Insurance Claim Help

[EventingMum]

I have insured with this particular company for many years and have always had great service from them up until now.

My horse was unwell in August with uveitis and whilst at the vet school developed violent and distressing head shaking. The uveitis was sucessfully treated and after a CT scan he had 3 rounds of PENS treatment which so far seems to have worked. However all this came with a large bill.

The vet schools (plural as he had to go to a second one for the CT) submitted their claim forms as did the referring vet. Eventually I got a letter asking for a full veterinary history from my usual vet which they sent twice. Next was a letter saying my claim was on hold because they didn't have the veterinary history so the vet sent it again, I received the same letter again so my vet kindly emailed while on the phone to the insurers so she could check they have received it which they confirmed. There then ensued several weeks of silence. Last week I phoned three times and spoke to different people who claimed they would chase it up with the claims department. Today I got hold of the lady I spoke to on Friday who said she feels like she is banging her head off a wall, there has been no response from the claims department, the file is showing the vet history has been received but nothing else. She has escalated it again but said honestly she doesn't know if or when anything will happen - she could log it as a complaint but said in all honesty it wouldn't make a difference.

Help!! Any advice on where do I go from here? Obviously the Ombusman is an option but I really want it resolved quickly - the vet schools have been great waiting for their money but can't be expected to wait for ever. I have 4 horses insured with this company and after this would be sorly tempted to moved insurer but two are elderly so changing wouldn't be easy

 

[Red-1]

Hi, I had to make a claim last year, I felt much like you, but it was paid after 3 months.

Getting on their case did not seem to help much. They also claimed not to have received documentation.

I guess they have got you to a certain extent, when claiming you can hardly leave them.

I hope yours is sorted as well as mine was, even though it is delayed.

 

[rifruffian]

Name and shame.........

 

[EventingMum]

Name and shame.........

Scottish Equestrian Insurance - seem to have gone downhill since they've been taken over by PetPlan.

 

[Sandstone1]

Ask to speak to a manager.

 

[EventingMum]

Ask to speak to a manager.

The lady I spoke to was a senior team member, they can't speak directly to the claims department but have to email them.

 

[VRIN]

Sounds like a rubbish system!! Can you go direct to someone official at Petplan ?

 

[Sandstone1]

The lady I spoke to was a senior team member, they can't speak directly to the claims department but have to email them.

I'd still ask to speak to her manager.
If that doesn't work I would email them and say you intend to contact the insurance ombusman.
I've emailed managing directors before now. If you have given them a reasonable amount of time to sort it out it's time to get tough.
The other thing to do is send a copy of the veterinary history by recorded delivery. They can't deny they have received it then

 

[angel7]

Write and email a letter to the insurance company outlining the issues and what you would like done about them. Then send the same letter to RESOLVER, google it. Petplan is listed as one of the company's it deals with. The complaint should be dealt with quicker this way.
Send same copy to the insurance ombudsman if no result with resolver, stating what you have done to resolve the matter.
Shame SIS were good for me and paid every bill within 2 weeks.

 

[EventingMum]

Maybe I'll look at this although I think they run separately.

 

[EventingMum]

Write and email a letter to the insurance company outlining the issues and what you would like done about them. Then send the same letter to RESOLVER, google it. Petplan is listed as one of the company's it deals with. The complaint should be dealt with quicker this way.
Send same copy to the insurance ombudsman if no result with resolver, stating what you have done to resolve the matter.
Shame SIS were good for me and paid every bill within 2 weeks.

Thank you, this sounds like a possible plan, I hadn't heard of RESOLVER before. I'm very disappointed, I've insured a number of horses with them over many years and never had a problem with any claims in the past.

 

[angel7]

I've used resolver twice with good results within 3 days of emailing. its easy and straightforward. the complaint will go direct to the chief execs and I was called back within days with money refunded from gas company.

 

[gingerfan]

Sounds exactly like my experience when it took from November until last week for a well known company to settle my claim, even to claiming they hadn't received information which had most certainly been sent. Eventually I rang up and spent half an hour on the phone (the words Financial Ombudsman may have been used) and the claim was then settled.

 

[Shooting Star]

Lodge a formal complaint, there are then strict timelines in which they have to handle your complaint and if it’s still not resolved satisfactorily after that period you can take it to the ombudsman.

Making a formal complaint will make a difference as they are obliged to report complaint volumes to the regulator however ones that are resolved quickly aren’t reportable ... if you then go on to take it to the ombudsman the insurer will also have to pay a fee too regardless of whether they were in the wrong or not and they really don’t like paying that

 

[whizzer]

I would lodge a complaint,set a date & say you’ll go to the ombudsman if not sorted. I had to use the ombudsman a year ago,they were brilliant,so helpful & got me a positive result. At the time the vets I was using said they had a file full of claims that petplan were dragging their feet over.