Disclosing history to Insurance companies

RE: Disclosing history to Insurance companies

rhmrcvs — Mon, 15 May 2017 21:20:18 GMT

Most ( actually all ) policies I have seen have included in their small print that full disclosure of clinical notes when required is part of the agreement when taking out the policy

RE: Disclosing history to Insurance companies

Rob Loxley — Sat, 13 May 2017 11:48:16 GMT

[quote user="J G Wray"]particularly at the budget end of the market[/quote]

The budget end of the market has always been about offering cheap premiums as the level of cover offered and the likelihood of payout is lower, no?

RE: Disclosing history to Insurance companies

Anthony Dennison — Sat, 13 May 2017 11:46:44 GMT

[quote user="Anthony Todd"]

[quote user="Braden Collins"]If a puppy has a murmur, it needs to be noted in the records.[/quote]

Point taken, and, as some say the murmur can disappear, I suggest noting this, if so, on reexam might be the best solution.

Whether the insurance co. will accept this is another matter.

[/quote]

If I see an 8 week old puppy with a murmur, I note it in the record, and write something along the lines of 'likely innocent murmur that will disappear with age. recheck @ 2nd vacc'

Then 2nd vacc comes along, no more murmur, this is put in the notes. Same with diarrhoea. If a puppy comes in with diarrhoea after just being picked up or changing food, I nearly always put 'likely self limiting' or 'likely due to change in diet' so that it won't be considered as an exclusion.

RE: Disclosing history to Insurance companies

Anthony Todd — Sat, 13 May 2017 09:27:34 GMT

[quote user="Braden Collins"]If a puppy has a murmur, it needs to be noted in the records.[/quote]

Point taken, and, as some say the murmur can disappear, I suggest noting this, if so, on reexam might be the best solution.

Whether the insurance co. will accept this is another matter.

RE: Disclosing history to Insurance companies

Braden Collins — Sat, 13 May 2017 07:22:15 GMT

If a puppy has a murmur, it needs to be noted in the records. What if the puppy becomes septic, is seen by another vet who heads down the path of endocarditis because there was no previous mention of a murmur. The itchy puppy might be relevant as it might have an early onset allergy.

If things are not put into clinical records for the purpose of "hiding" them from insurance companies, I think you're on very shaky ground.

We should note anything which may be clinically significant. What the insurance company does with that info is beyond our control.

RE: Disclosing history to Insurance companies

Anthony Todd — Fri, 12 May 2017 21:11:57 GMT

PS Would it be in order to note anything that required treatment at the time of data entry which could define a significant condition?

This is going to bite some poor vet or client in the buttocks in this modern age.....

And could be a lot of money.

RE: Disclosing history to Insurance companies

Anthony Todd — Fri, 12 May 2017 17:24:03 GMT

[quote user="David Mills"]

Clinical notes are releasable with the consent of the owner. Technically the notes belong to the owner but practices have obligations under Data Protection.

Police can access medical records with proper authorisation.

[/quote]

Makes vets reluctant to note that a puppy had an itchy ear or slight reddening or anything that 10 years later could be connected or related.

What about a "slight systolic murmur" in an 8 wk KC spaniel then 8 years later????

[I never mentioned them back in the day, owner panicked for ever, but now er what?]

RE: Disclosing history to Insurance companies

David Mills — Fri, 12 May 2017 16:58:01 GMT

Clinical notes are releasable with the consent of the owner. Technically the notes belong to the owner but practices have obligations under Data Protection.

Police can access medical records with proper authorisation.

There are two threads on insurance. One with vets bemoaning premiums and exclusions. One saying it's nothing to do with them. Insurance companies will look to reduce their liability. Vets potentially have an influence on that. We are not perfect agents and we get things wrong. Insurance companies don't care. We need to recognise our role in the process and not be pompous and aloof when things become sticky or difficult.

RE: Disclosing history to Insurance companies

Bob Russell — Fri, 12 May 2017 16:45:25 GMT

We do when we tick the box (or not) to confirm whether the pet has had this problem or a similar one before.

Damned if you do, damned if you don't! Agree to send history to stop them refusing to pay a claim.

RE: Disclosing history to Insurance companies

Anthony Todd — Fri, 12 May 2017 15:59:40 GMT

[quote user="Bob Russell"]Most insurance policies include a requirement for permission to access a patients history[/quote]

So the vet has to agree, as the notes belong to the vet?? [just asking, not arguing]

I thought human medical records were confidential and couldn't be accessed by police etc.???

Couldn't the vet just certify "no preexisting conditions" or no on-going conditions etc.??

What about a cut hind toe then a cruciate in the same leg??

Insurance exclusions are going to become more and more litignatious or similar.

RE: Disclosing history to Insurance companies

Bob Russell — Fri, 12 May 2017 15:47:19 GMT

Most insurance policies include a requirement for permission to access a patients history. Others just require it before settling a claim.

RE: Disclosing history to Insurance companies

Anthony Todd — Fri, 12 May 2017 15:39:58 GMT

Are not vets notes the property of the vet AND confidential? viz Xrays, which comes up again and again,

ie can vets refuse to divulge the contents of clinical notes to insurance COs???

Can I get some animal's notes from a vet I choose to ask?

Who is legally entitled to have access to a particular animal's veterinary notes, apart from the owner of the animal?

RE: Disclosing history to Insurance companies

J G Wray — Fri, 12 May 2017 10:20:59 GMT

No one is advocating fraud. The shark pool which is equine practice is fortunately , for me, supported by a separate pot of cash at VDS. Given levels of litigation I'm not surprised that the controlling factor there is fear, rather than evidence.

RE: Disclosing history to Insurance companies

Martin Atkinson — Fri, 12 May 2017 10:16:50 GMT

[quote user="David Mills"]This is pompous stuff [/quote]Well there's the pot calling the kettle black.

[quote user="Anthony Todd"]Again a one star without explanation! [/quote]He deserved it without explanation (NB I didn't give it), Chris' thread was perfectly reasonable, albeit I might give the client some guidance on which companies/policies IME are better/worse.

[quote user="Wren"]Owner gets insurance renewal through with - surprise surprise - an exclusion for sarcoids. Owner hits roof as feels vet was overstepping the boundaries making clinical notes when all they requested was a vaccination. The feeling from the many, many respondents is that the vet was totally unfair to make a note on the history about something he/she was not directly asked about. Most suggested that a phone call to the vets could get the notes expunged from the clinical history permanently, and several said that their vet had done this for them in similar circumstances.[/quote] I would politely tell this client to find another vet and wouldn't want 'the respondents' as clients either. Maybe why I'm so quiet, but I won't put up with this kind of crap from clients.

RE: Disclosing history to Insurance companies

Wren — Fri, 12 May 2017 08:42:58 GMT

There is a long running thread on a horse forum that I occasionally frequent when I feel like I haven't banged my head off a wall enough for one day have a bit of free time. Vet saw horse for vaccination and noted a minor condition (undisclosed, but reading between lines suspect small sarcoid) on horse's records. Owner gets insurance renewal through with - surprise surprise - an exclusion for sarcoids. Owner hits roof as feels vet was overstepping the boundaries making clinical notes when all they requested was a vaccination. The feeling from the many, many respondents is that the vet was totally unfair to make a note on the history about something he/she was not directly asked about. Most suggested that a phone call to the vets could get the notes expunged from the clinical history permanently, and several said that their vet had done this for them in similar circumstances.

Now, obviously, owner pressure (particularly horse owner pressure) is a powerful force, but do people really delete things from clinical histories in order to 'pretend' that they never saw something, thereby facilitating owners to essentially participate in insurance fraud with regard to pre-existing conditions? Not here they don't.

RE: Disclosing history to Insurance companies

Chris Barker — Thu, 11 May 2017 19:58:41 GMT

[quote user="David Mills"]

This is pompous stuff / tripe....I've seen many insurance issues arising from crap vets putting vague notes years before about ears or somesuch then tecas being refused.

[/quote]

Sorry, don't follow your argument. I see a young(ish) animal and it has some ear issues. I recall the fact that 70% of ears are/may be allergy/atopy related. As I cannot see every animal every time in my practice (and even if I could I wouldn't begin to remember every nuance of every examination) I record it in the clinical records for the better information of myself and colleagues in the future.

A few years later the ears have deteriorated to such a degree that they require a TECA; Insurance declines to fund the surgery due to it being part of a pre-existing condition.

Where's the error? Not with the clinical records. Perhaps it lies with the owners who took out insurance too late, perhaps only after a vet had suggested there might be a future problem with the ears....?

RE: Disclosing history to Insurance companies

Anthony Todd — Thu, 11 May 2017 17:02:18 GMT

[quote user="David Mills"]I've seen many insurance issues arising from crap vets putting vague notes years before about ears or somesuch then tecas being refused. [/quote]

Again a one star without explanation! I would have thought any otitis was a prexisting condition, crap notes or an essay, so I need a bit more than "crap".

RE: Disclosing history to Insurance companies

David Mills — Thu, 11 May 2017 07:49:15 GMT

[quote user="Chris Barker"]

[quote user="J G Wray"]

I do not venture into this territory, because I am not allowed to discuss the merits or otherwise of financial and insurance products.

[/quote]

Agreed. But I would go further. Your responsibility is to examine, to assess and to record your findings for the better future care of your patient. Period. If such examination reveals something that becomes clinically significant in the future then so be it. The insurance relationship between your client and their insurance company is nothing that needs to involve you - you have/should have no input on their choice, and its value is entirely dependent of the timing of commencement and the details/exclusions applied under the policy. I can understand an owner's resentment of unjustified exclusions, but their choice of insurance policy was nothing to do with you, and you should carry no blame should entirely proper recording of clinical suspicions, or of owner reported history, damage their insurance standing

[/quote]

This is pompous stuff / tripe.

It would only obtain if the veterinary surgeon was an infallible agent and right each time.

I've seen many insurance issues arising from crap vets putting vague notes years before about ears or somesuch then tecas being refused.

RE: Disclosing history to Insurance companies

Chris Barker — Wed, 10 May 2017 20:29:40 GMT

[quote user="J G Wray"]

I do not venture into this territory, because I am not allowed to discuss the merits or otherwise of financial and insurance products.

[/quote]

RE: Disclosing history to Insurance companies

Chris Milligan — Wed, 10 May 2017 18:26:04 GMT

[quote user="rhmrcvs"]it should be possible to counter the 2 excesses in some way by itemising the costs involved in each of the conditions.[/quote]

makes sense to me, though I think the client had no excess. We shouldn't have to do this though of course

RE: Disclosing history to Insurance companies

Bob Russell — Wed, 10 May 2017 09:50:43 GMT

£3m over 20 years is not contributing much to animal welfare nor is their attitude to fairly processing claims doing much for the welfare of their client's pets IMO!

Any company that takes premiums but resists paying claims is bound to make more profit and have more upset clients.

RE: Disclosing history to Insurance companies

Neil Wheadon — Tue, 09 May 2017 23:13:31 GMT

Animal Friends featured in the Sunday Times top 100 fast track company list this year.

Elaine Fairfax, 62, founded this pet insurance company in 1998 with her husband Chris, 59, with the aim of raising money to fund animal welfare. The Wiltshire firm has since donated in excess of £3m to more than 300 charities. It has sold over 600,000 policies to date and profits rose to £7.6m in 2015, on margins of 43%, among the highest on the league table.

Neil

RE: Disclosing history to Insurance companies

rhmrcvs — Tue, 09 May 2017 20:53:41 GMT

[quote user="Chris Milligan"]

I had an absolutely stellar experience with an unnamed supermarket insurance brand (let me tell you that every little definitely doesn't help).

I arrange for dog to come in for resection of 10cm lipoma in the inguinal region. ON the day of admission note a 3mm cyst on the face that o wants taking off whilst under anaes. Surgery went well, resect the mass and the pinhead sized cyst. Note we didn't charge anything for removing the cyst and o declined histopath so it didn't even go off to the lab.

Two weeks later, client is furious with the insurance company who insist on charging her two premiums for two seperate conditions because I mentioned in my notes that we'd removed a cyst by the by. I had it out with the insurance rep but I think it was to no avail. Disgusting they can charge that when we as a practice have done a favour for the client.

[/quote]it should be possible to counter the 2 excesses in some way by itemising the costs involved in each of the conditions. E.g. if ga was 60 minutes , 1 minute for tiny cyst , 59 for lipoma , pre med drugs, iv fluids, analgesics etc , surgical time the same. So if total cost 500 , cost for large mass 475 , cyst 25. It means the claim for cyst won't go over insurance excess so can't claim but is a fair representation of the costs.

RE: Disclosing history to Insurance companies

Chris Milligan — Tue, 09 May 2017 20:45:06 GMT

I had an absolutely stellar experience with an unnamed supermarket insurance brand (let me tell you that every little definitely doesn't help).

RE: Disclosing history to Insurance companies

Thomas Johnson — Tue, 09 May 2017 18:46:13 GMT

[quote user="J G Wray"]Just a minute ago you were pointing out how this enquiry might lead to reduced premiums and possibility of discounts - a whole raft of speculation.[/quote]

I suppose what I'm getting at is that insurance companies are interested in the relationship between clients and practices and how that affects claims, that's their business. My feeling is that more practices are offering some sort of practice plan with the aim of benefiting both the practice and clients. Of course insurance companies will want to know whether this is going to affect how much they pay out.

[quote user="J G Wray"]

[quote user="Thomas Johnson"]Do you encourage your clients to take out 'lifelong' insurance policies as soon as they take on a new animal? If this is the case then anything noted down on the clinical history shouldn't lead to an exclusion on the policy.[/quote]

I do not venture into this territory, because I am not allowed to discuss the merits or otherwise of financial and insurance products.

[/quote]

My understanding is that you are not allowed to discuss the merits, or otherwise, of individual policies unless, for example, you are a Pet Plan member practice and have gone through their training allowing you to discuss Pet Plan policies. However you can recommend the concept of pet insurance, and discuss in broad terms the options that are available such as the difference between 'lifelong' and 'annual' policies.