Are you the Owner of this Business? ×
BBB® Accredited Business Seal

Are you...?

If yes, click here to login.

Are you...?

BBB Accredited Business since

Pets Best Insurance

Phone: (208) 947-3896 Fax: (866) 777-1434 View Additional Phone Numbers 2323 S Vista Ave Ste 100, Boise, ID 83705 http://www.petsbest.com


BBB Business Reviews may not be reproduced for sales or promotional purposes.


BBB Accreditation

A BBB Accredited Business since

BBB has determined that Pets Best Insurance meets BBB accreditation standards, which include a commitment to make a good faith effort to resolve any consumer complaints. BBB Accredited Businesses pay a fee for accreditation review/monitoring and for support of BBB services to the public.

BBB accreditation does not mean that the business' products or services have been evaluated or endorsed by BBB, or that BBB has made a determination as to the business' product quality or competency in performing services.


Reason for Rating

BBB rating is based on 13 factors. Get the details about the factors considered.

Factors that affect the rating for Pets Best Insurance include:

  • Length of time business has been operating
  • Complaint volume filed with BBB for business of this size
  • Response to 43 complaint(s) filed against business
  • Resolution of complaint(s) filed against business


Customer Complaints Summary Read complaint details

43 complaints closed with BBB in last 3 years | 22 closed in last 12 months
Complaint Type Total Closed Complaints
Advertising/Sales Issues 0
Billing/Collection Issues 13
Delivery Issues 0
Guarantee/Warranty Issues 1
Problems with Product/Service 29
Total Closed Complaints 43

Customer Reviews Summary Read customer reviews

12 Customer Reviews on Pets Best Insurance
Customer Experience Total Customer Reviews
Positive Experience 1
Neutral Experience 0
Negative Experience 11
Total Customer Reviews 12

Additional Information

BBB file opened: September 06, 2005 Business started: 01/01/1970 Business started locally: 01/01/1970 Business incorporated 08/25/2000 in ID
Type of Entity

Limited Liability Company (LLC)

Business Management
Mr. Jared Hight, Claims Manager
Contact Information
Principal: Mr. Jared Hight, Claims Manager
Business Category

Pet Health Plans Insurance Companies Insurance Agency Insurance Services Pet Services Animal Online Drug & Prescription Services


Customer Review Rating plus BBB Rating Summary

Pets Best Insurance has received 0 out of 5 stars based on 0 Customer Reviews and a BBB Rating of A+.

BBB Customer Review Rating plus BBB Rating Overview

Additional Locations

  • 2323 S Vista Ave Ste 100

    Boise, ID 83705

X

BBB Customer Review Rating plus BBB Rating Overview


BBB Customer Reviews Rating represents the customers opinions of the business. The Customer Review Rating is based on the number of positive, neutral and negative customer reviews posted that are calculated to produce a score.

Customer Review Experience Value
Positive Review 5 points per review
Neutral Review 3 points per review
Negative Review 1 point per review

BBB letter grades represent the BBB's opinion of the business. The BBB grade is based on BBB file information about the business. In some cases, a business' grade may be lowered if the BBB does not have sufficient information about the business despite BBB requests for that information from the business.
Details

BBB Letter Grade Scale

BBB Rating Value
A+ 5
A 4.66
A- 4.33
B+ 4
B 3.66
B- 3.33
C+ 3
C 2.66
C- 2.33
D+ 2
D 1.66
D- 1.33
F 1
NR -----
Star Rating scale

  Average Score
5 stars 5.00
4.5 stars 4.50-4.99
4 stars 4.00-4.49
3.5 stars 3.50-3.99
3 stars 3.00-3.49
2.5 stars 2.50-2.99
2 stars 2.00-2.49
1.5 stars 1.50-1.99
1 star 0-1.49

BBB Customer Review Rating plus BBB Rating is not a guarantee of a business' reliability or performance, and BBB recommends that consumers consider a business' BBB Rating and Customer Review Rating in addition to all other available information about the business. If the BBB Rating is NR then only Customer Reviews are used for the Star Rating.

Complaint Detail(s)

9/23/2016 Problems with Product/Service
9/22/2016 Billing/Collection Issues | Read Complaint Details
X

Additional Notes

Complaint: My dog was diagnosed with Diabetes in July 2016. She was seen at my vet in October of 2015 for a neck injury. At that time, her blood glucose was 105. Normal is 100. According to my vet, this is normal with a stressed animal. In July, her blood glucose was over 500, and she was diagnose with diabetes. She had NO symptoms until late June of diabetes. Due to the blood glucose reading in October, I was denied any claims for the diabetes. I will be filing a 2nd level appeal with the company, although I suspect the same outcome. My vet agreed with my position and sent a letter to the company advising them of his medical opinion. I will also be filing a complain with my state's insurance board against Pets Best. Steer clear of this company.

Desired Settlement: I would like my claim reimbursed and the "pre-existing condition" removed.

Business Response:

Mr. ***,

Your policy was purchased on 2/13/2016.  According to records from your veterinarian, your pet's blood glucose level in October 2015 was 130, not 105.  This is 30% above "normal".  Upon receipt of your second level appeal, we will send all documentation, including the letter from your veterinarian, to an independent medical examiner for evaluation.  If he agrees with your argument and there is evidence to support it, we will overturn the denial and pay your claim.

Consumer Response:
Complaint: ********

I am rejecting this response because:
I stand corrected on the blood glucose reading in October. But, as stated by my veterinarian, and backed up by AAHA diabetes guidelines, that a one time elevated blood glucose reading in a non fasting and stressed animal is by far a sign or symptom of diabetes. I will follow with the second level appeal as agreed upon, but would like to keep this complaint open pending the outcome of the second appeal. 
Sincerely,

******* ***

Business Response: Attachment redacted by BBB

9/9/2016 Billing/Collection Issues | Read Complaint Details
X

Additional Notes

Complaint: My first claim for my bulldog who had a cyst on his foot and was denied as a pre existing condition, even though our veterinarian wrote a letter stating it was NOT. My other dog has the accident only policy and she got bit by another dog requiring several stitches. The claim was denied again, this time because she had suffered another bite from a completely separate incident in the past 18 months. The two injuries are completely unrelated and the second injury should be covered in full at 90% as it says in my policy

Desired Settlement: They have the responsibility to pay me out what is owed on my policy minus the applicable deductible and co-pay

Business Response:

Hello Ms. *******,

The policy you purchased has a repetitive activity exclusion, designed to ensure that the rates being charged to everyone are not covering pre-existing or behavioral problems that lead to repeated treatment.  This includes regular dog fights as they are preventable by separation of the dogs that don't get along.  The records we obtained from your veterinarian indicate that this bite wound is the fourth such that your pet has suffered in the past 4 months (5/5/2016, 5/30/2016, 6/4/2016 and 8/19/2016).  Your policy has a clear exclusion against this if it occurred twice in the previous 18 months.  As such, your claim was appropriately denied.

As to your concern about a foot cyst claim, I see no such claim in our records.  One of your pets did present a claim for a tumor on the foot about 6 months ago, but that claim was paid in full after deductible and coinsurance so I am not sure what the complaint is.

If you would like further explanation or to discuss, please feel free to call our customer service department at 1-877-738-7237.  It is much easier to have these conversations directly rather than through a third party such as the BBB.

8/10/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I signed up with pets best Accidents insurance for my 2 years chihuahua. a couple weeks ago my dog was playing at the park with other dogs and while running really fast around a sharp corner at least two other BIG dogs that were chasing/playing with him suddenly collided into him, instantly he screamed and start limping. i immediately took him to the pet hospital emergency where they did some X-rays and diagnosis. later they told me that he severely broke his ACL but since he's so tiny he will not need a surgery and should be ok within few weeks. the next day i filed a claim with pets best thinking i was covered since i had ACCIDENTS insurance with them, they asked for his medical record and two days later the sent me an email stating that my claim was rejected and i will not be reimbursed for the $400+ i spent at the vet. Not only that made no sense since it was an ACCIDENT which what my dog is covered for but i also read their entire exclusion list and there was no indication that ACL injuries isn't covered!! I'm very shocked and frustrated by this and will take them to court if i had to.

Desired Settlement: i need them to fulfill their obligation and reimbursed as my policy states

Business Response:

Please refer to your policy form, page 5 under the section "Additional Coverage Limitations".

"Additional Coverage Limitations - ... Cruciate injury and patellar luxation are not considered Accidental Injury and as such are directly excluded."

 

The condition you are claiming is plainly excluded under the policy language.  The policy you purchased is a very inexpensive policy with very limited benefits and is not intended for an injury of this type.

Consumer Response:
Complaint: ********

I am rejecting this response because: that's the most bs i ever heard. if it cost you too much to fulfill your obligations you should charge more or not be in this business. i dont care if that's actually in whatever document you're talking about, i made sure that my dog will be covered for all COMMON SENSE accidents and looked at the exclusion list, i even asked your rep and they confirmed that my dog will be covered. attached is a transcript with your sale rep confirming the acl is covered by your accident insurance. i expect you to reimburse the fees i paid or i will not only SUE you but also tear up your sketch business everywhere 

Sincerely,

**** *******

Business Response: The chat transcript you attached was from two days ago indicating that you do not have a policy.  The answer the sales representative gave you was correct.  The accident/illness plan that she described and quoted you does cover ACL injuries after a one year waiting period which can be waived with an exam and certificate from your veterinarian.  The discounted accident-only plan that you purchased does not cover this condition, as is clearly outlined in your policy form.

Consumer Response:


Complaint: ********

I am rejecting this response because:

i have already submitted my dog medical record which clearly indicates there was no "pre-existing condition"! The hospital report also states that the injury was actually due to an accident which is the TITLE of the plan I purchased from you after being mislead by one of your sales reps at the time who not only assured that my dog will be covered for any type of accidents including ACL but they also said it will take effect in 14 days or so!! 

Your response MAKES ZERO SENSE, your business is SKETCH!!!

 

You will be hearing from my lawyer :) 


Sincerely,

**** *******

7/27/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: This issue stemmed from a call placed july 8. I asked if there was an early termination fee for taking 3 of my 4 dogs off my policy and was told no term fee and I get prorated reimburse. I said I would cancel and then I changed my mind within a minute and she said it was reinstated. There was no interruption since my coverage never overlapped cuz I was still covered until midnight and I was only cancelled for 2 minutes and was still covered and paid up. She was able to stop everything from processing. There was no letter printed out there was no reimbursement. In 3 days I have 2 reoccuring debits from them on my card on file. I never authorized a debit or gave my card # or set up pymts. I called and was told it was supposed to be credits not debits and to call bank. Banks says reoccurring debits.I asked if there were any credits on my acct from pets best and maybe they were pulling them off. There were no credits anywhere in my bank history. What I can't seem to get any1 to tell me precisely is what that money paid for. What product or service did I pay for. Thats alot of fraud to set up unauthorized auto withdrawels and then accept the money without providing my product. So today I am confirmed it's an unauthorized debit that the CSR took out of my acct as reinstatement change and she did not inform me. This is simple you take money away from sum1 without asking them is theft. And when you withdraw money electronically without telling me is theft. If you need money from me for sustain you ask me and you tell me what it's for or you don't get it. Ppl keep gvn me excuses and their opinions on why your right now I'm wrong. But you offered up the doc. That clearly states I was charges reinstatement fees and handwritten note that it was meant as a credit and was never processed. And same doc along with. A letter confirms the 41.57 your putting in my account is prorated from a separate. Call on 17th cancelling and is not reimbursement of the 41.49 taken out 11th

Desired Settlement: I want this money put back in my account. I want the truth. I want all these ppl who have verbally and mentally abused for hours at a time today to apologize and all be reprimanded. I want the accounting depth held responsible for their lies and manipulation trying to twist words and numbers around to insult my intelligence. They are not stupid they know they accidentally took money out and don't want to own up to it and have to go abt and do their job that they chose then don't wanna do it. You spent more time and energy on trying to manipulate me that had you used that effort to actually do your job and further yourself you would be putting a lot more money in your pocket. You trying to save 40$ all day took up at least 3 employees 4 hours each of working hours that's a day n half pay you lost your business. Divide that by each of your salaries and the overtime. Your costing business more than ur making. I have earned. I hv date time name recordings and I took notes.

Business Response:

We emailed a statement and refund receipt that was processed on 07/17/2016 for $24.98 to ****** yesterday.  We also explained there will be an additional refund of $41.49 processed on 07/22/2016.  The charges were due to multiple cancellations and re-instatements run on the same day causing a system error.  I have attached a statement and receipt of the refunds here.

Consumer Response:  
Complaint: ********
TThese are not the same documents they provided me. They never said I was getting 41.49 it was 41.57 I have the letter they mailed stating that and the original document they sent me said 41.57. There was never at anytime on phone or in print there was ever mentioned the total 41.49
I am rejecting this response because:

Sincerely,
****** ********

Consumer Response: I have had 3 different disputes 3 different days with this business they are each seperate but they are trying to tie them into 1 dispute and taking the balance owed of the least expensive owed and using it for all 3. They set up 2 unauthorized reoccuring debits on my stored info and began withdrawing 41.49 out of my account monthly. My pymts is 151.91 and it was already paid up for the month so when I call Noone will admit the money was taken out. That charge was set up July 11. I assumed it would be corrected and didn't check back onto the account to see if it was credited until yesterday July 21. I did call July 17 to cancel and was given a prorated balance of 41.57. I had not gotten my prorated or my cancel letter yet but I had no doubt it would come but I noticed the charge was nvr put back so I called and was told they were putting 41.57 on my card tomorrow. I asked what that credit was for they said my prorated balance which I was already expecting so I move onto the 40.49 charges that were taken out extra if they were gonna put it back. They said the 41.57 u get tomorrow will cover it. So I'm only get 1 fee and it covers the 41.57 fee and the 41.94 fee. They go me a document clearly stating the 41.94 was unauthorized and was scheduled to be put back that next day but was never processed. O.k. so now I hv proof. Then I get a letter saying I cancelled July 17 and I'm getting prorated 41.57 confirmation. So after leaving a bbb review yesterday they said I was told I was getting 141.94 and they created a brand new document showing I was right but said they gave me the 2 docs yesterday but it was a completely different doc I'd nvr seen and it even had today's date on it and my phone shows when I received the doc and when bbb got the doc they never sent it to me I see it 1st time online then ask for a copy. So now theyre admitting the 41.94 and have erased the prorated amount of 41.57 that's owed for cancelling. 3 times in a row.

Alot of apologies and alot of reprimand ingredients. I want a personal phone call from the CEO of this company to contact me so we can discuss the issues I have been having and informing him of problem areas that need attention to implement a better education of the company and your job responsibilities. Proper phone etiquette using a calming voice since ppl who call for insurance are already frustrated and a pleasant tone of voice can set a good tone on how the call will end. Saying sir and maam and Mr n Mrs thank you please just polite. And education in all the areas since so many depts don't take calls the reps cannot answer any questions for those departments and then the client has to do all the work tracing to his account on his own by calling banks when they can pull up ur policy number and guide you thru. I have a lot of great ideas. I know when my pet had lymphoma it was the staff at the hospital that really showed they cared and that your feelings are valid and you matter



O.K. I called for info on my pet insurance. On July 8 during the call I ask if I could just cancel 3 of the 4 pets I then changed my mind and decided to keep them all on the policy. That was that. on July 11 I receive 2 reoccurring automatic withdrawels hv been set up from them under my card I hv on file. I nvr authorized any debit or set up payments or go my card info now was I asked if they could take money or told they were taking money. I called to ask abt the fees and was told they were supposed to be credits and not debits n to call bank. It was obviously debits but ins said they see them on their screen as credit . I was then told it was reinstatement fee since I said i wanted to cancel 3 pets then turned around n said no never mind they charge you 2 fees totalling 41.49 even though their was no lapse in coverage had I cancelled I'd still be covered til midnight and I didn't even cancel and reinstate I was discussing it out loud and she just clicked buttons for fun so I was a paid in full active client until my next pymts. On July 17 I decide I am going to cancel so I make a phone call and at no time was any of my previous calls or charges were even mentioned since I was unaware the money had not been put back. So call I cancel get a prorated refund amounts of 41.57 in 3 to 5 days get a letter yesterday confirming phone call cancel July 17 41.57. That was simple enuff. But that day before I got the letter I called abt why the 41.49 was still on my acct. They said they were reimbursing me next day 41.57 and I was getting even more money since pc calculations aren't precise and you need to check them manually...hmmm so he found me an extra 6 cents. Hmmmmm.. all day long I am telling them you took 41.49 out of my account and to just tell me what I was paying for nobody ever gave an answer they said you're getting back 41.57 2morrow for a prorated from cancellation and if you ask where the 41.49 is they say it's covered in the 41.57 your getting 2morrow.
So all day this 1 charge of 41.57 is a prorated amount of 41.57 and also a reimbursement for 41.49 and you get free 6 pennies. So I get an email of the document showing the 41.49 charge and 1 showing the 41.57 charge so I have proof it's 2 different transactions. So I show them clearly on the printout they sent me confirms everything so I goto bbb and they have made a new document showing it my way and said it was given to me yesterday but has today's date on it. Except now the 41.49 covers the unauthorized debit and the 41.94 now also covers the 41.57 prorated. So they lost the 6 cents they were just giving me free

I am rejecting this response because:  pets best sent 2 documents 1 saying they owed me 40.25 and 1.24. I was told it was supposed to be a credit and not a debit.  They sent me a document stating in handwriting beside the totals that these were supposed to be processed as credits and we're never processed. And it showed the 2 amounts on their document as debits.  When I pointed it out and posted the complaint on bbb they responded that they provided me with the attached document.  And they created an entire new document that it was a credit but it had that days date on it but they say they gave it to me the day before

I want this money put back in my account. I want the truth. I want all these ppl who have verbally and mentally abused for hours at a time today to apologize and all be reprimanded. I want the accounting depth held responsible for their lies and manipulation trying to twist words and numbers around to insult my intelligence. They are not stupid they know they accidentally took money out and don't want to own up to it and have to go abt and do their job that they chose then don't wanna do it. You spent more time and energy on trying to manipulate me that had you used that effort to actually do your job and further yourself you would be putting a lot more money in your pocket. You trying to save 40$ all day took up at least 3 employees 4 hours each of working hours that's a day n half pay you lost your business. Divide that by each of your salaries and the overtime. Your costing business more than ur making. I have earned. I hv date time name recordings and I took notes

7/21/2016 Billing/Collection Issues | Read Complaint Details
X

Additional Notes

Complaint: My husband and I had a Pet's Best insurance policy for our dog (we cancelled it today) and they won't a claim for her dental cleaning. We have submitted two different invoices and each time they ask for something different. Our dog had her teeth cleaned by a mobile dentist at a pet store on April 21. We paid the pet store for the cleaning, not the dentist directly. I have explained this to them multiple times and they are unreasonable. I submitted the only invoice we have, which is a register receipt listing the services provided and the amount paid and they refuse to reimburse us because we paid the pet store. They want an invoice on company letterhead listing the dog's name and the services provided, but this doesn't exist. I feel like they're making unreasonable requests just so they don't have to pay the claim.

Desired Settlement: I want them to pay the claim.

Business Response: The claim for dental services has not been denied, it has been marked as incomplete due to a lack of information required to process it.  Our pet medical health insurance covers dental cleanings performed by a veterinarian only.  In this case, the dental cleaning was performed at a pet store by a company called ********.  This is highly unusual as non-anesthetic dentistry goes against the standard of care established by the veterinary industry.  What is needed to complete the claim and process it is the name and contact information of the veterinarian who performed the procedure.  Once that is received we will be able to move ahead with the claim.

6/28/2016 Billing/Collection Issues | Read Complaint Details
X

Additional Notes

Complaint: Pets Best sent me a letter stating my policy was about to renew and the premium would increase $250. I didn't want this and tried to cancel, before the new policy went into effect. I tried via chat, was told I had to call. Called 4 days in a row, excessive call times on hold prevented me from speaking to a representative. I tried chat again to cancel, to no avail. I tried the website. The website said I had to call. Tried calling the following week. Excessive call wait times. Finally got through today, 6/16/16. They are charging me this excessive premium prorated from June 1-today.

Desired Settlement: Refund the new policy premium as I tried diligently to cancel. This is a racket. I tried to cancel prior to June 1.

Business Response:

Hi *****,

Thank you for sharing your experience with Pets Best. We are sorry to hear you’ve cancelled your policy—we prefer to have a word with our policyholders before they cancel so they understand the implications of cancellation, especially, as in *********** case, if we’ve covered conditions. That said, we’re disappointed to hear your hold times were unsatisfactory and your cancellation experience arduous. Pets Best is committed to delivering some of the lowest hold times in the pet insurance industry. To illustrate, this June we’ve answered 89.3% of our calls in 60 seconds or less. Regardless, your experience—while out-of-the-ordinary—was unsatisfactory and we apologize. We have looked into your cancellation dispute and will be contacting you by phone to discuss your refund. Please keep us in mind if you are interested in insuring ********* in the future. We wish you the best.

5/31/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: Pet's Best refused to issue a refund to the claim filed on 04/27/2016 for a skin infection, stating that the infection was due to a pre-existing condition. I wrote to the company, using the online customer service form, and have not got any response after more than 2 weeks. In the email, I explained why the decision was not scientifically justified and should be reconsidered, and I am going to repeat it here. As a student in the medical scientist training program, I can think of many many conditions that may result in a skin infection or a condition that resembles a skin infection. Allergies by no means can account for all types of skin irritations and secondary infections. Pet's Best seemed to have used the record that my dog has had an allergy in the fall 2014 to make the big leap that the same kind of allergy caused his skin infection this time, and I think this leap has many shortcomings. First, the timing of the two events are completely different - early spring this year compared to fall 2014. Second, the presentations are also rather distinguished. This time, patches of crust were scattering among almost the entire body of my dog, and there were signs of inflammation around his genitalia. The previous time, these patches were not present. The different timing and clinical presentations at least should have prompted a more careful examination as a different etiology is very likely to be responsible for this skin infection. Now let's take a look at the word "allergy." Scientifically speaking, allergy is an exaggerated reaction of the immune system to antigens to which it should not react, and the antigens can be of any origins. In humans, they can be pollens, peanut butter or perfume in laundry detergents; and these allergies are never considered as "pre-existing" conditions. Dogs are obviously not human, but they share physiologic similarities. As a scientist, I cannot see why such discrimination was made, and my inquiry has been ignored by the company.

Desired Settlement: (1) I would like to request that Pet's Best issues a refund to the claims filed for the skin infection. There were a charge on 04-26-17 for examination fee and antibiotics and on 04-27-16 for the medicated shampoo. (2) I would also like to seek responsiveness to inquiries from customers as I really have an impression from this experience that the company is not comfortable explaining the scientific basis for their decision making. (Pet insurance is, after all, still a form of health insurance and should/must be driven by scientific knowledge and evidence.)

Business Response:

The denial of this claim was due to the diagnosis that you provided on the claim form matching with a condition that you admit your pet was diagnosed with before pet insurance was procured.  All pet insurance companies must deny pre-existing conditions in order to keep the coverage affordable.  According to your provided summary, your pet was diagnosed with Atopy (a common skin allergy in dogs) in 2014.  On the claim form that you submitted to us you wrote "The vet diagnosed that he is having a skin infection likely secondary to an allergy."

Reinforcing your own narrative of the condition, we gathered your pet's medical records from Red Cedar Animal Hospital and Lake Lansing Road Animal Clinic.  The notes for your visit on 11-4-2014 at Red Cedar Animal Hospital indicate a diagnosis of Atopy.  Your visit of 10/21/2015 at Lake Lansing Road Animal Hospital (the date of service in question) indicate a "suspected allergies" diagnosis.

As you indicate that the condition being claimed is a condition that your pet was diagnosed with prior to purchasing coverage, and your veterinary records support this statement, it appears that this condition was appropriately denied as a pre-existing condition.

4/12/2016 Billing/Collection Issues | Read Complaint Details
X

Additional Notes

Complaint: I requested cancellation of my insurance policy on September 3, 2015. Only when going through my bank statements on April 1, 2016 did I realize that they had continued billing me $38.98 per month for 7 months, a total of $272.86. I used online chat to inquire about this, and the representative, Jennifer, said she saw that I called and they told me I had to submit a cancellation request in writing, which I was not told at the time of the call. She said she would review the call from September and call back. When she called back, she asserted that I was told to submit a cancellation request by email. I requested a transcript of the call which was sent as a Microsoft OneNote attachment I could not open. I called back to request it again, and received an audio attachment that would not play.

Desired Settlement: I am seeking a refund of $272.86 and cancellation of the policy.

Business Response: My apologies.  That cancellation should have been processed as you requested.  I have made sure that it went into effect today and your refund should be on its way.

3/28/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: Pets Best is my insurance company for my cat April and has been for many, many years. I am now very tired of their repeated attempts to try to get out of paying a claim. In the past they have even paid out incorrectly, mistakenly converting Euros instead of British Pounds, and when I asked to see proof of the claim being corrected I was told there would be a charge for this (!). However, my complaint today is that in full absurdity they have refused my most recent claim - a basic prescription refill, accompanied by the mandatory vet visit to do the refill, and the charge to issue the prescription. I have submitted all documents and was flabbergasted to have this claim denied. Enough's enough. I pay over $100/month(!!!) to Pets Best for the peace of mind in knowing my cat will be cared for in any event. After years of her chronic medication, to suddenly have it denied is simply preposterous.

Desired Settlement: Pets Best need to reimburse my recent claim for my cat's ongoing medication, as they have been doing for years(!)

2/29/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I obtained this pet insurance in 2015 and never had to file a complaint until Feb 2016. I filed my complaint on February 4, 2016 and per the companies website; reimbursement of claims will come within 3-5 days. I received an email after this time had past from the company apologizing for the delay and again reiterating they reimburse within 3-5 days. I filed a complaint email asking for my reimbursement for my claim. I soon received another email stating that claims can take up to 10-14 days. This is different from what is advertised on their website and from the first email I received. The reason I went with this insurance was due to the quick reimbursement they advertised. I just received a call today; 2/18/16 and they are now requesting medical records for my dog. I am furious with the timeframe and lack of customer service as to what is advertised. This is false advertising.

Desired Settlement: I want my entire money refunded from when I started with this company. I am completely appalled by the service and lack of what has been offered and as to what was being served. They advertise false information to lure people to obtain their insurance services. Yet when you need to use it; they do not deliver in the 3-5 days.

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference t* ********* ** ********* and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

Verbiage direct from Pets Bests website includes: 

 Pets Best processes claims in only 3-5 business days on average (this is also called “claim turnaround time” or “TAT” for short). Once the claim is processed, we can release the reimbursement payment. Our customers can provide us their direct deposit information so that the funds will get released directly into their checking or savings account. This is all easily managed in their online customer portal or by contacting customer care.

Some pet insurers don’t offer direct deposit and will only reimburse you with a check. So even if they process the claim in 7-10 business days, you still have to wait for a check to be processed, printed, and then mailed before you’ll receive your reimbursement.

Imagine if you paid a $2,000 veterinary bill upfront and then your pet insurance took 4-5 weeks to pay you back. If that was on your credit card, you’d be charged interest. If you paid with your checking or savings, your available cash reserves would be on hold for weeks until you got paid back. This is why Pets Best puts so much emphasis on processing claims quickly. It’s stressful enough worrying about your pet when they’re sick or injured, so we want to relieve the financial stress as soon as possible.

- See more at: https://www.petsbest.com/blog/fast-claims-reimbursements-are-important/#sthash.tcaCOhTP.dpuf
******** ***** ****


Business Response:

The quoted language states "3-5 days on average".  Most claims are processed within that time, which is what maintains the average within that range.  Stating an average claims turn-around is not a guarantee of individual performance any more than stating that most claims are processed within that time frame. We are unable to refund premium for a contract that has been performed, in that premium was paid, claims were incurred, and the claim was paid within a legally reasonable time as is established by state statute.  To do so would both unjustly enrich the policyholder as she would receive the benefit without paying for the coverage, would violate the mutual contract as the conditions for a refund are established therein and are in no way tied to a 3-5 day claim turn around, and is beyond the authority that Pets Best has been granted by the company that issued the insurance policy* ************ ******** ********* ********

While Pets Best apologizes to our customer that our performance was not what was expected, there is nothing further we can do short of cancelling the policy effective today and refunding a pro-rate share of currently unearned premium.

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference t* ********* ** ********* and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

No claims were filed under this policy for over a year. The one dated January 25, 2016 is the first and ONLY claim ever filed with your organization. You have yet to still respond to this claim and reimburse for it. The reason I was given as to why it has taken longer than 3-5 days in your first email was due to an increase in claims being filed. If that is the case; your company should have taken the appropriate action to staff your facility so that customers--such as myself; are not incurring the lag time of being reimbursed for their policy. This is a company operation issue; not a customer issue.

When looking at multiple reviews of your company online; there are quite a few complaints listed stating the same concerns as mine. It seems as though this is your practice to either stall or deny claims on a consistent basis.

I delivered my promise by paying for your service each month; your company however; has not delivered the service that was offered and expected. Therefore; I am seeking a reimbursement for the 1 year of premiums that I paid and DID NOT file a claim with your company.

Additionally; when I completed the application for my dog; your company was aware I had just rescued her. However; ******** *alled me yesterday stating that your office called them requesting 18 months worth of medical records. How is this possible to produce those when I haven't owned the dog for 18 months?

 

******** ***** ****

Business Response: The claim in question was paid last week.  No new requests for medical records have been made.

2/5/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I have been using Pets Best for a number of years. I purchased the basic plan/ maximum per incident was$2500.00. My dog was diagnosed back in 2010 with Kidney Disease, had to be hospitalized and the max was used then. I was well aware any incident with her health involving kidney disease I would not be reimbursed. (Cremation/Euthanasia was never mentioned as an incident). I never really had any other claim with Pets Best as any illness issues were always related to her Kidneys. On three different occasions I had conversations with Representatives at Pets Best in reference to my policy benefits, as Zoey was aging and her only issues were her kidney disease, and thought about cancelling policy. On these three occasions I always asked the same question when the end should come and she is cremated/ and possibly will have to put her down WOULD I BE COVERED for these expenses and was always told yes. They never said if it is related to her kidneys, then there would not be coverage. If they had told me there would not be coverage I would have cancelled this policy. I was never informed properly.

Desired Settlement: I would like to receive the 80% of the cost of cremation/euthanasia, as this is what I was told. Never mentioned anything about coverage if it was her kidneys/ or that this was considered an incident.

Business Response:

Ms *******,

I wish I could respond more directly to your complaint, but I cannot find any policyholder in our system by your name.  Is there another name the policy may be under, or can you provide the policy number?

 

Thank you.

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me. 

Regards,

****** *******

 

  My Policy # with Pets Best - *********   Policy under my name ****** *******


2/2/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: My insurance policy with Pets Best Insurance went into effect on Nov 16, 2015. I have a ****** ********* ***** who on Dec 22, 2015 ingested a Christmas ornament which contained metal wire. He started vomiting after ingesting and I took him to the vet. Vet recommended x-ray to verify the wire was not lodged in his gut (only metal shows up on x-rays) causing his vomiting. No metal showed up on x-ray. My vet stated there certainly could have been a non-metal object from the ornament that irritated his belly, but these do not show up on x-rays. I was denied my claim by Pets Best because no metal showed up on x-ray. The Pets Best rep stated that this obviously was not the reason my puppy was sick so they will not cover under the insurance. They also stated that my puppy had a "pre-existing condition" as he had been to the vet with vomiting prior to this visit. Here is a brief outline of our visits to the vet: *August 25-We had brought him home on August 24 and he vomited on August 25. The vet suggested we bring him in as puppies can sometimes have illnesses that can cause vomiting and they become dehydrated quite quickly. Thanks goodness blood work was OK and it turned out to be stress from leaving his littermates. *September 22- he got into grapes and spent 2 nights in puppy ER (The reason I decided to purchase insurance in the first place!!). Grapes can be very toxic to dogs, causing vomiting and renal failure. *October 27-He had episodes of diarrhea that were found to be food related. Once I changed his diet, this cleared up. It is quite obvious that these past trips to the vet are not directly linked to my dog ingesting a Christmas ornament on Dec 22, 2015 and in no way should this be considered a "pre-existing condition". I am quite shocked that the insurance I paid in full for a full year would not cover something so simplistic.

Desired Settlement: As this is clearly not a "pre-existing condition", Pets Best needs to pay the claim submitted.

Business Response:

***** ***** thank you for taking the time to provide us with your feedback—it is reviews like yours that help us to continually improve. We value you as a member of the Pets Best family and have reviewed the claim submitted for **** and reprocessed in your favor. Reimbursement for ****’s claim was processed via check on January 22nd, 2016. We apologize for troubling you, please contact us with any questions or concerns. We hope **** is feeling much better!

1/20/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I have purchased the basic insurance coverage from the Pets Best Insurance for my two cats, ***** *** *******, since 2011. Back in Dec 2015, ***** got sick (kidney stone) and went to the hospital. We have kept all the itemized receipts and filed a claim with the Pets Best. Then the Pets Best started to ask for medical records. I went ahead and request the medical record to submit it to the Pets Bests. Later a rep from the Pets Best called and asked for records since 2011. I told them that this was the only time that my cat went to the hospital since I purchased the insurance policy and there was no other records. After three days, when I called back and checked the status, they started all over again and said they need medical records even back in 2009 or 2010. I recognized that ***** got depressed when I tried to change his normal sandy litter to wood litter and he got some urinating problems back in 2009 or 2010 (I don't remember exactly). The rep from the Pets Best told me they have the rights to ask for the medical records that they deem necessary. It sounds very smoky. In either case, I called the vet that we visited back in 2010. They don't keep the record for that long... Yet, the Pets Best insurance insisted that was necessary.

Desired Settlement: Cover the reasonable cost, please!!! Otherwise, there is no need to purchase insurance at all...

Business Response: Please review the section of your policy entitled "Your Duties in the Event of a Loss."  As the policyholder you are required to authorize the release of all medical records, including and especially those from before the policy was purchased.  A claim that is not complying with this provision of the policy cannot be processed until the records have been received.

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference to ********* ** ********* and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

The Pets Best Insurance is primarily an online pet insurance company. If the sale rep did not go through that specific policy requirement with the customer over the phone, the customer had to wait for almost two weeks to receive the policy package to review the details. To be honest, in this case, the sale rep did not mention a single word about that and I did not read the fine print-outs after two weeks that I purchased the policy. Meanwhile, asking the customer to keep the medical history record is a big burden. I don't know how they keep their own health record and I certainly would ask the record from the doctor. In this case, the vet's office did not even keep records for that long (>5 years), or it could be that they just don't want to dig it out.

While I appreciate the timely response from the Pets Best Insurance, the response did not address the issue at all. If they don't want to cover the cost on the ground of lacking a complete medical history, please be clear. Please be aware that they have received the medical history for this illness and this is the only illness that my cat had since I become a policy holder back in 2011. If they decided that they are not going to process my claim because I was not able provide the medical record back in 2010, please be clear about it.

****** ***** *** *** **** ****** ********* * ********* **** * **** ** **** **** ****** ******** ********* **




Business Response: To be clear, we cannot pay any claim that is lacking a full medical history as is outlined in the policy contract.  As a third-party claims firm processing claims for your insurance company, ******** ************ ********* ******y, we are as bound by the contract as you are.  The policy documents are emailed immediately upon enrollment and you are given 30 days to look them over and cancel the policy with a full refund if you are unhappy with the policy.

Consumer Response:

**** ******

First, it's ridiculous to ask the customer to keep a full medical history record for that long when the Vet did not even keep.

Second, it's ridiculous when you are trying to link the cat's illness to one depression when they are about 1 year old.

Please don't waste your and our time.






1/19/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: This insurance company happily collected premiums in amounts in excess of $300 for insurance coverage of our pets. We closely read the policy provisions and accepted them. When one of our pets got sick, Pets Best dithered processing our claim for the better part of 2 months (all while continuing to collect premiums), then proceeded to deny our claim based on this language: "The amount of time required for this condition to develop indicates the condition existed before the effective start of the policy..." Viewing this statement in its most literal sense, ANY condition of any animal who was not insured through this company from birth would qualify as a preexisting condition. When we sought a refund of our premiums (for services effectively not rendered) not only were we refused, the company offered no recourse, no higher level customer service, nothing. They simply stated "they cannot offer refunds". I cannot think of another business which will simply take your money, refuse to give you what you paid for, and refuse to refund your money... except for possibly a carnival barker. For shame.

Desired Settlement: The company should pay its claims. Their myopic decision making saved them a few hundred dollars, and cost them thousands of dollars they would have collected in premiums for the coverage of our pets for the foreseeable future. They defrauded us of $250 in paid premiums for which no service was rendered.

Business Response: Your policy has already been cancelled as requested yesterday and a pro-rata refund has already been applied.  If you would like to appeal the denial of your claim for dental extractions, please follow the instructions provided in your policy form or contact our customer service department at 1-877-738-7237.

12/29/2015 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I have been a member with Pets best for a few years and have multiple policies on different animals. Last November my Dog had a surgery and everything went realtively well. there was a pre-authorization done and seemed smooth. Well this year my dog needed surgery again. This time I requested a pre-authorization and was the told that my account had been flagged and a NO -PRE-AUTHORZATION WAS ISSUED. I asked why our account had been flagged and was told that I had committed insurance fraud and altered documents. After hearing this I became very frusturated as we have had several smaller claims and nothing had been mentioned. When speaking with pets best to find out what they believed to be altered they told me that it was invoice that was sent to them from us for my pets surgery last November. I called pets best after going back through all of our records and expressed to them that nothing had been altered and everything could be verified by our Vet. Again I was told to deal with it that they had proof that I altered documents and my account would always have to be verified prior to any funds being reimbursed. My fiancé went to our Vets office for a follow up on Daisy and told our Vet what was going on. Our Vet immediately called Pets Best and expressed to them that the invoice in question was issued by them! When our vet was on the phone with Pets Best the represinitive from Pets Best was very rude with the staff. After all of this I then received a phone call from Pets Best apologizing profusely and was told that our claim now 2 weeks later was being processed and our account would have all of the restrictions lifted. Well this is not the case. I have not been reimbursed the money per the contract between Pets Best and I and am still be treated as a criminal. I was told last week that everything was in order and the claim was on the Vice Presidents desk and no further documents were needed. I called today and was told that I have to provided a copy of the check showing payment for the surgery. I have provided this information.

Desired Settlement: My pet needs physical therapy and I don't want to have any issues moving forward. The business needs to do their due dillagence before making criminal accusations.

Business Response: The claim in question was paid on 12/22.

Business Response: The claim in question was paid on 12/22.

Business Response: The claim in question was paid on 12/22.

Business Response: The claim in question was paid on 12/22.

11/23/2015 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: In an attempt to get them to cover medical expenses for my service dog, I was informed it was my fault due to a failure on my behalf. As my extended conversations over a period of weeks, that story would change as I showed where I had done what they required. In the end, I was told it would be violation of law to do what I had asked. It appears it is up to the consumer to know everything they need to do even some of it is contradictory and confusing. I was told I shouldn't have signed up online, but should have done it through an agent. Why make it available to be done online then?

Desired Settlement: They should pay the medical bills that it said would be covered.

Business Response: The policy in question has a one year waiting period for cruciate ligament injuries.  That waiting period can be shortened by sending in a form completed by your veterinarian during the first 10 days of the policy indicating that your pet is not suffering from any symptoms of such.  This form is sent along with your policy and declarations page.  As that form was not filled out and returned, instead a different form that applies a 10% discount was returned, your pet has a one year waiting period for that condition.  Your claim was properly denied as having occurred during that waiting period. 

11/9/2015 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: This company claimed completely biased and un-documented medical records as "fact" and thereby denied claims that were clearly within all legal boundaries. Their customer service treatment was almost child-like, with lots of "I don't knows" and "sorry, can't do that" and "I'm not sure if a manager is available." They didn't respond to email inquiries, didn't support their "findings" with facts, didn't uphold their policy explanations, didn't represent true working hours in which I could call back, and most importantly - didn't have any concern for the customer's satisfaction and refused a money-back guarantee.

Desired Settlement: Cover the claims that were without-doubt within legal standards. And, at the very least, reimburse me for the two months of a paid service that was not ONCE received.

Business Response: I am sorry to see that your pet was diagnosed with Parvovirus.  The insurance policy that you purchased has a 14-day waiting period before benefits go into effect, with an exclusion that excludes any condition that manifests during that period.  As your policy was purchased on 9/4/2015, and your first claim for this condition was incurred on 9/17/2015, the condition falls within the waiting period and is excluded from coverage.  If you would like to file an appeal, please contact customer service at 1-877-738-7237.

10/29/2015 Guarantee/Warranty Issues | Read Complaint Details
X

Additional Notes

Complaint: After ten months of paying $50/month for "premium coverage," my 1.5-year-old puppy suffered a fall and injured his knee (luxating patella) requiring a $3,000-surgery. Pets Best refused to cover a single cent of the surgery because we were two months shy of making a full year with Pets Best AND because we failed to submit the "optional health check" report within the first 6 weeks of starting our policy with Pets Best. Apparently, if I had submitted the "optional health check" form within the allotted time, my puppy's surgery would have been covered. (When you're paying for "premium coverage" it seems dishonest to not provide service because the customer didn't realize the "optional health check" was actually REQUIRED in order to fully utilize said health coverage.) In short, I did NOT get what I paid for with regards to Pets Best, and I question the integrity of this business.

Desired Settlement: I would like Pet's Best to retroactively cover the medical expenses for my dog's surgery. Or, I would like to receive a refund for 13 months of paying $50/month for Pets Best's "premium coverage."

Business Response:

The policy has very clear language, and the website is very clear in explaining that luxating patellas have a one-year waiting period that can be waived by submitting a form from your veterinarian indicating that the condition is not present when the pet enrolled.  Lacking that form, the one year waiting period outlined in the policy was enforced.

https://www.petsbest.com/pet-insurance-plans/pet-health-checklist

 

10/27/2015 Problems with Product/Service | Complaint Details Unavailable
10/12/2015 Problems with Product/Service | Complaint Details Unavailable
10/8/2015 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: This complaint is in reference to our policy with Pets Best and the most recent claim we have filed with them. We filed a complaint back on 9/23/15. Since the filing of this claim we have been asked on three different occasions for three different items. The claim was for our dog who had teeth cleaned, teeth extracted, two lumps removed and biopsied. We submitted the itemized invoice showing we paid. A week later after calling we were told they needed medical records from the surgery because they needed information about the biopsy. We called the vet and on Friday October 2 the records were faxed to them. We called on Friday to verify that Pets Best had the records and they confirmed this. Today I called to inquire about the claim and I was told yet again they needed more information. They needed a dental chart. First of all our policy states that it will not pick up dental extractions however since we have the wellness policy it will pick up the cleaning. So why do they need the dental chart. They are just stalling again. The customer representative said since the diagnosis was dental disease it would not be picked up, she would let the processors know to proceed without including the extraction of the teeth. Later today I received an email stating that they needed more information. I called and was told that one of the medical records they had from 2013 did not have the name of the vet. Well I was a little confused since the records were okay back in August when they processed a claim using these records. I was told they needed the name in case they were audited. Again our claim is being held up because of their mistake. I feel that Pets Best is trying not to pay our claim. I have provided all the information to them and they keep asking for more. Plus some of the stuff they are asking for is not even necessary and they know it.

Desired Settlement: We want our claim paid immediately . We want the company ( a supervisor-although every time we ask for one we are told we are speaking to one) to contact us and explained the delay.

Business Response: *** ********

The policy you purchased has very specific exclusions for dental conditions.  We had understood that you were claiming the extractions as part of your medical coverage.  As such, we have to get very specific records to determine if these extractions fall under the narrow window of coverage that the policy provides.  As I now understand from your complaint that you are not actually claiming these extractions, only the associated cleaning, we will process the claim accordingly and will have it completed today.

Thank you for the clarification, and I apologize for the delay.

Consumer Response: Better Business Bureau:

I have reviewed the response made by the business in re******* ** ********* ** ********* and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

Our claim is for the dental cleaning AND the lump removal and biopsy.  The dental cleaning should have paid immediately since it is part of the wellness plan we have.  This has been done before (refer to claim sent in June).  In addition our claim is still being held up due to an error on your part.  You did not address this in your response.  You are requiring us to submit the name of the vet from the 2013 records.  You have stated that you cannot process the claim unless you have the name of the vet.  First of all you processed a claim back in August using these records and it was not a problem then.  Possibly due to the fact you did not have to pay out any money.  Secondly these medical records mentions nothing about the lumps and biopsy so there for they are irrelevant to our claim.  We again have asked the vet to send them to you stamped with their name and we are expecting to have to take time off yet again to actually get the medical records and fax them ourselves like we had to with the last claim.  By the way the last claim for ear infections took two months to process which involved my husband taking time off of work to go get the records and emailing them to you since Pets Best claimed the vet did not send them and they did.   However this will now start the whole wait time over again.  Which means by the time it is all said and done it will be a month since we submitted the claim.  
******** ****** *******




Business Response: The claim in question has been processed.

8/3/2015 Billing/Collection Issues | Complaint Details Unavailable
7/10/2015 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: Pets Best provides insurance for my cat. She was diagnosed over 1 year ago with lymphoma. She has been in chemo and has not had a recurrence of the disease at this point. She has maxed out her lifetime benefit of $2,500 for lymphoma treatment. Recently, Anya suffered a liver problem for which she received treatment and her liver was biopsied. The biopsy found that there was NO evidence of lymphoma in the liver and she was diagnosed with hepatic lipidosis. I submitted bills to Pets Best for the following treatment dates: 3/21/15, 3/24/15, 4/15/15, and 3/25/15. I provided 19 pages of ****** medical records with each. Page 13 of the med records states: "HEPATIC LIPIDOSIS. NO CYTOLOGIC EVIDENCE FOR SMALL CELL LYMPHOMA. This condition is usually secondary to prolonged anorexia. This anorexia is caused by another disease process, but results in excessive lipid accumulation in the hepatocytes. THE PRIMARY DISEASE IS NOT APPARENT." Pets Best initially listed the diagnosis as hepatic lipidosis, for which they would have had to reimburse the treatment under her policy. However, Pets Best changed the diagnosis to lymphoma and denied all the claims because the lymphoma benefit had been exhausted previously. When I contacted Pets Best, I was informed that they changed the diagnosis because hepatic lipidosis COULD be a complication of lymphoma. I have done internet research and there are many causes of hepatic lipidosis and approximately 50% are idiopathic. The treating veterinarians specifically found no lymphoma and said the "primary disease is not apparent." So Pets Best has absolutely no basis for its speculation that it's related to her lymphoma. This is solely an attempt to get out of compensating me under the terms of her coverage.

Desired Settlement: Pets Best needs to reprocess these claims with the proper diagnosis of "hepatic lipidosis" - not lymphoma - and pay according to what ****** insurance benefits were at that time. I have since reduced her coverage because of my dissatisfaction with this company and expect that any re-processing use the insurance terms that were in effect at that time when I was paying a significantly higher premium and the costs were incurred.

Business Response: The finding that hepatic lipidosis is secondary to the lymphoma event is one that was based upon a review of your pet's medical records.  This decision can be appealed per the appeal options listed in the policy form.  This can include a review by an independent third-party veterinarian of the medical records and medical history of your pet.  Should you choose to avail yourself of this option, we would be happy to review the appeal.

7/6/2015 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I signed up for cat insurance for my cat. I purchased a sickness and wellness policy. A month after purchasing the policy I took my cat for a check up. He was diagnosed with acute kidney failure. It is covered in the policy and since April they kept telling me we are working on it. I just got an email said the cat is not covered after I paid a lot of money to keep my cat alive because I thought he was covered. I had to fax over medical records saying they did not get them then they wanted doctors notes twice. They have given me a complete runaround. My cat died this month and that is why I think they are denying claim.

Business Response: Good afternoon,

The medical records of the pet in question show that the cat was showing symptoms of kidney failure, including increased kidney blood values, generalized muscle atrophy, poor body condition and hard stool only 9 days after the coverage went into effect.  The policy in question clearly excludes any condition that is present either before the policy is taken out. or during the short 2-week waiting period.  The pet's poor condition only 9 days after the coverage went into effect strongly indicate that the condition had been ongoing for quite some time, and the claim was appropriately denied as pre-existing the coverage.

Should the policyholder wish to dispute this finding, she can avail herself of the claims appeal process contained within her policy.  This can include an independent veterinary review of her records by an unbiased veterinarian we have employed for this purpose.

Consumer Response: Better Business Bureau:

I have reviewed the response made by the business in reference to ********* ** ********* and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

My cat did not have any symptoms. He was healthy and I got the insurance because my cat was 16 years old.  He went in for a physical and blood work and the results showed kidney failure.  The doctor prescribed a special diet, well since March the company gave me story after story did not get records, when the vet office said they faxed numerous times. I even picked up a copy and faxed over myself. then after 2 months they now needed doctor notes then shortly after that closed the case because it was open too long. Then I had to go to vet clinic again to pick up doctors notes and faxed after ********* said she faxed numerous times. at this time **** ********* ******** said the insurance sounds like a scam and I should check them out.  Finally in June they said they received paperwork and my cat died June 5.  I did not hear from them til June 30 when they said he was not covered.  Well, ********** said they would take down Petsbest insurance because this happened once before.  I felt I need to tell others, this is not right that they string you along. Then come up with he had prior signs and symptoms.

Regards,

****** ****




Business Response: As I previously mentioned, if you disagree with the findings of your claim, please feel free to avail yourself of the appeals procedure available to you in your policy form.

Consumer Response: Better Business Bureau:

I have reviewed the response made by the business in reference to ********* ** ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

That is unacceptable. You have all the records everything. It took Petsbest 3 1/2 months to tell me you were not going to pay. Both vets said it was chronic kidney failure and that is supposed to be covered according to your policy.

Regards,

Shelli Rich




5/28/2015 Problems with Product/Service
11/24/2014 Billing/Collection Issues | Complaint Details Unavailable
11/20/2014 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I called PBI and incepted a policy via phone with a licensed sales agent. During the recorded phone call, the agent, Laura, informed me I could incept and accident only policy and had the option to add illness and/ or wellness as long as I chose to do so within 30 days of the initial policy inception. I subsequently spoke with 2 other PBI representatives. A different ***** *** ****** I called and added wellness coverage to my policy. I called and confirmed during 2 separate phone calls that I would be able to use my dogs wellness coverage 11/21/14. I've had my dog scheduled for procedures covered under the policy since last week. Today, I got a call from Holly who said that intact, they can't add wellness, despite 3 separate representatives telling me I could. And the company refuses to give me a full refund despite their misrepresentation. Additionally, despite being issued a policy within the month, the company has now informed me that I am no longer eligable to have pets insured by them. All the phone calls were recorded, so if BBB could obtain the recordings, I'm sure that would be helpful.I've had a friend call the company for a quote. She was told exactly what I was initially informed by the sales representative. That she could incept an accident only policy and that she could add wellness or illness as long as she did so within the first 30 days of inception. I would like to know why I am not entitled to the same coverage as was initially described to me, and as was offered to my friend.

Desired Settlement: I would like the policy I was told I could have by the previous 3 PBI representatives, with the appropriate waiting periods waived so I can have services performed that are covered under wellness. In the event I am not able to incept the policy initially described, I would like a full refund, including the $2.00 processing fee, as the coverage offered was misrepresented by the sales agent.

Business Response: The policy in question has been cancelled at the policyholder's request, and a full refund will be issued immediately.

Consumer Response: Better Business Bureau:

I have reviewed the response made by the business in reference to ********* ** ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

On 11/7/14 my account was charged by PBI for $12.26. I received a cancelation notice for my policy from PBI that I would only be refunded $10.26, and was advised by the PBI customer service agent, ****** that they would only refund $10.26. I have yet to receive any refund whatsoever from PBI. Without a 100% refund, the outcome is unsatisfactory. 

******** ******** ******




Business Response: A 100% refund was processed this morning.  Her bank may take a few days to process the funds.

Consumer Response: Better Business Bureau:

I have reviewed the response made by the business in ********* ** ********* ** ********* *** have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

The PBI representative responding to this complaint has refused to respond concerning the assurances made by 3 of the  PBI employees via recorded phone call. Three PBI reps made assurances that the company will not stand behind. Additionally, the PBI representative has not responded as to why my policy would be treated any different than my friend who called in and was offered the same timeframe to modify her policy as I was. PBI reps gave me information that gave me a false sense of guarantee and coverage. I now have to find another policy and am subjected to waiting periods that are longer that what I would have to endure had PBI stood behind what 3 of their employees represent, or employed knowledgeable and honest employees. I feel strongly that other pet owners interested in insuring the health of their dogs and obtaining insurance should be aware that they can't believe the statements made by PBI representative!

So, no, the PBI response is not satisfactory in resolving this matter. 

******** ******** ******




11/19/2014 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: Pet's Best Insurance is denying a legitimate claim because I can't produce prior records for my dog for the past 12 months. I have had her for approx. 1 to 1 1/2 years and have never had her to the vet prior to this illness. Her previous owner had her spayed and vaccinated but never gave me the records and I have no way of contacting her previous owner. My contract states that the condition that I had her seen at the vet for is covered in my policy. It does not state that my claim would not be covered if I have no prior history of vet records. My policy was paid and in full force when I filed this claim. There is no legal reason that this claim should not have been paid.

Desired Settlement: If my claim will not be paid then I expect to be reimbursed for all of my paid premiums.

Business Response: *** **** took out a policy on 8/31/2014 with an effective date of 9/14/2014.  *** filed a claim for a potentially chronic skin condition from services dated 10/24/2014.  Because of the potentially chronic nature of the claimed condition and the short time period between the purchase of the policy and the date of the claim we require prior medical records be examined in order to verify that the condition did not pre-exist the policy.  This is the standard procedure for all pet insurance policies in the industry.  Records were received from the date of treatment, which was the first time this veterinarian saw her pet.  From these records we can verify that her pet was on prescription heartworm preventative medication as well as diphenhydramine.  These medications must have been prescribed by another veterinarian.  *** **** also confirmed with our customer service staff that her pet was vaccinated and spayed at another clinic, but *** **** refuses to disclose the name of this veterinarian so we can procure the records necessary to verify that the condition *** is claiming is not pre-existing to the policy purchase and therefore excluded.  Page 7 of her policy form, under the section titled "Your Duties in the Event of a Loss", subsection 4, mandates that a policyholder "Make available the Pet(s) or other relevant items or information in your possession or control for our inspection and examination."  Subsection 6 "authorizes us to obtain any additional records or other information we deem necessary directly from the veterinarian. Refusal to authorize medical records or other documents or information from treating veterinarian will result in denial of claim."

*** **** has had her claim denied for failure to comply with her duties under the contract.  Pets Best will be happy to reopen her claim and process it with the necessary records just as soon as *** either discloses the name of the prior treating veterinarian, or has that veterinarian send her previous medical records directly to our office.

10/31/2014 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I realized I filed this original complaint under the wrong category.... they have consistently delayed paying legitimate claims for my dog....the last incident - I sent in the claim form, the invoice as well as the medical record for October 16.. They've had it since that day and today I get an email telling me they will be calling me for additional information.. There is no additional information needed ..... its just a tactic to delay

Desired Settlement: I want them to pay me for this outstanding claim

Business Response: The claim in question has already been processed and paid per the policy terms.  If there is anything further that we can provide please contact our Customer Service department directly.

 
Thank you for choosing Pets Best.

7/21/2014 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I subscribe to this pet health insurance on the advice of my vet. The policy clearly states that after 14 days it is in effect (in my case, 6/9/14). I went to see the vet a few days after the policy was in effect (6/17/14). After a routine checkup, my cat was diagnosed with hyperthyroidism. The insurance refused to pay anything, arguing it was a preexisting condition, even though I had no knowledge of it prior to subscribing and there were no symptoms (my cat still looks very healthy and if it wasn't for the analysis, I would not know she is sick.) The company argues (citing paragraphs 9 and 11 of their policy) that any condition that had symptoms or may have started before the policy was in effect is not covered. That is not what they advertise and what they are saying cannot be proven. If they wanted to be sure my cat had no preexisting condition, they should have asked for a full physical PRIOR to me ensuring her, rather than take my $565.09, then tell me "sorry, we don't ensure preexisting conditions." As far as I am concerned, my cat was not officially sick until it was diagnosed on June 17, 2014, which was AFTER the policy had gotten into effect. The insurance is second-guessing when the illness started. I have no idea when it started and it is irrelevant. The policy was in effect, and they should have paid up. With the standard they are applying to "preexisting conditions", they could easily could back six months from now, say if my cat had developed cancer, and tell me "no sorry, this doesn't develop overnight. It must have happened before the policy went into effect." In any case, it is disingenuous of them to act in this manner. They are gaming the public out of their money because, since they do not ask for a physical prior to ensuring the pet, there is no way to prove I, the client, may be right, and I had no opportunity to make an informed decision to not ensure my pet once I knew they would not cover the condition.

Desired Settlement: I want the company and all other pet insurance companies to require a physical of the pet BEFORE the insurance goes into effect so that the client can make an informed decision as to whether or not insurance is worth it for them. If this is not possible, then pet insurance companies should be held to their word and pay up unless they can prove that the pet was sick prior to the insurance taking effect.

Business Response: This pet was diagnosed with a chronic metabolic condition only 9 days after the policy went into effect.  The level of free T4 in the blood stream indicates that the condition had been ongoing for much longer than 9 days.  As such, this claim was appropriately denied under the exclusion of any condition that manifested prior to the expiration of the policy waiting periods.

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference to ********* ** ********* *** have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

This answer only confirms what I'm complaining about. My pet did not show any signs of being sick before subscribing to the insurance (and still does not). It is only because of the routine blood analysis that was done that we know she is "sick". What I argue is that the pet insurance is applying an arbitrary and capricious criteria in their evaluation of when my pet got sick. Furthermore, they are judge and party in this, which creates a conflict of interest. The appeal system is a joke since, again they apply a criteria that can be interpreted any way that's convenient for them and they are, again, judge and interested party.

I don't know when my pet got sick and neither does the insurance because no blood check-up was done BEFORE starting the insurance. Also, in the event that I would have had the routine check-up done three months into the insurance, the insurance could still apply its arbitrary and capricious criteria and still claim this disease takes a long time to develop and must have happened before the insurance policy went into effect. Again, there is no way to prove this conclusion one way or the other because we do not have the facts from BEFORE the time the insurance went into effect. 

The insurance pretends that they will cover anything (except listed diseases) after the 14-day waiting period, but they rig the system because they reserve the right to determine when a disease started and they are not required to provide proof of what they are alledging. They decide unilaterally and without the help of a blood analysis when a disease has started. Most importantly, they do so AFTER taking the pet owner's money and knowing fully that there is a very good chance they will deny any early claim as "preexisting condition" because the criteria they use is arbitrary and capricious. In other words, it's a scam. Even if you cancel your insurance (which I did once I understood what kind of business I was dealing with), the pet owner is charged for a month of "insurance" when in fact there never was any intention of insuring anything at all for as long as the insurer could get away with claiming that the disease probably started before the insurance went into effect. By this criteria, I have no idea when the insurance would finally say, yes, this disease probably started AFTER the insurance went into effect and we will cover it. It is likely they could play this game for several months, all the while collecting premiums at no cost to them. And the pet owner has no recourse.

In my case, to add insult to injury, I was charged for two months of "insurance" even though I was barely into the begining of the second month. Also, it is important to notice how things were handled when I told the insurance representative over the phone that I wanted the insurance to be cancelled: the representative immediately agreed (in fact, she almost interrupted me to agree to cancel the insurance!) and even waived (without me requesting it or even suggesting it) at a speed that astonished me the necessity for me to send a written letter to the insurance asking for the policy to be cancelled (as spelled out very clearly in the insurance rules). They were so eager to get rid of a troublesome client that they even sent me an email confirmation before I had had time to log into my email (i.e., less than 1 minute after I hung up). This tells you this business is used to dealing with my kind of complaint and when someone is being a trouble-maker over the phone, they just cancel the policy, no questions asked (but after taking the maximum amount of money they can. Very easy money for them. If they apply this policy to several hundreds of people a year, they are making very good money for no effort at all.)

This is not an honest business. if they were honest, they would require that pets take a blood test BEFORE the pet owner subscribes to the insurance, and not wait for the pet owner to have paid for the insurance, then deny coverage when their intention is clearly to deny coverage for as long as they can claim the disease must have started before the insurance went into effect. What harm is there in discovering that the pet is sick BEFORE the pet owner pays for the insurance? Then obviously, the insurance might not get money because the pet owner, once informed that this or that condition will never be covered, is likely to decide NOT to subscribe. This is a dishonest practice and a scam from the point of view of the pet owner. Either the insurance demands a pet physical BEFORE the pet owner signs on for the insurance, or they must prove beyond the shadow of a doubt by showing a blood analysis that the pet was sick BEFORE the insurance went into effect. If they cannot provide proof, then their decision is arbitrary and capricious and they must provide coverage for the disease in question.

Regards,

 ******* ****************

 

 

Business Response: The policy in question refunds all premium on a pro-rata basis, so you were not charged for any period of time in which you did not have coverage.

 
I direct you to the exclusion under which your coverage was denied.

We will not be liable for paying any of the following:  Pre-Existing Conditions, which are Claims for Accident or Illness to the Pet(s) that occur or manifest, whether treated or not, prior to the effective date of the Policy or during the waiting period.

The definition of pre-existing condition is located on page 13 of the policy form, and reads:

"Pre-existing Condition - An illness or the recurrence of any illness or condition which first occurred or displayed any signs and/or symptoms consistent with the stated illness or condition prior to the expiration of any applicable waiting period; or an injury or recurrence of an injury that occurred prior to the expiration of any applicable waiting period; or any condition or complication resulting from an illness or injury that occurred prior to the Policy effective date.  A condition may be considered Pre-existing: whether or not it was specifically diagnosed by a veterinarian, whether or not it was treated by a veterinarian, is in remission at the time of application, is seasonal in nature even if in remission at the time of application, is currently or previously being controlled by medication(s), or is a latent infectious or parasitic condition that manifests itself within a known incubation period following the policy effective date rendering clear evidence that the condition had to be contracted prior to the expiration of any applicable waiting period."
 
I do not believe that the exclusion could be any clearer.  While you accuse the insurer or being arbitrary and capricious, I do have to remind you that this policy form was sent to you on the day you bought the policy, and you were given a 30-day grace period to read it and cancel your coverage for a full refund if you did not agree with, or did not want, the coverage that you chose and purchased.
 

 

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference ** ********* ** ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

Again, this answer is irrelevant to my complaint. The exclusion quoted in Pets Best's answer is buried far into the Rules document, which is only given to you AFTER you have subcribed to the insurance. It is not at all publicized by Pets Best, which instead publicizes heavily that they will start covering illnesses after the 14 day waiting period. As for the 30 days during which I could have cancelled the insurance, I don't remember seeing anything about this. But I suppose I could have missed it. Again, no publicity on that, but plenty of publicity when it comes to assuring us clients that all will be covered if you just wait 14 days.

If Pets Best alledges that my pet was sick earlier than when the insurance went into effect, it should have to prove it. Otherwise, this is an open door to abuse. How can Pets Best know for sure that my pet did not become sick within the first week of coverage? I'm the owner and I didn't know she was sick, and still wouldn't if we hadn't done the blood test.  With the arbitrary standard applied by Pets Best, which answers to no rules or necessity of proof, Pets Best can refuse to pay anything at all for as long as they can say "this illness must have started before the insurance went into effect." This could go on for months, which means that for months, the pet would not be insured at all, while Pets Best is cashing in, thus making this "insurance" a scam.

This policy does not openly publicize the enormous level of discretion Pets Best has over deciding when an illness is "preexisting". There are no standards of proof and they can claim whatever they want. The fact that Pets Best pulled one over me by burying this clause far into the Rules document so I missed it (FYI, I am not a lawyer and don't peruse law documents for a living, as is probably the case of most of their clients) doesn't make it an honest and open business practice. If Pets Best is an honest business, then it should have no problem requiring a pet blood test BEFORE the client subscribes to the insurance, so that any illness that will not be covered is announced before the client makes the decision of getting the insurance or not, not after subscribing to the insurance. And it should have no problem clearly announcing this obscure exclusion rule from the begining, BEFORE the client subscribes to the policy. The only reason Pets Best would not require a blood test and would not give out the Rules of its policy ahead of time is so that they can prey on people who either do not read or do not comprehend the rules properly. An honest business would have no problem being upfront about this exclusion rule and explain it before people subscribe to the insurance. In the end, after Pets Best has successfully ensnared its client, the client has no recourse (Pets Best being judge and party, there is no way to get vindication and, of course, Pets Best applies no standard of proof whatsoever to their claims that an illness started before the insurance went into effect. So there is absolutely no possibility for the client to contest their "judgement" because there is no standard to judge by.) 

 

If Pets Best wants us to believe it is an honest business, then it must require a pet blood test and it must clearly state exclusions and discretion on how exclusions are determined BEFORE the client buys the insurance. This will remove any doubt as to whether or not a pet was or was not sick before the insurance started. It will be transparent to all. The only reason Pets Best would not want this kind of clear and transparent practice is because it intends to use obscure rules to deny insurance while cashing in premiums. I demand transparency, proof of alledged preexisting conditions and fully publicized disclosure of the extent of Pets Best discretion on determination of preexisting conditions BEFORE the client has already signed the policy. If Pets Best is an honest business, this should pose no problem at all, as my request is well within the rights of a consumer to transparency and full disclosure so he/she can make an informed decision before the company takes his/her money.

Regards,

 

******* ****************

 

 

Business Response: I would direct the policyholder to the application agreement that *** attested to reading and understanding before purchasing her policy:

 
http://www.petsbest.com/terms-and-conditions/application-agreement
 
The relevant language being:
  • I understand that pre-existing conditions will not be covered:
    I acknowledge understanding that a pre-existing condition is any condition that was present prior to the expiration of the policy waiting period, whether or not the condition was diagnosed or treated previously, and is not covered under your Pets Best Insurance policy.
 
 
We are happy to take her suggestions under advisement, and thank her for taking the time to make them.  Unfortunately, her desire that the policy form be rewritten and the nature of the pet insurance industry be fundamentally altered is simply not feasible at this time.  The vast majority of individuals purchasing a pet insurance product do not want to go through the trouble and expense that *** is suggesting prior to purchasing their coverage.
 

Consumer Response:

 

Better Business Bureau:
 

 

I have reviewed the response made by the business in reference to********* ** ********* and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

Thank you for acknowledging the fact that you do not want to require a pet blood test PRIOR to a client subscribing to your insurance because, according to you, "people don't want to go through the expense". That's a ridiculous argument, as attested by my own situation, where I did have a blood test done shortly after the insurance started. I don't see what difference it would have made to do it before or after, except for the fact that I would then have known you would not cover this illness and therefore, there is a good chance I would not have subscribed to your insurance. My doing so would have cut in your bottom line, where you took me in for some $60 for services you never intended to render (charging me for an entire second month even though I was barely into the second month of "insurance", I might add). So yes, you are right: being honest with people would probably cut a number of people you game in this manner. That is precisely why, as a consumer, I'm asking for protection against predatory enterprises like yours.

As for the second part of my demands, which you do not address, I see absolutely no reason why people have to sign up first, THEN get the rules about the insurance. As far as I know, the rules are not available (in their entirety, including the obscure rule you now are using against me to deny coverage) until the client has signed up. That is a dishonest practice by any standard.

 

I am sorry to see that you take all this with a "cheeky" tone and find it appropriate to make fun of my requests to "change the entire industry", as you put it. I do not think that protecting consumers from devious businesses like yours is something to make fun of.

 

As it is obvious that you have no intention to take any action to remedy your dubious practices (I shudder to imagine how many people fall in the same trap I did on a daily basis), I will not continue to respond to your messages. I do not consider this matter resolved. I will examine my options so I can continue to protest against the abuses you perpetrate, and hopefully, eventually get vindication for the consumers you wrong day after day.

Regards,

******* ****************

 

 

6/3/2014 Billing/Collection Issues | Read Complaint Details
X

Additional Notes

Complaint: i bought an insurance policy for my dog ******** roughly 6 months ago. The policy was set to be cancelled on the 13th of May, 2014. I had recieved a message from Pets Best Insurance notifying me that if I took no action to renew the policy that it would be cancelled on the 13th of May, 2014. They never said anything on the phone about renewing the policy automatically, and I have never heard of an insurance company renewing a policy and taking money out of a customers account without the customers consent. My mortgage payment was due this week on May 12th, 2014 and I had just enough money to cover that payment. Pets Best Insurance however caused my account to go negative and later I recieved an overdraft fee of $37.00. I called Pets Best Insurance, trying to stay calm, demanding they put that money back in my account now before I got an overdraft fee. The representative Isa said the best she could do was 3 or 4 days and gave me her supervisor's voicemail, supervisor *****, is what i was told. I still dont have my money. I got an email stating they would refund a prorated refund of 97 dollars of the 112. No that is not right at all!! i need the 112 dollars and change refunded plus the 37 dollar overdraft fee they caused me to have. I even caught the transaction the same night they took it out. There is no reason I should not get back the full amount they took. I will never choose pets best again and I will not quit fighting for this until i get what i deserve. Pets Best Insurance is a bunch of ******* if you ask me. I never authorized them to take money from me and they never informed me they were taking money out of my account. I need this issue resolved quickly. As, I live paycheck to paycheck and cant afford my bills some weeks.

Desired Settlement: I want the 112 dollars back in my account and I want them to pay for my 37 dollar overdraft fee. thats all i want

Business Response: This policy was purchased on 10/23/2013 and will not renew until 10/23/2014.  The policy is an annual one.  Your premium due on 4/23/2014 was rejected by your bank.  Per our standard procedure we made a couple of attempts to collect what was owed before sending  you a state mandated advance cancellation notice on 4/28/2014 indicating that if payment was not received by 5/13/2014 your policy would be cancelled for non-payment.  On the morning of 5/13/2014 our system made one last attempt to collect what you owed before we cancelled the policy.  That attempt was successful.  You then called in that same day asking to cancel the policy.  We cancelled the policy effective that day and refunded all unearned premium, which was the one month's premium we had just collected less what was owed for time that coverage was still in force while we tried to collect payment (4/23/2014 - 5/13/2014).  Ten days of unearned premium was refunded to your account on the 13th, and your policy was cancelled as requested.

 

6/3/2014 Billing/Collection Issues | Read Complaint Details
X

Additional Notes

Complaint: I had to pay over $800 for my dog only because petsbest thinks that it was not an accident? But this was an accident and the doctor sent in all the necessary paperwork! They still do not want to pay!Aweful insurance! I want my money back!

Desired Settlement: Please, refund the money that I had to pay myself for my dog ******

Business Response: Your policy was purchased on 3/2/2014 and contains a 14 day waiting period, unless the pet is subject to an accidental injury in which case the coverage is subject to a 3 day waiting period.  Your pet's claim from 3/8/2014 falls well inside the 14 day waiting period.  The medical records obtained indicate that your pet began vomiting 4 days prior to the visit, placing the manifestation of the claimed condition on 3/4/2014, only two days after the policy was purchased and inside either waiting period.  As such the claim was properly denied as pre-existing the purchased coverage.

Consumer Response:

No, you got all the info. wrong! The puppy ate the inside of the blanket that day. Thats why we went to the doctor!

He could not eat or poop! This is definitely an accident!

It didn't happen 4 days before! *** *** *******

I wouldn't even use your insurance at my doctor if it wasn't an accident!

I paid for the visit to the doctor one week before, even when i didn't have your insurance for my dog's vaccinations, check up and

physical and neutering!

I used your insurance for this particular accident!



Better Business Bureau: 

I have reviewed the response made by the business in reference to complaint ID 10045086, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below. 

[To assist us in bringing this matter to a close, we would like to know your view on the matter.] 

Regards,

Ludmila Vosky

 

 

Business Response: Good morning.  If you have further information to submit substantiating your claim, please go ahead and send in an appeal as is outlined in your policy form and we will be more than happy to review it.

6/3/2014 Billing/Collection Issues | Read Complaint Details
X

Additional Notes

Complaint: They would not pay for dental service on my dog because they could not find past information on my dog from the ***** that neutered him. That is not my fault. I asked for a full refund of all the money I paid them and they denied it. Because the ***** can't find his neutering file, Pets Best will not pay anything. If I had known that I would not have paid over $180 in premiums.

Desired Settlement: I would like my 3 months of Premiums refunded or my legitimate claims paid out.

Business Response: *** ******* filed several claims for an undiagnosed skin disease that presented during the policy waiting period, and another claim for dental disease that is generally excluded from policy coverage.  In an attempt to try and find a way to see if the claim was in fact payable we have been trying to receive medical records that might indicate that the claim is something other than what it appears to be, an excluded condition.  Unfortunately we have been unable to contact his veterinarian as the phone number we have been given is never answered. *** ********* policy has already been cancelled at his request, but if he can send in any further documentation showing a compensable diagnosis for his claim we will be happy to reprocess it.

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference to ********* ** ********* and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

Pets Best spoke to the vet many times. It was a dental cleaning and some teeth extractions. My vet forwarded all the needed documents.  The ***** that neutered my dog about 18 months ago lost his file. What does a neutering that took place 18 months ago have to do with dental work. And it is not my fault the ***** has lost a file. Please refund all my money or pay my claims.

Regards,

***** *******

 

 

Business Response: We cannot issue a refund for coverage that was in effect.  If you send in medical records showing that your claim is not for an excluded condition we will be happy to reopen your claim.

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference to ********* ** ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

Forms have been sent weeks ago. This is just another tactic to avoid paying out a claim. Please check your records and pay the claim or refund my money.

Regards,

***** *******

 

 

Business Response: The attached documents are not medical records, they are receipts.  Most of them seem to be for an unrelated condition and none contain the diagnosis required to show your claim as compensable.  If you have further information to send in to substantiate your claim, please go ahead and send it to our office along with an appeal form and we will be happy to review it.

5/20/2014 Billing/Collection Issues | Read Complaint Details
X

Additional Notes

Complaint: I have always had ALL of my pets shots reimbursed. To my surprise it was NOT! Also my plan has increase over 60 PER MONTH!!! I never agreed such a huge increase and a loss of money. I am very upset with this company and their shady doings. I have had this for several years and this is the 1st time i have had issues. I am very upset, i want the money back for the shots for the two cats. And someone needs to fix my plan asap! I had it where it was 101 a month for coverage for all the pets wellness and the dog had extra because of his teeth.

Desired Settlement: I want my refund for the two cats and someone to fix my policy the way it was before, there should be no way it increased 720 dollars more a year!!!!! I haven't changed anything with my plan and this is unacceptable.

Business Response:

Rates are set by the policy underwriter, ************ ******** ********* *******, and are filed and approved by your state's Department of Insurance before they go into effect.  Your policy has been subject to a rate increase due to the inflation of veterinary medical services combined with the aging of your pet.  Just as is the case with human health insurance, the older a pet is the more expensive health insurance becomes.  These rates are not something that Pets Best has any control over.  We understand your frustration, but are pleased to remain your pet health insurance provider.

4/3/2014 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: Hi,thanks in advance for your time. I have been with Pets Best Insurance for many years now and have a cat with a chronic condition called rhinitis. Within the last year my policy amount has tripled from 29.99/mo to now over $89 /mo. Along with this enormous rate increase I am now having great difficulty in being reimbursed for my claims even though they are very straight forward as it is a recurring medication that my cat receives.I am currently in the UK tending to a family matter but Pets Best claims to cover worldwide so this should not be an issue. I have sent my documents SEVERAL TIMES now in digital format yet Pets Best is claiming they cannot read my documents. I can only say that this is not a valid excuse to withhold settlement of the claim as the documents are CLEARLY LEGIBLE as you will see from my attached files.

Desired Settlement: I am requesting immediate settlement of my claim. The claim total as follows, and rest assured Pets Best has all of the supporting documents for this claim in the form of receipts from both my vet and the issuing pharmacy. The amount in British pounds is 98.05 which converts to approx $160.80 (depending on exchange rate on the day.)Thank you again kindly for your time in helping me resolve this claim.sincerely,Natalie Gray

Business Response: These documents appear legible to me.  I will forward them on to the claims processors for immediate handling.

3/25/2014 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I submitted a claim for reimbursement for health care services for my dog. PBI delayed payment by requesting records. They then denied a portion of my claim, my dog had a CT scan & dental cleaning. Without support from medical documentation or *** statement, the assumed that 1/2 of the charge of the anesthetic required for the CT scan was for my dogs dental cleaning. In support of my appeal, my *** wrote a letter that explained that 100% of the $140.67 billed for anesthesia was for the CT scan - it is a minimum fee for said procedure. Despite receiving medical records previously, PBI waited 30 days with no additional contact to my *** concerning surgical minutes, yet denied my claim for lack of anesthetic minuets. They didn't try to obtain the information for the presumptive denial. And they have disregarded the written statement from the *** that performed said procedure. I want the remainder, $70.33 paid as supported by my ***, yet denied by the adjusters who don't have any idea what went on that day.

Desired Settlement: Payment of the $70.33 that was initially denied with no factual basis in the first place. (less the 20% co-pay of course).

Business Response:

*** ****** filed a claim for two separate procedures performed under anesthesia, one which was compensable and one which was a direct policy exclusion.  As such, the anesthesia charge was split between the two procedures, and *** ****** was compensated for one half of that particular charge.  *** ****** is well aware of Pets Best / Independence American Insurance Company claims processing guidelines and procedures as she is an ex-employee of Pets Best, who previously worked as a claims adjuster for several years.  As she has indicated that she has filed a complaint with the** ********** ** ********* regarding this matter, she is already very well versed in the nuances of the policy contract, and is not claiming confusion or a misunderstanding as to the policy benefits, I see little more that I can offer her via this channel of communication.  Her concerns are being dealt with on several other levels at this time. 

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ** *******, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

After reading the review, I am certainly still unsatisfied with the response by PBI. I am a former employee, and left the company on good terms. I have no idea why this has baring on my as a policy holder now. I left the company almost a year ago. While employed there, the adjusting practices were changed / modified on a monthly basis, so I'm confused as to why the PBI representative would suggest I would be familiar with the new adjusting practices. While working there, claims were adjusted to give the policy holder the "best benefit"; meaning, anything that wasn't a direct policy exclusion was paid for. At the time of my employment, if anesthesia was billed as a single line item, even when combine with a non-compensable procedure, we were directed to pay for the entire cost of the anesthesia. On a previous claim for my dog ******** who is also insured, the denial of the anesthesia was overturned and paid for after my first appeal with only some explanation by myself, no *** statement was required. Concerning my current claim, and my complaint, my *** has provided a letter explaining that the anesthesia was strictly for the CT (the compensable procedure), and unrelated to the dental cleaning (the non-compensable procedure). This statement by the *** was disregarded by PBI upon review of my appeal.

I will be submitting a third appeal with additional support from multiple veterinarians. The inconsistency in PBI's adjusting practices is ridiculous, and policy holders shouldn't have to go to these lengths to have adjusters that have no medical degree, override the statements of DVM's.

******** ******** ******

 

 

3/20/2014 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: Hi There,We contracted for this company to be our "pet insurance" firm against everybody's recommendation that "Pet Insurance companties" were ******* as we had been advised again and again.We should have listened.We ordered pet insurance from this company in January to which they told us over the phone that it would be no problem to set up insurance for our new puppy Pixie.We took pixie to the vet not too long after because she had developed some pinkish bumps resembling mosquito bites on her skin. It turned out that pixie needed to be scraped for skin mites and such.After paying $400.00 of investigative services, we then filed the claim with Pet's Best insurance company whom, like expected by everybody else but not us, immediately denied the claim.Their reasons for denying the claim for a 3-4 month old puppy, were as follows:1. No accurate medical history. (We picked her up in ***** from a family that had a litter.)2. Pre-existing medical condition. (She developed demodectic mange which apparently occurs at birth...) The website NOWHERE says that Demodectic mange is not covered. Mind you, we called the insurance company prior to putting her through these tests to determine what was wrong with her - something "new" to us, but apparently a pre-existing condition and we were assured that these skin scrapings and such were definitely going to be covered.3. Despite the fact that their website does not say an animals "birth conditioned genetic illness" is not covered, they've decided that it isn't... and on top of everything else, they're not going to give us our money back as we asked to cancel our policy. On top of being out $400.00 in testing that Pets Best told us was included in our policy, we're also out $50/100.00 for the monthly payments.Pet's Best is absolutely a terrible company to do business with. They do not care about their patients, or the people who are paying them for their services, and they're only out to steal from americans who cannot afford to pay legal fees

Desired Settlement: We would like to have our tests paid for, that we were assured would be covered and/or our money refunded as the insurace company has told us they will never pay for anything that has to do with her permanent health condition. They also insisted we needed to provide 12 months of medical history on our pet despite her being 4 months old.

Business Response: Good afternoon,

 
Your policy was purchased on 1/14/2014 and has a 14-day waiting period that expires on 1/28/2014.  Any conditions showing symptoms during this waiting period are deemed pre-existing to coverage and denied.  This exclusion is outlined in your policy form under exclusions, and on our website here:  http://www.petsbest.com/pet-insurance-plans/not-covered.  
 
On 1/28/2014, the day that the waiting period expired for your pet, she was taken to Durango Animal for the claimed condition.  At the time of this visit you referred to your purpose for the visit as a "second opinion" on the skin condition and indicated the pet was already on a prescription medication to treat it.  As this indicates that Pixie was clearly being treated during the waiting period of the policy the claim was appropriately denied.
 
We apologize that this outcome is not the one that you would have preferred, but we are under an obligation to adjudicate claims appropriately per the policy you entered into with ************ ******** ********* ********

3/10/2014 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I contacted customer service twice regarding a billing issue, both times I receives less then poor service. The first time I contacted them they could not explain why my billing charge jumped up 50%. She then process a payment on my card without authorization. I noticed that another charge went through for the same amount so I called back, this time I was told there was nothing I can do except dispute the charges with my bank and cancel the policy. I asked to speak with a manager, she said she was a manager so I asked to speak with someone above her and she said there was no one above her. The call ended with my policy cancelling and the rep hanging up on me and I have $120 worth of unauthorized explainable charges.

Desired Settlement: $120.00

Business Response: We have reached out to the policyholder directly and resolved the issue to mutual satisfaction.  If this is not the case, please let us know.

2/13/2014 Billing/Collection Issues
1/27/2014 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: Contacted PB a few months ago because our dog-who was on their plan since she was 6 weeks old-had chronic anal sac issues and needed to have them removed, they said this was a covered svs and suggested we file a pre-auth. We did and they denied it.I called and was told it was because my vet had "put in his notes that it was only for owner convenience". I called my vet, got the records and that was never said anywhere in the notes. Called back and said, no the real reason it was denied was because she was not seen enough times. Asked for clarification and was told needed to be 3 visits in the last 18 months. Proved medical records that showed 11 times in the last 18months she was seen for same issue. Then was told no, the real reason is because our vet needs to say its medically necessary.Took her back in, vet looked at her again, said she has the same issue and wrote in the chart notes-removed recommended due to chronic leakage and other issues. Submitted a new pre-auth with this info. Was then denied again. Called again and was told no, know its denied because she hasn't been seen recently enough, pointed out she was seen 4 days prior. Oh, know it's because she hasn't had enough inf's. Pointed out that was because we were proactive in keeping her clean and getting them cleaned out, and had a note stating this from our vet. Was told basically too bad. Asked to talk to claims dept who denied it, was refused and told they don't talk to anyone because then they might change their denial, asked to speak to a supervisor, was refused. Asked to get paperwork from individual ins plan outlining where it says 3 infections instead of 3 treatments for same issue and was denied.

Desired Settlement: Would like to have PetsBest cover this service as outlined in our insurance plan. We have done everything they asked and she has met all criteria they have come up with each time they deny the claim.

Business Response: This claim has never been denied as it has never been submitted.  The claim does not qualify for the pre-authorization procedure that we offer as a convenience for some claim types.  As this particular claim falls inside a specific policy exclusion against anal sac removal it cannot be pre-authorized and can only be adjudicated on its merits once the procedure has been completed and the claim filed with the records from the procedure.

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID *******, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

The response states that this procedure cannot be pre-authorized, however 4 people at their company have told me otherwise and they are the ones who suggested it in the first place.  There is no way to apply for the pre-auth process unless someone within PetsBest sends you the application, so why was I never told by anyone that they could not send me this form since I could not get it pre-authorized due to an exemption? 

Secondly, the response states that this procdure is exempt from coverage, however there is NOWEHRE in my policy wherre I find that and I have asked numerous times to get that in writing. 

Therefore, the response from PetsBest is unacceptable and in no way gives concrete eveidence that this procedure cannot be covered nor a concrete reason that if they do cover it, my pets condition does not fall under the criteria.

 

Regards,

 

******* ******

 

 

Business Response: Page 9 of your policy forms states:


"Exclusions Applicable to All Plans:

We will not be liable for paying any of the following:

13.  Preventative and elective procedures, including, but not limited to: tail docking; ear crops; nail trims; declaws; dewclaw removal; elective gastropexy; and anal gland expression and removal. "

The individuals in customer service sent you a pre-authorization form because you requested that service.  Sending a form does not guarantee that a pre-authorization will be approved, it only gives you the option of sending the claim to the Claims Department for handling by a claims professional.  We are sorry that your pre-authorization could not be approved, but we strongly suggest you send the completed claim in after the procedure has been performed.

1/8/2014 Billing/Collection Issues
12/24/2013 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: My dog had a patellar luxation and tore her cruciate ligament injury and had surgery to fix both. I was billed $2,293.91. Pets Best does not cover patellar luxations because it is a "congenital disorder," and they only reimbursed me for half of the surgery. I understand that they won't pay for the whole surgery, but I believe that they should at least pay for all of anesthesia, IVs, etc. After all, if my dog only had the cruciate ligament injury surgery, they would have had to reimburse me for the whole thing. I emailed them several times with regards to my concerns (November 27, December 3, December 4, and December 11, 2013). They got back to me the first 2 times within the same day, or at the latest the next day. However, when I contacted them the third time (December 4th), they did not get back to me at all and I had to email them again on December 11th. When they did reply, I felt that they were very condescending and I was very disappointed with the way they handled things. I did request to cancel my policy with them on December 11, 2013.

Desired Settlement: I would like them to reimburse me for the total amount of all the other items on the invoice, not just half. However, I'm sure that they won't. After all, they are an insurance company, and while they should be there for the policy holder, they aren't. They just want us to pay premiums and never really want to hold up their end of the deal.

Business Response: Surgeries to correct patellar luxations are specifically excluded from policy coverage as a congenital condition that by definition pre-existed the coverage.  Pets Best took the anesthesia and other charges that were related to both procedures and split them in half and covered one half of the charges.  It is the industry standard to apply the entirety of the charges to the non-compensable surgery and deny 100% of them.  We feel that we have acted fairly, and that Pets Best goes above and beyond in matters such as this.


Customer Review(s)

The customer review(s) below are un-filtered. These positive and negative reviews are not used in the calculation of the BBB Rating. If you wish to file a complaint and request a resolution to your issue please click here. This customer review section is not BBBs complaint resolution system. Customer Reviews are the subjective opinion of the individual who posted the review and not of Better Business Bureau. A customer review is not posted on a business if a BBB complaint on the same issue(s) is also filed. BBB cannot guarantee the accuracy of any customer review and is not responsible for the content of any customer review. Public comments are not customer reviews.

Customer Reviews Summary

12 Customer Reviews on Pets Best Insurance
Neutral Experience (0 reviews)
Fusion Chart
Fusion Chart