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Insurance Won't Pay Claim For Skin Condition


bianca.a
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:laugh: I took Molly to the vet when she was 10 weeks old for puppy pyoderma, then 2 months ago she had a hotspot that with four vet visits in four days, set me back nearly $800. Put in a claim and they rejected it. When I called to find out why they said she had a pre-existing skin condition (pyoderma) and that they look at the skin as one organ. So I cannot ever claim for ANY skin condition.

This is just more a rant than anything, I realise in the scheme of life, it's not so bad but this not quite 1 year old dog has cost me around $3000.00 at the vets which is why I got insurance ( a bit late granted) and for paying $450 a year I am so angry! Plus the woman on the phone was rude. I put in 2 claims for the same issue as she went to two different vet clinics. One claim is still being processed and when I asked why, she said they received the forms on different days....um HELLO I posted both forms in the SAME envelope?!!! What the?

Rant over but I would be interested if anyone has ever had a skin issue(s) refused for similar reasons?

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Do you mean you took the dog to the vet for a skin problem the first time when it wasnt insured,then got insurance and later claimed for a different skin condition?

Lets talk about the skin condition for a minute - not regarding the insurance but from the health point.

No matter what the skin condition is or what triggered it what you see is only a part of what is going on. Its a symptom of something else which is going on with the dog's immune system and its why you often see the first signs of it around 4 - 8 weeks after a vaccination.

The vet will treat the symptom but if you stand back and treat the immune system you have a greater chance at success for the rest of the dog's life and it wont cost you a truck load of money.

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The vet will treat the symptom but if you stand back and treat the immune system you have a greater chance at success for the rest of the dog's life and it wont cost you a truck load of money.

:laugh: Please do tell me how to treat the immune system...nearly 4 years on and 1,000 treatments later and not one has worked.

Edited by sas
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I've put in several claims for skin related matters and they've all been paid without question. Mind you I got insurance the day I got my dog so there had been no prior trips to the vet.

this would be the difference.

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I don't have pet insurance but I have researched it extensively and every one I've looked at says NO claims on pre exiisting conditions. If the dog has had a skin condition BEFORE you got the insurance, they wont pay out. It's very unfortunate, but normally this is the case.

My dog had a hot spot treated just this week and it cost me $60, with meds. :rofl::eek:

This was for consult 20 mins., steroids for 5 days (but have a lot more than that), a MASSIVE head bucket so she cant reach her tail :laugh: and follow up check up. I already have neocort cream at home for ongoing treatment.

Mine also sees a dermatologist as she gets allergies, so I dont like using the steroids, but she needed them this time.

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If the dog needed to be sedated to clip/clean the wound I'd expect a bill around $200. We have often had to sedate pets as the hotspot is so painful they wont let anyone near it :rofl: But $800 does seem a bit excessive!

Unfortunately with pet insurance, it really is best to insure your pet as soon as you get them so all major things will be covered.

Its also annoying but any pre existing condition will exclude the whole area/organ not just the same condition.

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The vet will treat the symptom but if you stand back and treat the immune system you have a greater chance at success for the rest of the dog's life and it wont cost you a truck load of money.

:rofl: Please do tell me how to treat the immune system...nearly 4 years on and 1,000 treatments later and not one has worked.

Treating the immune systems means you need to look at it holistically and do what you would do for yourself if you have a condition which is immune related.

Diet,environment ,medications, exposure to chemicals etc all have to be taken into account and there are some natural products very famous with good science to back them up for correcting immune related issues which the vet is unlikely to have an idea of.

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It is important to look at the Product Disclosure Statement of insurances before you take them out.

For instance, bilateral conditions like cruciates are considered one condition.

Was the skin listed as a pre-existing condition on the certificate of insurance, I think there is some wording somewhere to that effect.

Could it be that they are lumping it under atopy? I notice that is a term that seems to appear quite a lot on the vets records when my dog had the itchies when he was younger. When I took out insurance I pretty much understood I wouldnt' be able to claim for any skin allergy stuff as he had that pre-insurance when younger. Luckily with diet he has greatly improved.

That said I'm also with Medibank and they have been absolutely great so far. We have just made a claim for pre-op xrays for cruciate they have paid within 5 days.

I have also claimed health benefits (which we can on top cover) and again paid within 5 days sometimes sooner.

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Thank you all for your replies :(

I will say that her hotspot appeared literally overnight so it's not that I let it get so bad before I took her for treatment. I got her in to the vet first thing in the morning. She had to be anesthetized for them to shave, clean it and treat it. With the injections, sedation, cone, consultation, cream the bill came to over $280. The next day she was beside herself again (for want of a better description) so I took her back, and they gave her another pain injection. The next day she was still a wreck so I had to take her to another vet clinic (my vet was not open) and they sedated her again to be able to treat it. I had to take her back the next day for them to clean it and check it again. So the bill's were from 4 vet visits over 4 days. She was put on prednisone and cephalexin as well.

I had never had experience with a hot spot before so had no idea what to expect or how to treat it. All I know is that my poor pup was so miserable and must have been in a lot of pain that I needed it treated however they thought was best for her.

Again I have never had experience with medical insurance for pets before. Molly is the first dog I have done this with as i don't even know if there was such a thing available when I had my last dogs. I know now that I should have purchase it when I first brought her home. I just didn't realise that because she had a different skin condition earlier on, that ANY skin condition would not be covered. And no that was not listed as a pre-existing condition on the insurance certificate.

Molly had been on Royal Canin during all of this too. Since then I have swapped her onto RAW and she appears to be great! :(

Sorry this was so long too BTW.

Edited by bianca.a
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Sorry to be a bit off topic, but I had a question about insurance.

I read somewhere (maybe on DOL) that if you get treatment and claim for a condition/illness like, for example, Hip Dysplasia while you have insurance, then it will count as a pre-existing condition and won't be covered the following year/whenever you renew your contract. Is this true?

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Sorry to be a bit off topic, but I had a question about insurance.

I read somewhere (maybe on DOL) that if you get treatment and claim for a condition/illness like, for example, Hip Dysplasia while you have insurance, then it will count as a pre-existing condition and won't be covered the following year/whenever you renew your contract. Is this true?

As long as there is no gap in your cover with the same insurance company you successfully claimed HD related issues with, then the insurance company should be paying out for that condition for the life of your dog (but will usually charge you an excess once each year you make a HD related claim). Again, only if there is no gap in your cover.

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GSD's are prone to pyoderma (my Blackwell's says so :thumbsup:.) I assume the vet checked the risk factors - Allergy, parasites, fungal infection, conformation (short coat, skin folds), seborrhea (acne) , trauma, and foreign body - so that only leaves Endocrine disease and Immune incompetency. "Steve" is right - try boosting the immune system. The Bearded Collie Club of NSW recently ran an article by Mogens Eliasen on boosting the immune system. You might like to check his web site out. As it is common with GSD's you could also try contacting one of the local breed clubs and ask for advice. There are vets - and then there are vets - we've used the ones that see all manner of animals but now only use a "specialist" vet - he knows what he's doing, breeds, shows and judges...

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Sorry to be a bit off topic, but I had a question about insurance.

I read somewhere (maybe on DOL) that if you get treatment and claim for a condition/illness like, for example, Hip Dysplasia while you have insurance, then it will count as a pre-existing condition and won't be covered the following year/whenever you renew your contract. Is this true?

No, not exactly... pre-existing is not the correct term in that situation. Pre-existing is an illness etc which was existing or arose prior to the policy ever existed on that dog, so prior to the dog being covered by this insurance policy.

If for example there are further ongoing complications with the same condition/illness (and your example of HD could fall into this category) in a following renewal period (let's say the next year) you will have to pay the excess fee again, if there is an excess fee with that particular policy. And as long as the policy holder did not allow the policy to lapse, the condition/illness will still be covered up to the agreed amount.

So, basically what I mean (if I have not explained it clearly) is that the condition/illness is still covered into the next policy period provided there is no lapse in cover, but the excess fee may need to be paid again to get on going treatment for an already claimed condition/illness.

For insurance companies that offer a percentage of the claim and do not charge an excess fee, I imagine they would be the same, as you are still basically paying an excess fee instead of receiving 100% reimbursement of the vet bill. Usually the insurance companies offer one or the other - excess fee and 100% cover or no excess fee and approx 85% cover.

My advice for anyone that is intending on covering a new puppy, would be to take out the policy when the pup is 4-6 weeks of age, even before you bring it home. Sure there will be situations when this is not possible as the breeder may not know which pup is yours etc. But as soon as your puppy is decided, I would get it covered, as this way, even if a condition/illness shows up before you bring the pup home (and I mean something minor, like a yeasty ear, UTI or loose stools for example all of which are not rare in puppies) if this condition is treated when the breeder takes the pups in for a check up, this condition cannot be classified as pre-existing as the pup was covered. Even if a claim is not put in. As long as it is on the vet's record, it should be fine.

Snap Rubystar

Edited by dyzney
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