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Question about John Lewis Insurance . .

Discussion in 'Dog Chat' started by heartagram, Oct 21, 2012.


  1. heartagram

    heartagram PetForums Member

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    Hello,
    Bit stuck with insurance, been looking at petplan and john lewis but leaning more towards lewis, but was wondering with the plus type, is the 7.5k the total in the pot for everything and not per condition?

    Also if anyone recommendations / experiances with jlewis would like to hearrr, thankyou ! ♥
     
  2. Sled dog hotel

    Sled dog hotel PetForums VIP

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    Without seeing the full terms and conditions and not being with either myslef cant say.

    I would say however when getting quotes you need to make sure the policy is a life time or life long policy. This means that you usually get a total insured for amount to spend on vet bills each year. Most companies seem to have different policies with different yearly amounts, obviously the higher the insured for amount the higher the premium. With lifetime/lifelong this means that no matter what claims you have had the yeat before, as long as you renew the full insured for amount will be re-instated the following year. This means should your dog get a re-occuring illness, later complications even from an accident or injury or a chronic ongoing life long illness requiring meds and testing you will always be covered up to the total amont insured for per year.

    Some policies look cheaper and might have a good monetary insured for yearly amount but they can be limited, some only insure an illness or condition from 12 months from diagnosis or accident, after the 12 months have passed then you can no longer make a claim. A lot of companies also group types of illness as well, so for example your dog may have a stomach upset needing a vet visit or a urinary tract problem, after the 12months you wont be able to claim,
    but if you do get another problem with the stomach or digestive treact or a urinary tract problem you then find that you are not covered for any of these problems what ever the cause as they are blanketed as disorders of the digestive tract or disorders of the urinary tract meaning anything to do with these "parts" is not covered.

    Another type of insurance is a monetary amount per illness or condition with no time limits, but once you have used up the monetary amount insured for that type of condition, and bare in mind its type not individual illness or condition as it can sometimes read and you can be lead to believe it can soon be used up and you can no longer claim.

    Sometimes one of the best ways is to contact your vet, ask if they accept direct claims from insurers and if so what companies. That way you will only have to pay the excess and then the vets will claim the rest direct. Some vets will but only from certain companies so find out which ones and get quotes from them. Thats usually a fair indication who pays out and without quibbles and time wasting as a vets not going to waste hours chasing up claims or not getting paid out.

    Dont forget that for the first 14 days of the policy you cant claim either, and anything the animal has on its records already or that it have illness wise or diagnoised in those 14 days will not be covered on the policy and you will have an exemption. Same if you decide to change companies further down the line too, so its important that you get it right at the start.

    Also when you get your documents after taking the insurance out go through it all and the terms and conditions with a fine tooth comb to check it is what you thought you were getting. if its not you have time to cancel it in the first 10/14 days and find another one that is.

    It can be a bit of a minefield but hope this helps.

    ETA although companies dont cover illness incured in the first 14 days some will cover accident from day one, I believe but you would need to check pet plan is one of these or was.
     
    #2 Sled dog hotel, Oct 21, 2012
    Last edited: Oct 21, 2012
  3. AlbertRoss

    AlbertRoss PetForums VIP

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    All John Lewis policies are 'lifetime' cover not 'per condition'. In the 'Plus' policy you get up to £7,500 each year to cover all illnesses/accidents in that year. If you exceed £7,500 in that year you'll have to pay anything over that yourself. However, the next year the £7,500 is re-instated so you can claim up to £7,500 in that year, in total, across any illness or accident, even if your pet had them before (providing he/she hadn't had them before you took out your first JL policy).

    You can find out just about everything you need to know by clicking the link in my sig below and then clicking 'Free Report'. In the comparison table on my site the insurers appear pretty much in order of popularity, which may help.
     
  4. heartagram

    heartagram PetForums Member

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    This is the two exact things that worry me!
    I've already taken him for both things, a suspected uti which he went on antiobiotics for though I don't think he had one and also was on antibitioics previously for a colitis attacks after eating some gravel.

    Niether serious but things that worry me are what if he needs surgery or something if he eats something and there is a blockage? because of the previous history of colitis does that mean that total area is now excluded? :mad2:

    I plan on asking vets on what insurances they find easy/get direct payment from, does say on john lewis website however they do direct payment if the vet is set up for it.

    John Lewis I believe covers after 48 hours for death or injury but not illness until after 14 days I believe.

    "We do not pay for claims under the death by accident or vets fees covers as a result of an accident that
    happens within the first 48 hours of the first period of insurance of your policy."

    "We do not pay for claims under the death by illness or vets fees covers as a result of an illness or disease
    that happens within the first 14 days of the first period of insurance of your policy."

    I assume all of John Lewis are life ones? as it says each year for "Veterinary fees treatment period".
     
  5. heartagram

    heartagram PetForums Member

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    Thankyou for spelling it out to me! I shall have a look at your link also thankyou.

    Do you know if my boy would still be covered even if he has been to the vets for colitis and uti in the past? I worry that the total area might be excluded now even though it wasn't serious.

    two things I worry about are him eating something causing a blockage, so concerned because of the colitis attack that area might be now excluded and him breaking something ( hes a very small chihuahua) thus why I'm looking at insurance, touch wood nothing will ever happen tho ;_;
     
  6. AlbertRoss

    AlbertRoss PetForums VIP

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    Anything on his current medical record will be excluded. BUT - it depends what it was as to how the insurer will treat that exclusion. In many, but not all, cases they'll exclude for a period - usually one or two years - and will then readmit the condition. All you can do is ask.
     
  7. Sled dog hotel

    Sled dog hotel PetForums VIP

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    With one of mine who was a RSPCA rescue pup, she had diarrhoea whilst with them that fecal tests found out to be caused by worms and coccidia parasite all treated and done with before I adopted her, thinking it would make no difference and had a specific simple cause, I declared it when taking out the insurance they did however exempt me from disorders of the digestive tract period for 12 months after which they said I could apply for the exemption to be lifted providing she was digestive tract problem free for that time, which she was by some miracle and true to their word they did. That was with Animal Friends who have been good with claims too, shes been with them for getting on for 4 years.

    When I changed my other boys insurance from More Than to Petplan, he had
    a tearing eye one night after sticking in his head in and rolling in leaves, I flushed it out in case there was something in there but by morning it was green gunge and infected, so took him to make sure nothing in there still and no injury to the eye, it turned out that I had flushed it, no injury but whatever it was had set up a simple bacterial eye infection just needing antibiotic eye drops a one off with a simple cause you would think, however, I still at the moment have an exemption for eye disorders, but they did say I can appeal with a letter from the vet confirming urelated if he gets anything eye wise in the future and get it lifted.

    Its something really you are going to have to speak to the insurance companies about Im afraid.
     
    #7 Sled dog hotel, Oct 21, 2012
    Last edited: Oct 21, 2012
  8. heartagram

    heartagram PetForums Member

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    I see thankyou! I have sent them an email though will ring if I hear nothing back.

    What a pain ! haha.
     
    #8 heartagram, Oct 21, 2012
    Last edited: Oct 21, 2012
  9. Sled dog hotel

    Sled dog hotel PetForums VIP

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    Good luck hope you can sort something out, I found out the hard way about exemptions, exclusions and treating illnesses as types rather then individual cases unfortuanately and know only too well that the written blurb is often not what it seems so therefore question, check it and read the small print.

    Dont know about a pain more like a blinkin minefield.
     
  10. heartagram

    heartagram PetForums Member

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    Well I got a reply from Lewis,

    "Our terms state that we do not cover any pre existing medical conditions.

    We use our claims experience as well as information from the vets to
    determine if anything is pre existing.

    If your pet was to eat something again like gravel for example, that would
    be classed as a seperate incident so we would cover for that.

    Yours Sincerely"


    I assume I would be covered for the type of things I've mentioned if they where to happen but going to save that email!

    and Vets reply

    " We will do direct claims in exceptional circumstances but only if we can get written confirmation from your insurance company."

    not sure what exceptional circumstances would be, is this normal for v ets? how does it normally work, you pay upfront and then you claim from insurance and they pay you?
     
  11. Sled dog hotel

    Sled dog hotel PetForums VIP

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    If your vet will accept a direct claim, all you need to do is pay the excess on the policy, fill in your part of the claims form and give it to the vets to do their bit and they do the rest and the insurance pays them.

    If your vets will not accept a direct claim, then you have to pay them in full,
    fill in your part of the claims form, give them the form to fill in their part and either send it off yourself or they will do it depending on what their own procedures are. Then you will get the money paid back to you.

    My own vets will do direct claims for everything with certain Insurance companies but not others. Im assuming the ones they dont they have hassle with or are slow.

    From your vets reply I would personally assume that exceptional circumstances are more of an exception then the rule as far as that practice goes, so looks like you will mostly have to pay them and wait for the money to be paid back from the insurance to you.

    You can actually get pre authorisation from some companies before you have a procedure carried out, by filling in a form similar to a claims form and they will look at it and confirm that your claim will be accepted before you have the procedure done so that you know they will pay out. I should think this is what your vets may be reffering too. In exceptions they will accept direct payment but only if you get pre-authorisation so they know before the procedure they will deffinately get paid.

    Some Insurance companies you have to do pre-authorisation anyway if the procedure is going to be more then a certain monetary amount. So thats something you would need to check in your full terms and conditions too.

    Looks like in the main this particular vet you are mostly going to have to pay in full and then get the money back to replace it from the insurance company.

    Can only suggest if there are other vets in your area who you know are good,
    to check with them to see if they will accept direct payment in all cases and what companies from and then transfer your business to them maybe and get insurance quotes from the companies they accept direct payment from and go with one of those.
     
  12. heartagram

    heartagram PetForums Member

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    I've recently got another reply, there was a bit of confusion as their are two practices runnign from the same branch.
    Anyways they've said

    "he only insurance company we do direct claims with without pre – authorization is vetsure."

    I can't say I'm familiar with vetsure other than the leaflet they gave me and their cover seems a bit crap compared to others and very expensive!

    So is pre authorization something I can do straight after I've gone with an insurance, to cover me if anything would happen within the future to avoid fuss? or is it something that is only done when a condition/problem arises ?

    Theres another vet in town which my cats are registered too but I decided to try these other vets due to them having a surgery whereas the other one doesn't near by.
    Just thought it would be better incase of an emergency, but both places are ok.
    I do have money if needed but would prefer to go direct with insurance, if I can.
     
    #12 heartagram, Oct 24, 2012
    Last edited: Oct 24, 2012
  13. Sled dog hotel

    Sled dog hotel PetForums VIP

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    Pre authorisation is done case by case, so should you take your dog for example and it needs an operation and of course its not urgent/emergency then you would have to get the pre-authorisation to say they will except and pay out before its done. So if you stay with that surgery from what you have said and got anything other then this vetsure insurance then you will have to get either pre authorisation or pay out yourself and then you claim it back.
    Which is likely fine for smaller things, but if you have something costing a lot might not be much fun.
     
  14. Sled dog hotel

    Sled dog hotel PetForums VIP

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    Just had a look at the vetsure insurance, it looks like you can only go to certain affliated vets, even if you have to have a specialist refferal they prefer you to go so an affliated consultant specialist, so if Ive got it right and you wanted to change to another vet who wasnt affliated you might not be able too.

    Likewise the particular vet you are with will only accept direct payment without pre authorisation from them because they are one of their affliated vets.
     
  15. heartagram

    heartagram PetForums Member

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    I'm going to ask the other vets what they do about their insurance and perhaps move if they're easier to deal with, I've never had insurance with my cats so not sure how they go about things.
    hopefully moving isn't too much of a drama? oh dear, all new things ha!

    I've gone ahead and bought with John Lewis, Plus cover.
    Vet sure is like 40 pounds a month for only 2k cover and 5k being the max.
    I can't afford that and it seems ridiculously expensive for such low cover and high excess.

    Really bloody awkward this is! so If an emergency was to occur, with my current vets I would have to pay upfront as the pre authorisation would take too long? then claim my money back from john lewis. :sosp: Hmf they don't make it easy on you do they!

    Thankyou for all your help SledDog, appreciate it :)

    edit:
    Arugh just checked other vets, they're also with vetsure so again I will have the same problem.
    Doesn't look like I have much choice :( just hope if I need to claim Lewis will pay me back.
     
    #15 heartagram, Oct 25, 2012
    Last edited: Oct 25, 2012
  16. Sled dog hotel

    Sled dog hotel PetForums VIP

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    If they are looks like you will, its the first time Ive heard of vetsure to be honest. They seem to do several covers the premier one I think it was is 5000
    per condition a year life time policy, not 5000 in total a year. Its a Bummer they both operate the same direct payment policy though for sure.
     
  17. heartagram

    heartagram PetForums Member

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    Oh yes so I see :( very expensive though, he is only 16 weeks lol, I can't personally afford that currently :eek:

    Hopefully nothing will happen! but at least now I have some sort of back up and peace of mind if something does happen, just hope it won't be too much of a kerfuffle with my vets and lewis if I do need to claim :eek:
     
  18. Sled dog hotel

    Sled dog hotel PetForums VIP

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    Hope not the point if insurance and carefully selecting a policy is to relieve stress in the first place. Dont forget though you likely wont be covered for any illness during the first 14 days of cover although some (dont know about JL will cover accident from day one) also anything that occurs in that 14 days you likely wont be covered on there after either.
     
  19. heartagram

    heartagram PetForums Member

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    Just peeved that they're both with vetsure. I hate that I don't have much choice over things, at least not an easy one.
    Though I feel I'm probably better off with somesort of insurance than nothing at all. ;_;
     
  20. AlbertRoss

    AlbertRoss PetForums VIP

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    You should be delighted. Vetsure is a 'per condition' insurance. JL is a 'lifetime' insurance. Those vets don't have their clients' best interests at heart.

    I'd be fairly convinced that a lot of the Vetsure marketing is just hype - and, just for interest, Vetsure seems to be very, very similar to Animal Friends. Same underwriters (based in Gibraltar).
     
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