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Chronic gingivitis-stomatitis insurance Q

Discussion in 'Cat Health and Nutrition' started by Lucky_Blue, Mar 20, 2019.


  1. Lucky_Blue

    Lucky_Blue PetForums Newbie

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    Hi guys,

    Apologies for the lengthy post in advance, in need of some advice.

    I adopted a lovely British Blue girl from a reputable rescue centre last September who's been nothing but an absolute joy.

    However as of mid-February, she started having trouble with her food (pawing at her mouth/dropping food/less of an appetite). I took her to the vet who assessed her and found she has advanced gingivitis-stomatitis.

    She went on a course of antibiotics and had a blood test to check for FIV FELV, which thankfully was negative. The antibiotics didn't clear up her issue however, so the vet recommended a full dental extraction. She is now on a course of anti-inflammatory steroids to prepare her for this surgery, and is responding very well.

    For the purposes of claiming back on insurance, I asked the rescue centre for a patient history from the vet she was originally checked/treated at when rescued (to check she has received dental treatment - a prerequisite for claiming back. On this history, it mentions the vet recording advanced gingivostomatitis. This was never disclosed to me by the rescue centre - I was told she was perfectly healthy.

    I believe this information could potentially affect me claiming the expensive dental treatment back, as my insurance details mention:

    Not insured: Any event, illness, injury, disease or changes to your pet’s normal healthy state that happens, or your pet shows signs of, before the start date of the policy, including conditions that are related or linked.

    I'm a bit at a loss as to what to do. It sounds like the above clause throws the claim into doubt, but I'm wondering if the fact I was not disclosed of her condition has any weighting. Would love to know if anyone has had a similar experience.

    Thank you
    J
     
  2. lorilu

    lorilu PetForums VIP

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    I have asked a moderator to move your thread to the correct forum where you wil be more likely to get the help you need.
     
  3. chillminx

    chillminx PetForums VIP

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    Hi @Lucky_Blue and welcome :)

    I am sorry to hear of your lovely girl's problem with advanced gingivostomatitis. 8 years ago one of my previous cats (also a beautiful BSH) had the same disease and it was a nightmare to manage it. Removing most of her teeth helped but it was done late in her life (she was 14 when the surgery was done) and it would have helped if it had been done sooner. Nowadays the thinking is early removal of the teeth in such cases.

    I am sorry but I very much doubt that your insurance will cover you for the dental work seeing as the teeth are being removed due to a pre-existing condition. The fact you did not know about the condition when you insured your cat is irrelevant to the insurer. As the cat was not a kitten the insurer would have wanted your cat's previous medical history before making a decision about covering you for the dental work, and so the information would have come out anyway, at that stage.

    The only party you could ask for financial help with the cost is the Rescue from whom you adopted your cat. I help to run a Rescue and if one of our re-homed cats becomes ill or needs expensive vet treatment within 3 months of the adoption we will either pay the vet bill or we will share the cost with the adopter. Our only stipulation is that the cat must be treated by the vet we use.

    I appreciate it is 6 months since you adopted your girl, but a condition like she has takes a lot longer than 6 months to develop, particularly as it has reached the point where total extraction is recommended. I would be surprised if the Rescue had not been aware she had chronic inflammation in her mouth, and I assume they did not mention it to you.

    It may be difficult to get the Rescue to pay the whole bill but if I were you I would contact them and firmly and politely ask them for help towards the vet bill for the dental work. I would be insistent you need their help. Please don't feel awkward about it, reputable Rescues should always keep some funds aside for such emergencies. They should be willing to help you.
     
    #3 chillminx, Mar 21, 2019
    Last edited: Apr 5, 2019
    Quartermass, lorilu and buffie like this.
  4. Lucky_Blue

    Lucky_Blue PetForums Newbie

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    Hi chillminx, thank you so much for your informative reply and sorry for being slow to get back to you. It's great to hear from someone who's been through something similar.

    Yes, I was expecting the insurance to be a null point now it's emerged it was a pre-existing condition. Sad, but to be expected. It's only a financial sting at the end of the day. I'll be sure to take your point on contacting the rescue centre on board. Broaching the subject with them amicably seems like the best route for all parties, whether it results in any help with the payment or just for some closure.

    Thank you again for taking the time :)
     
    chillminx likes this.
  5. Quartermass

    Quartermass PetForums Senior

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    You may have grounds to claim if you can prove it was left out from some kind of information that was given to you. In which case you produce that and not what the rescue centre has now given you.

    However I think it sounds very, very much like the only thing that they can produce is the information saying the cat has been diagnosed with the condition.

    > The fact you did not know about the condition when you insured your cat is irrelevant to the insurer.

    That's actually not quite correct. However I fear it will come down to them reasonably not believing you because the cat was diagnosed already and the information was available to you in theory.

    I know that life insurance policies cannot exclude conditions that you do not reasonably know about. So for example of you take out life insurance, and then later die from a condition that was present but you were unaware of, and were not ignoring symptoms or medical advice then you will be covered. In fact the T&Cs you have quoted say that in a different manner.

    You can and should try to make a claim in good faith. You did not know about the condition until after the insurance was taken out. However if they try to object to the claim and ask you for the vet's assessment etc then you're going to face problems. It sounds like they have told you to do that and have already made the claim. If you have not yet claimed, and are just aware they may ask for it then do go ahead and claim and cross your fingers that they don't ask. You're not being dishonest but you're going to face an uphill and probably impossible battle proving you didn't know.

    I don't think though that it's going to work. I don't underwrite insurance policies, but I am qualified and I do give financial advice on them. Never on pet insurance though. So I'm not really an expert on this by any means.

    Failing all that I think @chillminx is on the right track with contacting the rescue centre. That's where one of her many areas of expertise is! :)
     
    chillminx likes this.
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