Insurance Not Paying Out. Vet Going To Take Me To Court.

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fredthoroughbred

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Hi there,

Last February, we very traumatically lost our beloved greyhound, Fonzi. It's a very long story but to cut it short the insurance company, Animal Friends (yeah right!) have said that the problem could have been connected to a previous problem and therefore won't pay out. My vet has written them a couple of letters declaring that it is unlikely that it was connected to the previous problem but she can't completely rule it out. Fonzi had been referred to the Dick Vets in Edinburgh and ran up a bill of £4500 which they are now saying we have to pay by November 25th or else it's going to court. Can anyone advise me on what to do or if anyone has been involved in a similar situation, how did you resolve it? Is the only answer paying?

Thanks for looking : )
 
unlikely that it was connected to the previous problem but she can't completely rule it out

really shouldnt have said this - you've admitted it! Will the vets not take installment payments? They usually do for huge bills. Otherwise get a 0% credit card pay on that and repay yourself. Sorry not very helpful, NEVER admit anything or say maybe to anything. You could get the vet to right to the insurance company to say that it is not related, if it isnt.
 
I would tell the vet that is their fault the insurance are not paying due to what they wrote and see if they will split the bill....
 
Oh I really feel for you how dreadful. Surely the vet must have realised by giving a smudgy answer the insurers would wriggle!! On that basis alone he should give you a hefty discount. I would ask for a discount and some payment time - maybe by installments over 5 or so mionths at least.

Would it be worth getting a second opinion? Could the vet refer and ask an expert what likelihood regarding this condition being caused by an earlier one? Worth checking up I would say - you have a little time. I have had to get a further assessment statememnt re a lou case and am hoping the second assessment statement will be successful.
Good Luck
 
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Could you suggest to the insurance company that you get another vet to give a second opinion as to whether the two incidents were related?

Alongside this, if I were you I would approach whichever ombudsman (Financial Ombudsman?) represents insurance companies and ask them to help settle things.

I certainly wouldn't be paying up without a fight, and don't let them bully you with talk of court etc.
 
Katie_A - It is all very well telling her not to pay - but the Royal Dick are not to blame for an animal being ill. They treated the animal to the best of their ability, they deserve to be paid. The argument is between fredthoroughbred and the insurance co - not the vet.

You are liable for a large vet bill. You should pay it, unless you want to be taken to court, where you will lose. And you will have a very unpleasant stain on your credit rating for a long time. The court are only interested in the fact that you took your dog to a vet, got it treated and have failed to pay that bill for 9 months.

I have vet insurance, but I would never allow a vet to run up a bill I could not pay, because there is always the risk the insurance co will wriggle out of paying.

I feel really sorry for you, and I would personally argue with the insurance co in any way I could, but I would have paid the bill by now.
 
The vet that wrote the letter is my regular vet and I don't owe them the money, it's the vet I was referred to that is demanding the money so I doubt i'll get a discount. I never really thought about a second opinion. I'll get on and organise that this afternoon. I really don't feel that I should have to pay it and even if it's over several months, that's a huge chunk every month. What's really annoying is that i'm sure these vet schools push the bills higher so that they can "show" the students how all the fancy equipment works. It should be really cheap as those poor vet students pay through the roof for their fees anyway! Rant over! If they do take me to court, what is the procedure? Will I then have to take the insurance company to court? If they win, will I have to pay everyones fees as well?
 
BigRed said:
Katie_A - It is all very well telling her not to pay - but the Royal Dick are not to blame for an animal being ill. They treated the animal to the best of their ability, they deserve to be paid. The argument is between fredthoroughbred and the insurance co - not the vet.

You are liable for a large vet bill. You should pay it, unless you want to be taken to court, where you will lose. And you will have a very unpleasant stain on your credit rating for a long time. The court are only interested in the fact that you took your dog to a vet, got it treated and have failed to pay that bill for 9 months.

I have vet insurance, but I would never allow a vet to run up a bill I could not pay, because there is always the risk the insurance co will wriggle out of paying.

I feel really sorry for you, and I would personally argue with the insurance co in any way I could, but I would have paid the bill by now.
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^ This
lexiedhb said:
I would tell the vet that is their fault the insurance are not paying due to what they wrote and see if they will split the bill....
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The vet was being honest. Hardly her fault.
 
If you get taken to court, you will lose and you will probably have to pay their legal fees too - are you really prepared for that ? And do you have the money to take your insurance co to court ?

Why do you feel you should not be responsible for paying the vet bill ? Do you dispute your dog was treated ? Did you only have the treatment because you thought the insurance co would pay ?
 
Was in a similar situation with Animal Friends. Was partly my fault as i had miss read the policy but i ended up paying £2.500 for my dog!!

My advice would be pay the bill and then go down the Insurance Ombudsman route if you think you have a claim!!
 
Your issue, if there is one, is with the insurance company not the Vet school. You should pay the vet school and then take it up with your insurance company. Take them to court if you really think you have a case.
 
I don't think it's fair to criticise the vet school - you were obviously happy enough for them to try all their 'fancy equipment' at the time. Also, that fancy equipment is hardly cheap, and nor is the time of the kind of expert vets you get working there, that is just the name of the game. I'm really sorry that you lost your dog and that the insurance company are being unhelpful but your quarrel is with the insurers and not the vet school IMO.
 
I just feel (obviously naively) that if you're insured your insured. That's what you pay the insurance company for. If I felt that there was anyway in which my dog could be saved, I was prepared to do it. Had I not been insured then it would have been a very different story. What's the point in having anything insured then? Anyway, I definitely am not prepared to pay the court fee's as well so I guess by the gloomy sound of your prediction, I should just begrudgingly pay up.
 
fredthoroughbred said:
The vet that wrote the letter is my regular vet and I don't owe them the money, it's the vet I was referred to that is demanding the money so I doubt i'll get a discount. I never really thought about a second opinion. I'll get on and organise that this afternoon. I really don't feel that I should have to pay it and even if it's over several months, that's a huge chunk every month. What's really annoying is that i'm sure these vet schools push the bills higher so that they can "show" the students how all the fancy equipment works. It should be really cheap as those poor vet students pay through the roof for their fees anyway! Rant over! If they do take me to court, what is the procedure? Will I then have to take the insurance company to court? If they win, will I have to pay everyones fees as well?
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Sorry, but these vet schools operate at world class level, so costs are bound to be high, you should have been aware that there were bills building up, they would not have run up the bills deliberately, most are run as charities non profit making, and they tend to be animal lovers!
Your will be very lucky to get a second opinion who will say what you want, and who is the court to believe?
Your dog obviously had a pre-existing condition and you should have been very careful, I am sympathetic to some degree, but really, I don't think you have a leg to stand on, any court costs will be added to your bill.
The only chance you have is if you can get the referral vet to say that in his opinion [and he MUST be an expert in the condition], the condition which he treated the animal for was NOT in any way related to the first condition. BUT if for example the insurance company have advised you of exclusions, eg no cover on "Xleg", you have no hope.
in the meantime you will have to start paying, as again the courts take a dim view of "non payers"
 
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I woudl talk to the vet school. Explain the difficulty you are having with your insurance and ask them to write to the insurers confirming that this was not connected to a pre-existing condition. If they do this then the insurers may well pay up.

If the insurers still won't pay ask them to offer you installments. Explain that you had expected it to be funded by insurers and therefore you will have difficulty disharging the bill in full but are willing to pay.

Do not sit on this as the vet school will win if they take you to court and it will cost you much more. If you continue to have difficulty with the insurers then raise a complaint about them by all means but you should make arrangements to pay the vet school in the meantime. If the insurers pay out in the end then this will pay back what you have spent.
 
fredthoroughbred said:
The vet that wrote the letter is my regular vet and I don't owe them the money, it's the vet I was referred to that is demanding the money so I doubt i'll get a discount. I never really thought about a second opinion. I'll get on and organise that this afternoon. I really don't feel that I should have to pay it and even if it's over several months, that's a huge chunk every month. What's really annoying is that i'm sure these vet schools push the bills higher so that they can "show" the students how all the fancy equipment works. It should be really cheap as those poor vet students pay through the roof for their fees anyway! Rant over! If they do take me to court, what is the procedure? Will I then have to take the insurance company to court? If they win, will I have to pay everyones fees as well?
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Why don't you ask this referral vet for his opinion regarding the existing condition being the possible cause or not? That would make sense to me - presumably he must be the 'expert'? I have always been in he position of the insurance company advising that the condition was covered or not, that's not to say they cannot wriggle later if they can find a pre-existing cause.
 
This is why I always advise the more expensive/better known insurers. I would want the bill paying form the get go and for it not the be at that amount before then putting a claim in (to make sure they are going to pay)
Have you asked the college as suggested by others if this is connected to an ongoing illness, if not a specialist in this condition, would be interesting to know what it was?
I would pay up and then settle it with the insurers.
 
The vet school have a contract with you for you to pay them for services rendered.
They don't pay the insurance fee so it is not for them to fight the insurance company. It is for you to pay the fees and then fight your insurance company unfortunately.
 
'I would tell the vet that is their fault the insurance are not paying due to what they wrote and see if they will split the bill.... '

No. The vets have a responsibility to tell the truth. If that truth is that they cannot rule out the problem being caused by a previous health issue, that is what they have to say. Why should they pay for telling the truth?
 
I would be going nuts at the insurance company, but I would be paying the vets because, like the others have said, it isnt their fault.

Awful situation though, I feel for you. xx
 
Was it a pre-existing condition? Had you had any form of treatment on the leg before? Had they put any exclusions on the policy?

I had a similar thing years ago with an income protection policy, and they wriggled out - my doctor said a very similar thing. They have to be honest - they could be sued by the insurance company for not telling the truth. In my case there was probably a 5% link to a previous accident, unlikely, but could be possible. My previous doctor would have said it wasn't linked, but I'd just moved areas and the doctor who wrote the letter didn't know me as well, so just replied in a clinical way... TBH I don't blame her, even though I lost my money..
 
sorry for the dilema. i would agree a payment plan with the vets, and pay it. and argue the case with the insurance. scotland doesnt charge university fees for scottish residents.
 
Maybe the other posters are right about paying the vet school, I really don't know. But I do think that you should be taking advice from the Ombudsman, not us lot. There is some useful information here: http://www.financial-ombudsman.org.uk/publications/technical_notes/pet-insurance.htm I suggest you also give them a call to ask their advice about payment of the bill, and about how best to go about trying to get the insurance company to pay out.
 
Thanks everyone. There were no exclusions on the policy and with regards to a pre-existing condition, kind of. Basically he broke the leg a year previously but it wasn't a clean break, it was very messy and he had to have it flushed at the vets every 48 hours until it grew some flesh coverage. It went well and amazingly he made a 100% recovery. A few months later he had a funny turn on a walk, very lethargic, no appetite etc. I took him to the vets, he was put on a drip and given antihistamines and made a full recovery within a couple of hours. The same thing happened a few months later, the vet gave him a course of antibiotics and he came back fine again. Maybe five or six months later, he had his final episode, was referred and they found 800ml of fluid in the cavity around his heart, they drained it but it came straight back. They then operated but his kidneys failed as his blood pressure went very low and he was pts : ( Pretty traumatic and pretty sketchy in terms of knowing what happened. The insurance are saying that it was linked to getting an infection a year before when he had his open wound. Everyone has said, it's unlikely but it can't be ruled out.
 
fredthoroughbred said:
Everyone has said, it's unlikely but it can't be ruled out.
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It's unlikely that pigs can fly but you can't rule it out until you throw every last pig in the world off a cliff.

If you are sure about what your vet wrote, then your insurance company have been unreasonable, but there's nothing new in that, unfortunately.

The standard of proof in a civil court is "balance of probabilities". On that basis, your insurer will probably lose the case if you take a small claim against them, and it is easy to do it and not too expensive. Threaten them with court, quoting balance of probabilities and see what happens. You have nothing to lose.
 
fredthoroughbred said:
What's really annoying is that i'm sure these vet schools push the bills higher so that they can "show" the students how all the fancy equipment works. It should be really cheap as those poor vet students pay through the roof for their fees anyway!
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I'm sorry you're having problems with the insurance company paying out OP...but I can assure you that this ^^ statement is miles from the truth!! In actual fact the majority of vet schools run at far lower costs than most private referral centres. Yes, we want out students to learn...but just like any other vet, all the treatments and investigations we offer have to be justified in terms of their benefit for the patient and certainly are not done just to demonstrate things to the students!!!
 
karen_c said:
I'm sorry you're having problems with the insurance company paying out OP...but I can assure you that this ^^ statement is miles from the truth!! In actual fact the majority of vet schools run at far lower costs than most private referral centres. Yes, we want out students to learn...but just like any other vet, all the treatments and investigations we offer have to be justified in terms of their benefit for the patient and certainly are not done just to demonstrate things to the students!!!
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I'm guessing you are Bristol from your area, so I'll confirm that this is not about Bristol hospital, but I have a similar problem with centres with big machines needing to use them to pay for them.

A friend of mine sent a horse for a single foreleg lameness investigation to a big name hospital two months ago. The FIRST thing they did was a gamma ray scintigraph. Only after that did they nerve block to the foot, where the issue was. I find it extremely difficult to understand any possible justification for a scintigraph before a nerve block in a horse which is reliably lame in one leg only.
 
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If the insurance company are grasping at straws by saying it is related, then they could say that for any animal about any part of them,

they could say that because an animal had a virus last year that the reason they won't pay out for a cruiciate (sp?) op because the animals immune system is compromised, from the virus last year, that would be crazy, but they would try, its what they do! I would go back to the insurance and say that it is unrelated, you have nothing to lose by trying, and everything to gain, if they can prove that it is related 100% then they have a case but by saying it is only 'possible' then they should at least agree to settle an 'amount' it might only be £1000 but it would help, stay calm when you talk to the insurance, ask for the contact details of the insurance onbudsman when the discussion takes a negative turn, just state that you are not sure that the service you are receiving is correct and you want an independent view and guidance on insurance practice, then at least you will get some realistic advice from the OM
 
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