This particular insurance company really getting on my nerves now

Re: This particular insurance company really getting on my nerves now

Luca Poddighe — Fri, 24 Apr 2015 12:05:28 GMT

I'm not a lawyer so I can only say what it is my opinion. If the adverse reaction occured following the prescription of the drug at the normal dose, it would have been a single claim. But considering that it happen following an accidental overdose I don't think they can be considered to be the same claim. It would be good to speak with someone that works for insurance company.

Re: This particular insurance company really getting on my nerves now

Bob Russell — Fri, 24 Apr 2015 11:29:57 GMT

Why is it a grey area? It is a case of the law of unintended consequences!

"If I had chosen to take my normal route home, I would not have been in the car accident" or "if only my neighbour had gone out to the pub on a different night he would not have been injured by a group of yobs".

As an insurance company I might have refused to pay for a repeat prescription on the grounds that the owners had been careless and the dog had got the tablets. Even this one seems a bit of a weak argument.

Two different claims linked only by the finest of threads IMO.

Re: This particular insurance company really getting on my nerves now

Martin Atkinson — Fri, 24 Apr 2015 10:25:57 GMT

[quote user="Stephen Courtney"]all your client needs to do is take their case to the Insurance Ombudsman. At that point the well known insurance company is likely to have a change of heart. It costs them plenty to defend a case, your client accesses the ombudsman for free. [/quote]I had an issue with an insurance company not paying out as much as I thought they should for a damaged laptop for which I claimed on the household contents policy. I threatened the insurance company I'd take it to the Ombudsman and they called my bluff so I did. The ombudsman decided in my favour and the insurers had to pay out a few hundred pounds more. Result I thought until the renewal came and they doubled the premium and no-one else would insure me.

It seems they took their revenge and there is a cartel/common interest bond amongst thieves insurance companies so the OP might like to tread warily.

Re: This particular insurance company really getting on my nerves now

Kate Richardson — Fri, 24 Apr 2015 09:40:10 GMT

I agree with Braden

Re: This particular insurance company really getting on my nerves now

Hannah Wynne Richards — Fri, 24 Apr 2015 08:14:14 GMT

Stephen It's a lawyer's opinion that's needed, not that of a veterinary specialist.

Wynne

Re: This particular insurance company really getting on my nerves now

Braden Collins — Fri, 24 Apr 2015 06:40:46 GMT

I think it's a grey area. I personally think there is enough of a link between the intial injury, the need for medication and the dog having access to the medication to say it's related so the same claim. That being said it could be called either way.

I hada case a bit over 12 months ago - a friend of the dogs owner drove into the owners garage and damaged it quite badly. The owners moved everything out of the garage, something fell over while it was on the lawn and broke the dogs leg. The car insurance company paid for the dogs broken leg. I think it's a similar story where it's a bit of a long bow to draw to say they're directly related but the insurance company thought they were related enough so treated it as a single incident and claim.

Re: This particular insurance company really getting on my nerves now

Stephen Courtney — Thu, 23 Apr 2015 21:17:06 GMT

the answer is very simple, all your client needs to do is take their case to the Insurance Ombudsman. At that point the well known insurance company is likely to have a change of heart. It costs them plenty to defend a case, your client accesses the ombudsman for free.

I see no grey area here whatsoever. Although the said was for one condition, the toxicity issue is quite separate. It shouldn't be hard to get a specialist or two to back that position up.

Your client needs to make a formal complaint to the insurer, give them a reasonable time to respond, and if they still deny the claim they can be taken to the ombudsman. I would make it clear to the insurer that you will assist the client to do this, and there is a good chance they will think again. and if they don't there is a good chance the Ombudsman will find for the client - they do in about 2/3 of cases.

Re: This particular insurance company really getting on my nerves now

Laurence Webb — Thu, 23 Apr 2015 21:05:13 GMT

Write to the manufacturers and ask if they will give you some cash to use it as evidence of their products high palatability!

Re: This particular insurance company really getting on my nerves now

Michael Woodhouse — Thu, 23 Apr 2015 17:21:43 GMT

I can see where the confusion comes from. I'd say this was clearly a related condition as the problem was caused by issues related to the drug prescribed due to the cruciate issues.

If the dog had eaten a packet of ibuprofen out of the owner's handbag then that's unrelated.

I would put that through as 1 claim.

Re: This particular insurance company really getting on my nerves now

listhestar — Thu, 23 Apr 2015 17:18:12 GMT

[quote user="Kishor Mahind"]Even if the charges didn't go above the limit I wouldn't have thought of claiming this under same condition - because it is not the same condition![/quote]

I would agree. I do not lump stuff together, can't take the mick out of insurance and still expect them to pay. I like my MRCVS and any hint of fraud/dishonesty/truth stretching, I keep well away from.

The dog could have easily have gotten into its owners supply of say aspirin or ibuprofen, the only difference here is that the doggy ones were tasty to the dog. I would preserve and I would escalate if needed. The insurances company blasé attitude means they know vets are time poor and they hope you won't be bothered to chase it up.

Good luck

Lisa

Re: This particular insurance company really getting on my nerves now

Kishor Mahind — Thu, 23 Apr 2015 16:45:42 GMT

[quote user="Martin Atkinson"]

Well I think you have to be honest with yourself and ask: if this hadn't taken the charges over the limit and you could have claimed for it all under one condition thus avoiding a second excess for the client what would you have done? And if they disagreed and said it had to be two different conditions would you have argued the opposite way?

Then ask how you would view it if you were the insurance company. You've tried arguing that its a different condition and they don't agree. It is easy to knock insurance companies and often they deserve it but this has a very big grey zone and I can't blame them for their decision, sometimes they are between a rock and a hard place.

[/quote]

Even if the charges didn't go above the limit I wouldn't have thought of claiming this under same condition - because it is not the same condition! The overdose didn't happen in the surgery - its not like I gave him 10 times the dose of NSAID by mistake. it is genuine case of toxicity by accidental ingestion. Why and how the tablets were dispensed is irrelevant in my opinion. It could have been any other tablets. What if the dog ate the tablets that were dispensed for another dog in the house - will this insurance company recover their costs from the other dog's insurance company? What if the dog ate human tablets - are they going to recover the costs from NHS or private medical insurance of the owner because the owner was dispensed those tablets and the dog managed to get hold of them?

Re: This particular insurance company really getting on my nerves now

Martin Atkinson — Thu, 23 Apr 2015 16:40:34 GMT

[quote user="Bob Russell"]

Just trying to get out of paying a claim IMO!

[/quote]I agree but some vets (and I don't necessarily exclude myself) think they are clever/helping the client by dumping stuff into one claim when it suits so can't cry foul when the opposite happens. I'm sure if I was a vet working as a claims adviser I would be looking for all the tactics claimants are using to get the maximum payout and I've probably used them - legitimately of course.

If the OP's client thinks it is a valid separate claim they should persevere but all I'm saying they should be honest with themselves about their motives and see how it works both ways.

Re: This particular insurance company really getting on my nerves now

Bob Russell — Thu, 23 Apr 2015 16:28:12 GMT

Or would it have been a valid claim if the dog had consumed a months worth of vet/nurse's chocolate ration in one go. Or consumed a month supply of rodent bait!

This is ingestion of a potentially toxic dose of a medication. Nothing to do with the cruciate (I bet the leg felt better though!).

Just trying to get out of paying a claim IMO!

Re: This particular insurance company really getting on my nerves now

Martin Atkinson — Thu, 23 Apr 2015 16:13:24 GMT