Pet insurance is something we vets always recommend you get. However, there may be times when you feel they have not fulfilled their role and you wish to make a complaint. There are different ways to do this; below we are going to discuss how it is best to formulate a complaint.

Why are you complaining? 

You must know exactly why you are complaining in order for your problem to be solved. Have the company not done what you wanted them to? Did they not communicate with you well enough? Have they not paid out when you expected them to? Have they increased your premium by too much? You need to be specific about what your complaint is about.

Read the terms and conditions for your contract. If you can find a clause that you feel has been broken, you can make a complaint about that specific issue. You can, however, complain about how a company has made you feel, if you complain directly to the company. Many companies care deeply about their reputation and want their customers to feel valued. So discussing with a company how they have made you feel may give them something to improve on in the future. 

Collect your evidence 

Collate all the evidence you have. You should include as much detail as you can about why you are wanting to complain. You should write all this information down as close to the event happening as possible. This is to make sure your recall is as accurate as possible. You may need evidence from other people including your veterinary practice. 

Writing down the information means you have something to look back on whilst making a complaint and you can also send this information over to any other parties involved. This means everyone can have the same document and therefore a similar understanding of the situation. If you have collected all this information prior to making the complaint, it should save time during the complaints process as they will not be asking you to go and find out more information before giving you any answers.

When you are looking at your policy check certain things:

  • Did you disclose all pre-existing medical conditions?
  • Have you claimed more than your maximum allowance in this period?
  • How long did you have the policy for before making a claim? Many companies have a ‘warm up’ period in which you pay for the insurance, but they will not pay out.
  • What is your time limit on the condition? Some companies will say that conditions are only covered for 12 months post initial diagnosis.
  • Bilateral conditions – some companies will consider diseases such as elbow dysplasia bilateral meaning that if your dog needs surgery on the left side one year, they will not pay out for any later surgery on the right side.

These are common reasons that claims get rejected, so be sure you have read the wording on your insurance summary clearly.

Who to complain to

Contact the insurance company first and see if they can resolve the problem in-house. This complaint process could result in an answer more quickly. By making a specific complaint, you should be able to talk to someone in the relevant department. If you feel your problem has still not been resolved, you can go one step higher. If you are genuinely unhappy about the situation, you can leave reviews online to warn others about the service you have received. Although this could damage the company’s reputation. 

If you feel that your problems are not being dealt with appropriately, you could contact the financial ombudsman. It may take a long time to get an answer or solution, but they have the power to enforce a fair settlement if they decide you have a case. Documents, terms and conditions, and veterinary clinical notes will need to be read in thorough detail prior to any decisions being made. Your cooperation throughout the process will be essential. If it is found that the insurance company have made the wrong decision, premiums could be refunded, part or all of the claim may be paid and, in addition, interest may be paid on top. 

You can complain about your insurance company but in most cases, the fault will be a result of misunderstanding the wording in insurance terms and conditions. If you choose to change insurance company following making a complaint, be sure to ask lots of questions and make sure you have it in writing that they are going to cover for the conditions and accidents you want them to.

And above all, read the small print before you sign up in the first place!

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