Anna’s pet insurer argued that her cat’s illness had gone on too long to be covered by her policy and refused to pay her claim.
What happened
Anna discovered that her cat, Florence, was ill and needed surgery. When she made a claim for the cost of Florence’s treatment with her pet insurance company, it told her it wouldn’t pay out.
It said her cat’s condition wasn’t covered by her policy. The condition had been affecting Florence for around 18 months, it claimed. Meanwhile, Anna’s policy only covered 12 months, starting from when the condition appeared.
Anna’s insurer rejected her claim, arguing that she should’ve taken Florence to the vet sooner to stay within that 12-month window. Anna thought this was unfair since she hadn’t known there was an illness that needed to be treated. She decided to bring her complaint to us.
What we said
Anna’s policy did say that cover would only be provided for 12 months from when a condition showed ‘clinical signs of illness or injury’. But, as we pointed out to her insurer, Anna had taken her cat to the vet as soon as she spotted ‘signs of illness’.
Before this, she hadn’t known that Florence was having any issues that would need treatment or require a claim on her insurance policy. Arguably, the clock hadn’t started ticking on those 12 months until she knew there was a problem.
We asked Anna’s insurer to pay her claim, making necessary adjustments for policy limit and excess. We also told the insurer to cover any of Florence’s further treatment costs during the 12-month period. This included the period after the end of Anna’s policy, as long as she renewed it and kept paying her premiums.