reimbursement and I left a 500 dollar deposit (2x my deductible) so my dog can get care. Pets Best then denied the claim, after preapproving the reimbursement. I submitted 2 appeals and both were denied. I also filed with my state insurance commissioner and that was denied as Pets Best deliberately mislead consumers in their fine print and wrote a misleading letter to the insurance commissioner. They owe *********************** ***** dollars for my dogs treatment. And refuse to pay for it.

  

  Business Response

  Date: 02/06/2024

  Dear Better Business Bureau,
  We are in receipt of the complaint filed by ************************* with your office. Thank you for the opportunity to respond to the concerns regarding the Veterinarian Reimbursement Release Form and claims experience. We empathize with the frustration felt by the consumer. 
  Pets Best has previously addressed the concerns raised by ************** during the 1st and 2nd Level of internal appeal, as well as at the highest level of appeal review available during the Department of Insurance complaint review, as referenced by **************. Unfortunately, there is no additional information or resolution available to provide to ************** directly and Pets Best is prohibited by law from releasing personal information without a signed release.
  Sincerely,
  Pets Best Insurance
  

  Customer Answer

  Date: 02/06/2024

   
  I am rejecting this response because:

   

  Pets Best preapproved to reimburse my veterinarian directly for emergency treatment on my dog.  My dog did not suffer an illness or preexisting condition yet AFTER ***** dollars of treatment was administered, Pets Best rejected the claim stating my dog had pre existing conditions- leaving the animal hospital not paid for services.  BBB was my next step and after this i am contacting the state Attorney General and getting a consumer fraud lawyer if Pets Best does not pay my vet what is owed.  

  This is not the first complaint, as this company has misled consumers in the past.  Pets Best needs to pay my vet and refund me my premiums.  

  

  Business Response

  Date: 02/12/2024

  Dear Better Business Bureau,

  Pets Best feels we have accurately addressed the member's concerns. A detailed letter explaining the coverage denial for her claim(s) has been provided to ************** directly as well as to the Department of Insurance in ****************** state. 

  The Veterinarian Reimbursement Release Form is not a promise to pay, but an agreement that if reimbursement is eligible, it is to be paid to the provider directly. The form indicates, under the Policyholder Declaration, "By affixing my signature to this document, I hereby release any claim reimbursement for unpaid amounts on the attached claim and request that any reimbursement be made directly to the veterinary hospital or clinic to which a balance is left owing in my name. I understand that this request does not guarantee claim payment. Eligibility of all claims is determined at time of review of the claim, and I am responsible for all outstanding balances."

  Additionally, under the ***************** or Hospital Declaration, the form indicates I understand that submission of the above referenced claim is not a guarantee of payment and that the decision to extend credit to the above referenced policyholder is made without any such warranty or promise.

  You can find out more about our direct pay option on our website at *********************************************;

  Thank you,
  Pets Best

• Initial Complaint

  Date:01/25/2024

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I have paid for this insurance every single month since my policy start date of 2/10/23. I had wellness coverage as well as regular insurance. I am looking for reimbursement of those services as they have done nothing but give me grief every single time I have filed a claim. The first claim that I filed with them back in February 2023 was denied because my pet received a prescription and they tried to tell me that it was an illness visit when it was a wellness visit. I had to fight with them back and forth on that for a month before they would reimburse me.Now, I have taken my pet to his annual exam and filed my claim on January 22nd, ****. I never received any policy documents that told me that all of my wellness money was exhausted. My claim was denied today, and the rep that I talked to told me that wellness reimbursement money was no longer available to me because I was 2 weeks early in my policy to take him to the vet for his annual exam that my vet sent me notice for. I scheduled him for what they have available.However, I never received any notice that money was exhausted and I am seeking a full refund of $261.30 for the vet appointment and 11 months of the insurance ($41.62 x 11 = $457.82) that I paid for that was a complete scam. I am happy to pay the first month that I actually used the insurance and got them to cover his first annual appointment in 2023, but I am incredibly unhappy with every interaction that I've had with this company.I have cancelled my policy effective tomorrow 1/26/24, and will never do business with them again. I can't believe how much I've paid for them to argue at every single turn.

  

  Business Response

  Date: 01/30/2024

  Dear Better Business Bureau,
  
  We are in receipt of the complaint filed by ************ with your office. Thank you for the opportunity to respond to the concerns regarding the Wellness Endorsement benefits and claims experience. We empathize with the frustration felt by the consumer and regret to hear that the experience was less than positive. We have responded to ************ directly as we are prohibited by law from releasing personal information without a signed release.
  
  If anything further is required, we are happy to assist.  Thank you for the opportunity to respond to this matter.
  
  Sincerely,
  Pets Best

• Initial Complaint

  Date:01/16/2024

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  *** had pets best for almost 6 years and never sent in any claims for reimbursements After a medical emergency I called Pets Best to ask a few questions and was told by a representative there ( and I do have the name ) that I should have submitted past vet bills as not all would be covered but things like anesthesia, Xrays, medication would be covered in certain instances So I proceeded to contact my vet who in turn sent pets best 30 pages of medical records including the last emergency on Dec 6 2023 Of course it took several phone calls with pets best saying they did not receive the 30 PAGES of email I finally said look back in your emails and YES they had received them !! Apparently no one monitors the emails ! Then starts the multiple requests for MORE AND MORE info !! They were missing this and that every day !I personally sent them the SAME papers multiple times and they kept asking me to resubmit claiming they were missing information I had to annoy my vet with rediculous questions of things pets best wanted!! Of course they denied all my previous claims outright ! My last claim on Dec 6 2023 was for $769 I honestly thought Id be able to recover some of the money I laid out after the thousands of dollars in vet bills they denied me any part of !My deductible is $500 so pets best somehow conveniently only covered $400 and something JUST UNDER MY DEDUCTIBLE! Pets Best was an absolute nightmare to deal with ! Every person you talk to gives you another story a different story Never the same answer twice !! Multiple requests for the same info that was already sent multiple phone calls Insane!! I honestly feel they think youll just give up after all the aggravation they give you ! I did not give up but also got nothing ! I would not recommend Pets Best and Im sorry I didnt do more research after giving them 6 years of my money !!

  

  Business Response

  Date: 01/19/2024

  To whom it may concern,
  Thank you for the opportunity to review and respond to the complaint filed by ***************************. Since the Policyholder is in disagreement with a claim determination, Pets Best offers, and encourages, our policyholders to utilize our voluntary appeal review process which, according to our records,was started on January 17, ****. An automated email confirming the appeal has been started should have been received by the policyholder.  
  The appeal review process includes a First Level Appeal review whereby the complaint, claim, and all of the Pet's associated medical records are provided to an Appeals Specialist for a thorough review. Appeals specialists are individuals who are not involved in making the initial claim determination, nor are they familiar with the case. If additional information is needed during this review, the Policyholder will receive a separate communication from our appeals team detailing what is needed. Once the 1st Level Appeal review has been completed, the outcome will be provided directly to the Policyholder via email.
  Thank you.

  Customer Answer

  Date: 01/22/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to my complaint, and find that this resolution is satisfactory to me.
  
  Thank you. 
  

• Initial Complaint

  Date:01/10/2024

  Type:Order Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I purchased 3 policies for my two dogs and one cat. At the time of purchasing my cat's policy I decided to add a wellness plan since he would be getting neutered soon. It only made sense financially to opt in to the wellness plan if I were able to cancel it after his neuter procedure was complete. I was careful to research that I would be able to cancel the wellness plan before adding it to his policy, otherwise I wouldn't have purchased the wellness plan to begin with. My diligent online research confirmed that I would be able to cancel the wellness plan and keep the accident/illness insurance. 3 months later, after spending $1,400 to cover all three pets, I am unable to remove the wellness plan online so I call in. The customer service agent told me that they don't permit cancellation of the wellness plan until the policy renewal (1 year) which differs from the information I found on their website prior to purchasing the wellness plan. This situation leaves me in a predicament, as I am now obligated to continue paying $57 per month for a wellness plan that no longer serves its purpose. The reimbursement from Pets Best for the neuter procedure was minimal compared to the actual cost I paid the vet, making this experience feel like a significant financial burden and a disheartening waste of money.I urge you to review and rectify this policy discrepancy to ensure that future customers are provided with accurate information before making crucial decisions about their insurance plans. Transparency and integrity in your policies are essential for building trust with your clientele.I appreciate your prompt attention to this matter and hope for a swift resolution to avoid any further inconvenience.

  

  Business Response

  Date: 01/15/2024

  To whom it may concern,
  Thank you for the opportunity to respond to the concerns regarding the inability to remove the BestWellness Endorsement mid-policy term. We empathize with the frustration felt by the consumer.
  Our Wellness Endorsements are a set schedule of benefits. Each line item on the schedule is the maximum the policy will pay for that item for the enrolled pet in a policy year. Unfortunately, the enrolled pet may meet the benefit limits quickly depending on what the veterinarian charges for their services.
  Pets Best urges all customers to review their selected coverage and policy documents within the first 30 days of enrollment, which is the time allowed to make any changes to the coverage selected (so long as no claims have been paid). Our policy documents reference the ability to cancel the optional BestWellness Endorsement only at the renewal of the base policy, which is one year from the date of inception. A copy of the BestWellness Endorsement page has been provided for reference and states the following:
  EssentialWellness/BestWellness Endorsement Cancellation: You may cancel this Endorsement coverage at the time of base Policy renewal.
  The total cost of the BestWellness Endorsement plan is $360 in Washington and includes $535 in annual reimbursement benefits. If the consumer opts to make monthly payments for this plan, the payment comes to $30/month in addition to their base Policy cost. Once enrolled, Pets Best does allow policyholders to use the benefits of this plan in advance, with the stipulation that this Endorsement cannot be canceled before it is paid for in full.
  After a thorough review, it was determined that all coverage has been provided as outlined in the BestWellness Endorsement. Pets Best must provide fair and equal service to all our members and, therefore, we are unable to make any exceptions to this policy provision. If any additional details can be provided for this matter we will be happy to provide them for you. 
  Thank you

  Customer Answer

  Date: 01/16/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to my complaint, and while I still strongly urge you to have more transparency upfront I understand that I cannot cancel until my policy renewal date. How can you ensure my policy doesnt renew?
  
  Thank you. 
  

• Initial Complaint

  Date:01/03/2024

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  This business has poor customer service. I provided all medical records and they still take weeks to provide a response which is typically them telling me that they will not cover due to pre-existing condition. They are horribly ran and have denied even my wellness claims making me fully cover exams that are clearly stated as covered within my policy.

  

  Business Response

  Date: 01/05/2024

  To whom it may concern,
  Thank you for the opportunity to respond to the concerns raised regarding the denial of the claims for the insured pet. Since the Policyholder is in disagreement with a claim determination, Pets Best offers, and encourages, our policyholders to utilize our voluntary appeal review process which we have started on their behalf. An automated email confirming the appeal has been started should have been received by the policyholder.  
  The appeal review process includes a First Level Appeal review whereby the complaint,claim, and all of the Pet's associated medical records are provided to an Appeals Specialist for a thorough review. Appeals specialists are individuals who are not involved in making the initial claim determination, nor are they familiar with the case. If additional information is needed during this review, the Policyholder will receive a separate communication from our appeals team detailing what is needed. Once the 1st Level Appeal review has been completed, the outcome will be provided directly to the Policyholder via email.  
  Thank you.

• Initial Complaint

  Date:12/28/2023

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I have insurance for my dog ****** with Pets Bests and submitted a vet bill on December 1 for ******. Three weeks later Pets Best emailed me that my claim was being delayed. I then called the company to see why it was being delayed and was told all documentation looked good and that it would be processed shortlyI then called today and was told everything looked good but could not say when my reimbursement would be processedthen about an hour after my call I get an email from the company stating they need to contact my dogs vet.I was told twice all documents looked fine now a month later they need to contact my dogs vetmy dog is almost 2 and she has no pre-existing conditions, so why would they need to contact the vet.I think this is just a company who plays games and is trying to delay paying I pay 90 dollars a month for this insurancethey claim they care about pets, I dont think so

  

  Business Response

  Date: 01/04/2024

  To whom it may concern,
  Thank you for the opportunity to review and respond to the complaint filed by *****************************. Upon receipt of the complaint, we found the claim(s) to have been processed with payment provided December 29, 2023. At this time, there are no additional claims pending adjudication at this time. 
  Please note, claims are reviewed in the order that they are received as Pets Best must provide fair and equal service to all our members, therefore, we are unable to expedite claim adjudication on an individual basis, as it would be unfair to other members waiting for claim adjudication. We understand the frustrations the delay in claims processing can cause. Please rest assured, that Pets Best is actively investing in our people, processes, and technology for our claims workflows to better service our pet parents. The changes are intended to improve accuracy and reduce processing times, increase staffing, and provide additional training and tools to support our Claims Team. We are committed to continued work toward decreasing claim processing time and providing more efficient service and a more positive experience for our members. If there are any additional details that can be provided for this matter we will be happy to provide them for you. 
  Thank you.
  

• Initial Complaint

  Date:12/20/2023

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  On 11/22/23 we began filing a few claims under Policy #: ********* because our dog Sunny was running around and ended up tearing her ACL. Although we have "accident only" insurance through Pets Best, they denied our claim claiming that the injury was not an accident. I would like to know how this could be considered to be "not an accident"

  

  Business Response

  Date: 12/26/2023

  To whom it may concern,
  Thank you for the opportunity to review and respond to the complaint filed by ****** Spartas. Upon receipt of the complaint, we performed a thorough review of the insurance policy and claims listed and found the original claim determination to be accurate. Our Accident Only policy, underwritten by American Pet Insurance Company, directly excludes coverage for any ******** Ligament events, under the following policy exclusion:
  Section 6 What Isnt ******** B. ******** Ligament Events: We do not cover the costs, fees, or expenses associated with ******** Ligament Events.
  The policy defines a ******** Ligament Event as Any strain,sprain, rupture, tear, or degeneration of any cruciate ligament in the knee of your Pet.
  Unfortunately,based on the type of injury and the applicable policy exclusions, Pets Best is unable to provide reimbursement for the claims in question. If any additional details can be provided for this matter we will be happy to provide them for you. 
  Thank you.