BBC Watchdog: Is claiming on insurance one of your pet peeves?

Tony

What Consumer Founder
Apr 7, 2008
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Bolton
As we all know, pets are expensive enough to keep, not least because vets have been rising by 12% year on year over the last few years. Pet insurance could be the answer, but premiums are rocketing and the small print is trickier than ever.

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We took four owners, five dogs and five insurers, some of the biggest names in the business, to see how their policies perform. We put all their policies on show, parading the problems some people have had, demonstrating the hoops they've had to jump through and the hurdles they've had to get over, to stand a chance of a successful claim or getting the right policy. Watching the action was our expert, vet and former president of the British Small Animal Veterinary Association, Mike Jessop...

(Do you have something to say about this story? Tell us what you think by emailing us here. Don't forget to include 'Pet Insurance' in the subject line. Watchdog will publish a selection of viewers' comments underneath each story, both throughout and after the programme is on air. Please remember to include your name as you would like to see it published).

First up, the premiums. Gail Owen has a German Shepherd called Lady and her insurance premiums haven't just gone up year on year, they've soared. Gail was paying £386 a year in 2008, in 2009 that bill jumped to £541and this year Saga demanded £750 because of Lady's age. Gail told us:

"Lady's been with them since she was a puppy. And now she's nine, well, I just can't afford to insure her."

John Walden insured his Jack Russell Terrier Jake and cross Collie-Greyhound Ellie with Healthy Pets. The premiums were £27 a month but when John got the renewal document for 2010-2011 they had put them up to £90 a month. Healthy Pets blamed the increase on rising vets' fees. But John can't afford them, so now Jake is uninsured.

We asked vet Mike Jessop what he made of the increases:

"At a certain age in a pet's life, when it usually gets to about 8, you'll get an age increase. But in the case of Gail and Lady this seems to be very excessive. With John, the premiums seem to be disproportionately cheap to start with and it seems to be that this might be a policy that hooks you in with low premiums only to gently rise it over time. But the threefold step increase is just extraordinary and doesn't fit in with anything like the increases we are seeing in the veterinary fees."

But what about the policies themselves? Paula Farrant insured her Dalmatian Merlin with Petplan in 2001 but last year they altered the terms. Paula told us:

"Initially it was unlimited for all veterinary fees. Now it's capped at £12,000".

At the same time, Petplan increased her annual premiums from £44 a month to £54 a month. So she was paying more but getting less. Mike Jessop gave us his view:

"It's perhaps understandable because of some of the more advanced procedures that are coming in to veterinary medicine, and perhaps the insurers are trying to protect themselves. But it does seem to me unreasonable in Paula's case that she wasn't explained the reasons clearly and the changes have been made to her mind unfairly".

Petplan is a specialist animal insurer. But what about a large general insurer like M & S? Stewart Moxon bought their pet cover for his Pointer Darcy in 2009. Stewart told Watchdog:

"The original policy I understood was coverage for £4,000 for any illness or accident".

But when Stewart got his renewal documents he realised there were strings attached. For any individual illness or injury, the cover was limited to just £1,000. Stewart added:

"I wouldn't have taken the policy out had I realised that from the start".

This was the case when Stewart first took out his policy, but he had not realised. Mike Jessop told us:

"A thousand pounds per condition in a Pointer is serious under insurance. Most conditions that we would see in Pointers could easily run to £1,000 plus."

These are just a few of the many viewers who've contacted Watchdog about rising bills and issues with their policies conditions. But we've also heard from some with a more serious complaint about insurers, namely owners who continue to receive demands for payment, even after their pets have died.

Watchdog met up with Lesley McGuire and Ann Hutchings who lost their dogs Jamie and Kerry earlier this year. Ann informed her insurers, More Than and submitted a claim for the £1,000 worth of treatment that Kerry had received. Ann told us:

"They said that as we'd only paid two months premiums for the year and they were deducting the further ten months which was over £500 from the claim. I couldn't understand why we still had to pay the premiums when Kerry was no longer with us. She is, in fact, insured until next May. It's just too upsetting."

Lesley's dog was insured with Pet Healthcare and as she explained:

"Jamie our Bearded Collie died in March of this year and we put in our claim. The amount they actually owed us was about £397. They said that because we owed them six months of premiums, we would not be paid any money at all. We are being asked to pay for a dog that's dead, that's no longer with us."

Our expert vet Mike had this to say:

"I can't understand why an insurance company would want to continue to take a premium for an animal that has passed away. It's understandable that you sign up for a year's cover when you take out your policy, but if your pet dies, it should be fair and reasonable that the policy stops."

The companies featured in the report told Watchdog:

Saga

Ms Owen has had Saga Pet Insurance from 2002 until August 2010. During this period Ms Owen has made 12 claims.

Pet insurance premiums have been driven up across the market because of a combination of higher charges from vets and advances in veterinary medicines and procedures that have enabled more conditions to be effectively treated.

The sad fact is that as dogs like Ms Owen's 'Lady' get older they become far more likely to fall ill and require treatment.

Saga Pet Insurance provides 'Cover for Life' which provides ongoing cover for pets such as Lady who require ongoing care. This is in contrast to some other insurers who only offer 'Cover per condition' - so if a condition persists, like rhinitis, which requires treatment for the rest of the animal's life, these other insurers will only pay out up to a set amount in total, so pet owners may find they can't afford to pay for the continuing care their beloved pet needs. Saga's Pet Insurance, on the other hand, refreshes the claim limit annually.

It is common practice in the pet insurance market that when a pet has an ongoing pre-existing condition an insurer is likely to exclude that condition. However, Saga feels that it is important to ensure that customers fully cover their pets for both long term conditions and illnesses, which can prove more costly to the customer to treat if not included.

Healthy Pets

In 2009 we reviewed our claims for all of our pet business after we had received substantial increases in our claim payments. Whilst we had encountered claims veterinary inflation in double digits for the previous 5 years as well as an increase in claims, we had held back from large increases in our premiums over that period of time. Sadly in 2009 it became apparent that we had no option other than to catch up with the rest of the marketplace in increasing our premiums dramatically. In order to ensure we had an underwriter in the future we had no option other than to put through a rate rise.

In September 2010 Mrs Walden was sent a renewal notice for her two pets of £90.16 pcm based upon our general claims experience and also the claims experience of Ellie and Jake who at that time had claimed £5177.95 since 2008. The renewal offer sent to Mrs Walden covered £4000 in vet fees per event as well as covering ongoing conditions.

Whilst the premium increases have been severe in some extreme cases this was due to our premiums being at a low starting point in 2008. We feel that the level of cover at £4000 is hugely competitive and offers good value for money. Mrs Walden was offered a lower level of cover at £47.08 for both pets but declined this offer in a telephone conversation with me on 8th September 2010.

In the same rate review we increased our base level excess from £65 to £75 in order to increase in line with the veterinary inflation we experienced. This had typically been increasing at 15% pa and we increased our excess by 15%. We also took the decision to join other insurers in introducing a percentage based excess for our older pets in order to keep premium increases to a minimum in the future and retain our future underwriters. We still pay out to the £4000 benefit level for each event. Healthy Pets has been in business as a leading Pet Insurer for the last 14 years. 14 years ago once a pet reached 8 years of age you could not start a new policy with any company. Now we are in a position whereby many companies are able to offer insurance to pets over 8 years of age and in fact Healthy Pets can take on pets of all ages. I would say that there is an option to move Pet Insurance provider that was not present 10 years ago. If a pet has a pre existing condition this would not be covered if you moved provider, therefore making it important to look at the claims you have made in relation to the premium as done by Mrs Walden who is now paying £41.10 per month for one pet having claimed £5177.95 to date from Healthy Pets.

Petplan

At Petplan we're a pet insurance company, not an insurance company that happens to insure pets. If your pet passes away we'll also never ask you to pay any remaining premium after that date - in fact we will refund you. You don't want to be thinking of money in what can be a very distressing time.

We were concerned with some of the issues raised by Watchdog about pet insurance and we wanted to clarify the questions that related to our policies.

Changes to our vet fee cover:

Any changes to our policies are always made after extensive research, in full consultation with the veterinary profession and by looking at what is happening to our customer's policies and the claims they make. In 2008 we changed our top policy to have a total limit of £12,000 per year, every year. It was previously unlimited but this made it harder to accurately price the policy as you don't know what claims to expect. Before making this change our research showed only 0.03 per cent of our customers would be affected. However the benefit to our customers is that it allows us to better understand our risk and keep our premiums at a price that reflects the level of cover.

Despite the introduction of a limit this is still the highest vet fees benefit on the market and means if your pet is insured with us for 10 years there is £120,000 available for vet fee cover during this period.

Increasing premiums:

Advances in the range of diagnostic, medical and surgical procedures, has meant that over the past 10 years vet fees have risen to cover these new costs. Despite annual vet fee inflation rising in double-digits (between 11 - 15 per cent) year-on-year, thanks to our large customer base we have been able to create operational efficiencies and absorb some of the pricing changes. This has meant that our premiums have only risen by an average of 8 or 9 per cent.

It is inevitable that premiums will increase as your pet gets older because like us as they get older they are more susceptible to injury and illness. In young pets approximately 3 in 10 will require veterinary treatment each year as they get older this rises to 6 out 10 and becomes more a case of 'when' they need treatment and not 'if' - so premiums have to reflect this - much like human health insurance.

Introduction of Complementary Treatment:

Complementary Treatment is classed as a 'non-routine' veterinary procedure and our claims data shows that it is not widely used by the majority of our policy holders. Complementary Treatment was made a separate benefit to ensure our policies are priced fairly and remain affordable. It also means if your pet does require Complementary Treatment rather than being bundled into vet fees you will have an additional £750 on top of the £12,000 per year of vet fee cover to spend on this type of treatment.

Communicating changes:

If we make changes to a policy or premiums they are always communicated to the customer. Every year a renewal pack is sent to the policy holder approximately a month before they renew, at this time we will notify them of any changes to their policy or premium. This is not just a legal requirement on our behalf but also as part of our commitment to provide excellent customer service.

Not being able to change providers:

We recognise that once a pet suffers from a condition you are unlikely to get that condition insured again if you change providers. That is why it is important to get the right cover from the start, a policy that will cover you year after year with no time limit for a condition. Our Covered for Life policy means that we'll cover a pet's ongoing condition year after year as long as the policy is renewed annually. We realise that pets are for life and that is why our policies are designed to provide pet owners with the most comprehensive life time cover. Most other policies in the market will cover you for only 12 months or up to a certain amount after which you are on your own.

M & S

We are surprised to hear that Mr Moxon was not aware of the details of his M&S Standard Pet Insurance policy, as it is clearly stated in the terms and conditions of the policy, both in the documents that were sent to him and on our website.

Whilst we are sorry that he was disappointed with the level of cover, the M&S Standard Pet Insurance policy's £1,000 limit is more than double the average claim for dogs according to the Association of British Insurers. Our policy's limit is also reinstated in full each year, which covers pets that require ongoing treatment.

In response to Watchdog's questions, M&S explained:

Q. Did Marks and Spencer change the maximum amount insurance holders could claim for each separate illness or injury from £4,000 in 2009 to £1,000 in 2010? If yes, why was this done? Does Marks and Spencer believe customers were sufficiently notified about the policy change?

A. No. No changes have been made to M&S Standard pet insurance or the levels of policy cover since it was introduced in 2007.

The £1,000 per condition limit has always formed part of the Standard policy, and is clearly shown on policy documents and on our website. Mr Moxon chose the standard cover and all the terms and conditions of the policy are made clear in the policy booklet which he received.

Q. Does Marks and Spencer believe that this level of cover is sufficient for a dog such as Mr Moxon's Pointer?

A. As we offer two options of cover, our customers can choose the level of cover that's appropriate to the needs of themselves and their pets. Mr Moxon chose the standard cover policy. It is worth pointing out that the £1,000 limit is more than double the average claim for dogs according to the ABI, and is reinstated in full each year which covers pets that require ongoing treatment.

Q, How does Marks and Spencer believe it compares to other pet insurance companies regarding their level of maximum claim for each illness or injury?

A. We don't comment on our competitors, but M&S pet insurance does compare favourably with other policies. Vet fees have been rising over recent years, so to make premiums affordable we offer a choice of cover levels. Some have higher limits but less cover and don't provide long-term cover. There are also 12 month policies available on the market that offer less than the long-term cover provided by M&S Standard pet insurance.

MORE TH>N/Pet Healthcare:

By asking the customer to pay the remaining premium, we were acting in line with the terms and conditions of our policy and believed that this was consistent with the rest of the market. It does however appear that other insurers are choosing not to enforce this policy condition when a pet dies but they've not changed their policy wording to clearly reflect this. We are constantly looking at ways to enhance the service we offer to our customers. We have reviewed our procedures and are pleased to confirm that from the 1st of November we will no longer request outstanding monthly instalments when a policy is cancelled due to the death of the pet.

At MORE TH>N/Pet Healthcare we aim to be fully transparent with our customers at all times. Our policy wording clearly states that if a policy is cancelled after a claim has been made then the customer will be responsible for the remaining premiums. By applying this procedure, we were acting in line with the terms and conditions of our policy and believed that this was consistent with the rest of the market. It does however appear that other insurers are choosing not to enforce this policy condition when a pet dies but they've not changed their policy wording to clearly reflect this. We are constantly looking at ways to enhance the service we offer to our customers. We have reviewed our procedures and are pleased to confirm that from the 1st of November we will no longer request outstanding monthly instalments when a policy is cancelled due to the death of the pet.

The death of a pet can be a very upsetting and we fully understand the distress this issue may cause. We offer a free bereavement counselling service to all our customers who are affected by the death of a pet. By asking the customer to pay the remaining premium, we were acting in line with the terms and conditions of our policy and believed that this was consistent with the rest of the market. It does however appear that other insurers are choosing not to enforce this policy condition when a pet dies but they've not changed their policy wording to clearly reflect this. We are constantly looking at ways to enhance the service we offer to our customers. We have reviewed our procedures and are pleased to confirm that from the 1st of November we will no longer request outstanding monthly instalments when a policy is cancelled due to the death of the pet.

Watchdog Viewers' Responses:

I took on a rescue dog, Teddy, a mastif/german shepard cross from a local shelter. Not long after getting him I noticed he had an ear infection, took him to the vet.. Im now left with a 450 pound bill for him despite having him insured, as pet plan decided it was pre-existing but the shelter claimed when I took him there were no health issues with him when I took him on.

Sadly his ear in fection also turned out he was stone deaf and the stress for him meant he lost a lot of weight got very frustrated bit me and my other 3 dogs, so I had to return him. Now Im still faced with this 450 pound bill for a dog I had to return.

Anonymous Watchdog Viewer


I too lost my cat early in May and am still paying the annual fee. I thought you might be interested in the chipper reply I got when I told them about my loss!

I did have a bit of a rant at them because I was really upset and they have changed to only cover 80% of the costs but as I have had insurance for years and my other cat has a long term condition it is still worth wile (sort of.)

Deborah Fairbotham


We left Healthy Pets insurance company as the premiums for our multi-cat household was going to nearly double for no extra cover nor new cats added. Plus for dog insurance PetPlan refused to pay out on a hotspot (inflamatory skin condition) on our St Bernard Pepsi, as they said it was a pre existing conditon even though she had no kind of skin problems when we got her nor in the 2yrs inbetween (which our vet backed us up
on) until this hotspot occurred they said she'd had treatment for some kind of skin problem at some point during the 2.5yrs she was owned by her breeder which we didn't know about and was not marked on the policy as a pre-existing condition until we tried to claim. Are we supposed to be psychic when buying an adult dog or question the previous owner in depth for every little bit of medical history, i don't think so! And if she had been a rescue/stray dog with no previous history before coming to us they would have paid out its only because she had been previously insured by PetPlan that they knew about her history. We spent up to £400 getting that condition treated including multiple vet and groomer visits as she had to be partly clipped and regularly bathed and as a big girl she's not the easiest to get in a normal bath!

Sonia & Ruth Mills (Owners of Pepsi the St Bernard, Piggy the Pug and 5
cats)


We have just had our renewal in for our pet insurance and it has increased from £12 per month to £23 per month. This is with 'Healthy Pets'. They did however note on the renewal that due to the cost of vet bills going up the premiums have had to have been increased.

Doing a price comparison we can get a similar cover from a different provider for £11 per month. No surprise we are cancelling and moving to a different company now.

Simon Young



Is claiming on insurance one of your pet peeves?