The story
From the time Sophie’s dog Jem was three months old Sophie insured her with Dog Insure. After a few years Sophie reviewed the cost of Jem’s insurance, and found cheaper insurance with Allpets. Sophie started paying Allpets for Jem’s insurance. Sophie was aware Allpets’ insurance policy had a 21 day stand down period, so to make sure Jem was continuously insured Sophie also continued to pay Dog Insure for a further month.
Two days after cancelling the Dog Insure cover Sophie took Jem to the vet because Jem’s hind legs had been a bit sore and stiff for the last two weeks. On further investigation Jem needed surgery costing about $9,000.
When Sophie claimed against the Allpets policy the claim was declined because Jem’s symptoms first occurred during the 21 day stand down period. When Sophie claimed against the Dog Insure policy the claim was declined because the policy had been cancelled.
Dispute
Sophie said she had done everything she could to make sure Jem was continuously insured. Sophie felt she had been caught out by a technicality and Dog Insure and Allpets should work together to cover the cost of Jem’s treatment.
FSCL’s review
We agreed Sophie had acted in good faith and done everything that could reasonably be expected of her but she had been caught out by an unfortunate series of events and unfortunate timing. However the policy wording was clear that Allpets will not pay for treatment where the clinical signs appeared during the first 21 days of the cover starting. We agreed Allpets was entitled to decline the claim but suggested Allpets consider contributing to Jem’s care as a gesture of goodwill.
Dog Insure is not one of our participants so we referred Sophie to Dog Insure’s external dispute resolution provider.
Outcome
Allpets did not respond to our suggestion that it contribute to Jem’s medical costs. Sophie maintained that she had done all she could do, and while we agreed with her, we could find no obligation under the policy and discontinued our investigation of the complaint.
