You didn’t think there’d be a part 3, did you? But pet health insurance is a near-and-dear-to-my-heart issue—so why not?
Remember when I mentioned all the exclusions and small print issues in the pet insurance industry? It’s no surprise that insurance for pets has all the same trappings of its human counterpart.
Funny, though, that vets are just now starting to take notice of some of the more i-dotting and t-crossing aspects of billing, claims eligibility and reimbursement for our pet health insurance users.
If vets want to reap the benefits of our freedom to independently set our prices (knowing someone other than our clients will pay for them) then we need to keep in mind that there might be some follow-up consequences should the insurance company have questions about the care we provide.
And here comes the slippery-slope we’ve all been warned about by our human medical brethren. Sure, we don’t have “managed care” for pets—yet—but we may be on our way (despite the low market penetration of insurance in the pet sector).
Here are a few issues sourced from a recent multi-vet conversation:
∑ How about the client who asks you to change the date on a procedure? (Umm…we call that fraud in my part of the world…)
∑ Another vet’s client who wonders how he should list his cat’s breed? (If the pet look predominantly anything but is clearly a “mix,” owners should know that they’re at a financial disadvantage to label their pet a purebred. Much as they’d like to think Fluffy is an Angora cat, truth is, she’s really a “domestic shorthair,” and to call her anything in particular undeservedly raises his premiums.
∑ When records get “audited” by a company trying to determine if a claim should be paid, how should vets respond? Some vets write lengthy letters detailing the case or ask receptionists to do so. Others just copy records or print out a skeleton of invoice items with their dates. Some even throw away any insurance correspondence, thereby limiting their clients’ ability to get reimbursed. Did you know that?
Increasingly, vets are being asked to work for their clients, much like the human medical establishment, now rife with billing specialists who handle claims for doctors, thus raising our healthcare costs. Even at this early stage where so few pet owners carry insurance, it’s an issue. Where will we be in five years? Or ten?
It’s still the Wild West in the pet insurance game, except in Great Britain where 40% of the pet-owing public carries it. Maybe they have the right idea and perhaps they’re better off because they sign up in big numbers. But I wonder…
I guess that’s my next pet insurance post. But I promise to give you a break—for now. Still, if any of you GB residents care to weigh in, it’ll be much appreciated on this side of the pond.
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Pet Insurance ..... hmmmm where does one start . Friend or Foe. Helpful or Unhelpful.
Its such a big subject I'll be surprised if you stop at part 3 !
I'm interested in your source of the percentage of pet owners with insurance in the UK as I would think that in our small animal practice probably less than 20% of owners carry insurance. Of those I think a significant number have problems of one sort or another with claims.
Premiums vary widely, excess charges are significant in many cases and the potential exclusions , maximum claims that can be made, length of claims is also vary variable.
That said, for the sudden unforseen event ... broken limbs, diabetes, pancreatic insufficiency, atopy, the presence of insurance can be a godsend for the patients treatment.
Then there are the issues that arise as a result of claims. I sometimes wonder who checks these and decides on the question. For example in the case of an animal needing surgery early in life for an elongated soft palate I found it odd to be asked to confirm how long the animal had had this problem.
Then we have the FSA .. this basically means that unless we are registered (and paid the fee!) to be an insurance provider we can stock the leaflets BUT we are unable to pass comment on which providers we think are best or that we prefer.
Insurance is a minefield. It is an annoying necessity(for example with car insurance,buildings insurance etc) that we all moan about having to have yet we would miss at times when we need it.
In the case of pets there will inevitably be people who paypremiums and never need to claim , those that the insurance companies wriggle out of paying and others where their pet is saved as a result of insurance.
We should always remember that the insurance companies are also a business , the aim of which is to make money.
Sorry thats a bit of a ramble but I'm with you ... insurance .... aaaaaghhhhhhhh !!!
jackholly May 5th, 2007 04:53:00 PM
Speaking as a former British vet nurse, much of what we did (for private owners at least) at the equine practice I used to work at just wouldn't be possible without the co-operation of the insurance companies. In fact, the situation in this country is probably the polar opposite of yours - because we have a state-run health care service paid for from general taxation, people generally don't carry their own personal health insurance. I'm in two minds as to whether that makes them more or less aware of the risks involved with their pets.
With horses at least, we have three main categories of animal insurance: all-risks mortality (i.e. death/destruction on humane grounds), loss of use (obviously more relevant for horses and working animals) and vet's fees. I have less experience with small animal insurance but my own collie is covered, take that as you will.
Large or small, with vet's fees cover (either 'normal' or with a very high excess and therefore effectively 'catastrophe only') you get one year to use the value of your insurance on any given issue and then that's often it for that issue the life of the animal: the insurer usually places an exclusion on the policy. So if you're insured for UKP5,000 and you come to us for a lameness work up, you've got a year to use up your five grand on (almost) any treatment the attending vet feels necessary - but then that's it for, say, problems associated with the navicular changes the vet found.
Bearing in mind that a day's stay with vet time, nerve blocks and imaging could easily run into several hundred pounds, it does offer a great opportunity to get to the bottom of the problem there and then. Horses being the problem-seekers they are IMHO it's good value for money.
From the vet's POV, it does mean paperwork to deal with but cheques arrive (mostly) promptly without fuss and for the full amount due, and you don't have to worry about the owner's ability to pay before doing any work - all for nothing more than a phone call, a claim form, an itemised invoice and a couple of paragraphs of case notes.
Aside from emergencies, insurers are involved from the day the client walks through the clinic doors, and the best ones like NFU and PetPlan bend over backwards to work with the clinics rather than against them; of course there's always the chance of a disagreement and subsequent referral but that happens very, very infrequently in my experience.
Jay May 5th, 2007 05:28:00 PM
I'm shopping around for pet insurance myself and came across a relatively new company called Embrace Pet Insurance...
http://www.embracepetinsurance.com/
One thing that's nice about this company is that you can customize the insurance you want for your animal - you can select the annual limit, the deductible, the co-pay, you can select whether you want dental and RX coverage and whether you want continuing coverage. They offer discounts for pets that are microchipped - for insuring multiple pets and for paying annually.
Has anyone heard of this company or had experience with them? I was looking at the ASPCA coverage (offered by petshealth.com) but they don't seem to be offering policies in Florida for some reason. The VIP company is by far the largest but seems to pay the least since it has a very restrictive schedule and then only pays a percentage of what's listed on the schedule.
MP
Maribel May 6th, 2007 01:32:00 PM
1 - On "changing date of procedure" -- not quite the same thing but this has to do with rabies vaccinations.
I recently went over some rabies certificates that my husband belatedly dug out from a pile of other receipts that I had to go over for tax purposes. House repairs, mileage, tools, etc had to be paired with their receipts. Anyway, so the dog rab-vac receipts turned up in the pile, folded up with lumber and hardware purchases. Go figure.
The dogs were brought in individually, over a several week period, for their revaccination with rabies last year. I had automatically assumed that all the adults had gotten 3 year vaccines. But I was wrong. Oddly our oldest female at 8 years had a "3 year" vaccine but two other adult dogs, each are four years old - had only "1 year" marked on their vaccine slips. The lot number and manufacturer for one of the 4 year dogs was identical to the 8 year old's certificate; the other four year old dog had a different lot number but the same manufacturer. I thought we should get a correction on the certificates... both of those with the same lot number *should* have been marked for the 3 year vaccine. I don't want to get into "rabies challenge", titers and all that, as this isn't the point of this comment.
So I handed the receipts to hubby, next time he went by the vet while doing other errands, could he ask about this? He did and he told me that the vet's office said that the two four year olds did get a '1 year vaccine'. Ahhhh... oooookay.
I had thought it would just be a simple matter for the vet to initial the certificates and mark it up that the vaccines were all '3 year'.
At any rate, when the two dogs are five years old and due for their next rabvac, I'll have to be sure that the correct box is ticked! And not wait til months later to review these certificates.
2 - On breed ID.. yee gads. I do breed ID for my breed and get some of the most interesting emails with pics of generic dogs that the owner, their vet(?) or the shelter, claimed as being my breed. It gets mighty interesting. :grin: I should make a webpage that collects some of the photos. But people do like to have some idea what is in the background of their cat. One of the rescues recently reported that there were some border collies and one Australian Cattle Dog in IRAN that needed to be rescued. Phenotype is everything. :grin:
3 - Insurance claims. Gosh this sounds like a mess. I'm on several forums where really BIG dogs are the primary dogs owned. So of course, some of the owners opt for insurance due to the BIG prices of some procedures. The stories of what some of them had to go through for compensation (and still not get it) was not pretty. Some of the dog owners opted to get copies of records, reports and expenses, initialed by the vet and taken home for a 'notebook'. These folks seemed to have better luck getting compensated. Definitely a sort of "Wild West" kind of thang...
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