ComplaintsforPetPartners, Inc.

• Initial Complaint

  08/22/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I bought a kitten from Animal care and protective services when my veterinarian examined the cat he found a cleft palate issue and did surgery to repair this in September of 2021. I purchased pet insurance in January 2022. In April 2022 a CT was done on my cat to find why his breathing was so noisy. The internal medicine doctor diagnosed him with nasopharyngeal stenosis and middle ear disease both of which would require surgery at University of ******* veterinary hospital. I spent 2397.52 at the internal medicine doctor for the CT and examine. Then I spent 8434.00 at University of ******* veterinary hospital all of which the insurance has refused to reimburse me a single dime. They state all of these things are due to the cleft palate surgery done in 2021. The surgeon at University of ******* veterinary hospital has written the insurance company a letter advising neither condition was a result of the cleft palate surgery however they still refuse to reimburse me. Please help. Thank you

  

  Business response

  08/23/2022

  We hope your cat is doing well. The vet and previous health records show the noisy breathing has existed since the cat was adopted in 2021, which predates your policy and is not covered. If you have any questions, please feel free to call us at 1*************.

  Customer response

  08/23/2022

  
  Complaint: ********
  
  I am rejecting this response because: What occurred in 2021 was the surgery to fix a cleft palate vet found, this Insurnace company is trying to say the Nasopharyngeal Stenosis was a result of the cleft palate thus a preexisting condition however the surgeon at University of ******* said it was 100% not caused by the cleft palate surgery. Also, the insurance company denied the CT which diagnosed the Nasopharyngeal Stenosis as well as the middle ear disease saying all of it predated the policy. The policy went into effect Jan 2022 & the CT / diagnoses was done April 2022 so not sure how April 2022 predates January 2022.

  
  
  Sincerely,
  
  ***** *********

  

  Business response

  08/24/2022

  We understand this condition is not related to the cleft palate surgery.
  
  The medical records and letter provided by the vet note the symptoms of upper respiratory noise (sterter) associated to the upper respiratory infection were first noted in December 2021 and continued to progress until the diagnosis of secondary acquired nasopharyngeal stenosis and middle ear infection. The onset of the respiratory infection in December 2021 is pre-existing to coverage and, therefore, any secondary and/or related conditions (nasopharyngeal stenosis and middle ear infection) are not eligible for coverage.

  If you have any additional questions, please give us a call at 1**************

• Initial Complaint

  08/05/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I have a policy for pet insurance with pet partners for AKC. They are making me jump through hoops for my claim and I have given all they have asked for. They are not communicating and are not approving my claim and keep putting my claim on hold for no reasoning! You are unable to get ahold of anyone to speak to as they don’t take calls. This is unacceptable and if you’re not going to pay my claim for the services I am paying for then I want my policy canceled immediately.

  

  Business response

  08/09/2022

  In some instances, we may require additional information and documentation to process a claim. The claim is on hold until we receive the additional information from the vet or the pet owner. For this claim we required additional information and once we received it, we continued to process the claim. We were in touch with the pet owner several times over the phone to discuss updates and what was needed to finish processing the claim.
  
  We apologize for any inconvenience we may have caused and have cancelled your policy. If you have additional questions, please call 1-************ and ask to speak with our customer care supervisor, *******.

  Customer response

  08/09/2022

  
  Complaint: ********
  
  I am rejecting this response because: I never asked you to cancel my policy I asked you for answers. You didn’t provide answers. Do not make me involve the CEO of AKC
  
  Sincerely,
  
  ****** *****

  

  Business response

  08/11/2022

  Per your request via phone on 8/9, we cancelled your policy. We have finished processing your claim and have sent you additional information via email. If you have any further questions about your claim or policy, please call 1*************.

• Initial Complaint

  03/15/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  Pet Insurance Bad Faith - We have been denied coverage for a condition for our French Bulldog based on a differential diagnosis issued prior to starting date of coverage. However, a differential diagnosis is a possible condition to later rule out, which is exactly what happened as laboratory work was later ordered, which ruled out the condition as the current diagnosis. The pet insurer is breaching its contract in refusing to understand the established differences between a diagnosis and a differential diagnosis. This complaint is an attempt to refund the policy premiums we paid in good faith, prior to being rejected on false grounds and prior to filing a 1st party civil Complaint for Breach of Contract, Breach of Implied Covenant of Good Faith and Fair Dealing, and Insurance Bad Faith.

  

  Business response

  03/30/2022

  Business Response /* (1000, 5, 2022/03/17) */ Hello **********, I'm afraid that I cannot locate a policy associated with your information. Is it possible that the policy information is under someone else's name, email, or phone number? Thank you for your help, Consumer Response /* (3000, 7, 2022/03/17) */ Policy ******* -Claim ******* Business Response /* (4000, 13, 2022/03/25) */ Hello *********, After reviewing the claims on the policy it shows that the condition is a preexisting one and therefore not eligible for coverage. It appears as though we spoke with another member of your household regarding the claim and the agent attempted to explain the situation and the appeal process. If you would like to discuss the claims and the appeal process please give us a call at ************ and just ask for **** or *******. Consumer Response /* (4200, 15, 2022/03/25) */ (The consumer indicated he/she DID NOT accept the response from the business.) This is not a pre-existing condition and a letter with the medical explanation was sent to you. This issue is not resolved and this company is unethical. I am the spouse of ********** and the person that called initially regarding this claim. Please stop insisting that it was resolved when we spoke because that is a lie. Thank you.

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