Pet Insurance Complaint
In Pennsylvania:
TLDR: Nationwide pet insurance is saying cancer, although undiagnosed and presented no symptoms, was pre existing.
I had a 12 year old golden retriever who recently passed away at the end of August. Rewind to mid July- I got a new job and Nationwide pet insurance was a benefit (not free but only $50/month). We had FIGO pet insurance for the prior 2 years, but they were going to raise our premium to over $200/month in August. We decided to switch to Nationwide since he didn’t have any major pre existing conditions that would be excluded. Policy went into effect 7/27, we scheduled his annual exam for 7/28 to make sure we were in coverage.
Our dog had a cough that would come and go for a few months so we mentioned that to the vet. They took chest x-rays and his lungs were completely clear but they noticed a mass on his spleen on the edge of the image. They did an ultrasound and confirmed he had a large mass on his spleen. After consulting with specialists a few days later, we determine he should get a splenectomy. Nationwide doesn’t do pre-approvals, so we had to go with good faith that this would be covered. Turns out the large mass was benign, but he had a second very small mass that was hemangiosarcoma. Considering how aggressive this cancer is, it’s amazing it hadn’t spread to any other areas. This was found 8/13, so about 2 weeks from the beginning of coverage. We proceed with scheduling chemo and are told he has about a year to live. He unexpectedly collapsed on 8/29 and had to be euthanized the same day.
None of our claims were processed until 9/24, totaling over $7,000. Nationwide is not paying a cent. They are claiming the cancer must have started growing prior to the policy effective date of 7/27 so it is pre-existing. This is such a scam because there was not a diagnosis prior to this date and his cough was determined by the vet to be unrelated. They’re grasping at straws, trying to connect a skin tag on his eyelid that was there for years to internal cancer.
There’s also no way of knowing when it started growing, as it wasn’t even in either of the ultrasounds conducted. It was very small, so there is a possibility it grew after. I am requesting letters from the vet to appeal, but I am worried they’ll decline again saying it must have started growing before the policy.
Do I have legs to stand on in a formal complaint?
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from Pets https://www.reddit.com/r/Pets/comments/j0i871/nationwide_pet_insurance_complaint/
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