Anna’s insurer wouldn’t cover treatment for her cat’s surgery because the condition had been around for longer than the policy would cover.

Insurer says surgery claim falls outside of policy time limits

Anna’s insurer wouldn’t cover treatment for her cat’s surgery because the condition had been around for longer than the policy would cover.

What happened

Anna’s cat, Florence, needed surgery. But when she made a claim on her policy for the treatment costs, her insurer refused to pay out. They said the condition had been present for around 18 months, and that cover only applied for 12 months from the date the condition appeared. They also said that Anna should have taken her pet to the vet sooner. Anna thought this was unfair because she hadn’t been aware earlier that there was an illness that needed attention.

How we helped

We agreed that the policy only provided cover for 12 months from when a condition shows clinical signs of illness or injury. But Anna had taken Florence to the vet as soon as she was aware of signs of illness – when there was an infection. Before then, she hadn’t been aware there was a problem that needed treatment or that she’d need to make a claim on the policy.

Putting things right

We told the insurer to pay Anna’s claim, taking into account the policy limit and any excess. We also said that they should cover any further treatment costs during the 12-month period – which would continue after the policy ran out – as long as Anna renewed the policy and continued paying the premiums.