Cautionary insurance story

[blindowlblues]

Hi folks I am cross posting this from Facebook because I’m really upset about this experience and I would like other folks to NOT go through what I’m going through right now.

Dasha wants to know if any of her online friends can explain how her heart has suddenly become part of her GI tract???

We (well, mostly me, Dasha’s mum) are really frustrated because her insurance company (Embrace) has denied my echocardiogram claim. They say that because she was diagnosed with the pre existing condition of diarrhea, it’s not covered. The ECHOCARDIOGRAM OF HER HEART. Was not covered because SHE HAD A PRIOR DX OF DIARRHEA.

Is this not making sense to anyone else or is it just me???

I called #embracepetinsurance and asked what in the devil the diarrhea has to do with her heart. The echo was recommended because she has the HCM gene. I would’ve gotten it even if she didn’t have diarrhea.

Now they’re giving me the run around and I’m supposed to wait for a claims adjuster to call me back tomorrow and “explain why”.

I didn’t expect this to be paid for but thought it would count against my deductible. I am literally in tears because I thought I was doing the right thing by paying for the insurance - but now it’s seeming like a real rip off.

If they tell me her echo is not covered because she had diarrhea I will cancel the policy. So that I’ll have some $500 to buy her special food with since apparently, if I took her to the hospital for any number of potential issues the insurance would probably deny her claim because she’s been diagnosed with diarrhea, a malady that apparently includes every organ in the body for insurance purposes.

I am so upset right now by this idiocy and excuse mongering. I am trying to remind myself that her echo turned out good and that’s what counts.

So if you’re looking for insurance, don’t go with Embrace especially if your cat has pre existing diarrhea because apparently then NOTHING is covered.

 

[Yoda mom]

@blindowlblues , oh my heart, I am so sorry for your experience dealing with the insurance. all paws crossed with the flwup tomorrow with claims adjuster. that sounds totally ridiculous. if it were me I would climb the food chain to get it covered, then there is always social media etc. unbelievable.

hugs n head smooches, keep us updated.

ps. you are not alone, my ex had an insurance company actually come to his house to video his positive experience etc.(on youtube somewhere awhile ago) everything was great. then his next claim ridiculously denied.

 

[Catzzzmeow]

Doesn’t make sense to me. Please keep us posted.


Sent from my iPad using Tapatalk

 

[blindowlblues]

Dasha wants to give another update on her insurance drama!!

After reviewing the issue with a claims adjuster who seemed much more knowledgable than the initial gal I spoke to, we’ve come to a more acceptable answer. Though her echocardiogram is still considered not covered (in this case because it was an elective scan and sis not result in any dx), it is for a more rational reason than diarrhea!

Exact wording is:
“the echocardiogram does not fit within the criteria for coverage under your Accident & Illness policy as it is not diagnosing or treating a medical condition.” And the policy terminology was quoted.

I’m ok with this because at least it makes sense within the policy as I understand it. I believe if she is dxed with heart issues in future it will be covered so long as I keep her policy consistent.

I think the confusion about the diarrhea was because I may have incorrectly submitted the claim. I do recall ticking a box about diarrhea but I didn’t realize it would result in that dx being applied to this particular vet visit which was all about her heart and not actually about the diarrhea. I’m still new to filing insurance.

So I’m KEEPING the policy and maybe I was too hasty to get angry at the Embrace company. Sometimes I am a hothead. Next year when it is renewal time I may still consider trupanion instead as apparently my vet clinic does partner with them in some way. I didn’t understand that when I signed up for Embrace.

Thanks so much for all the kind empathy and understanding!! I truly appreciate you all my fellow sphynx lovers.

 

[Catzzzmeow]

Great update and awesome picture!

 

[Letitia]

Thanks for updating!