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Description

Medical insurance for cats and dogs.


BBB Accreditation

A BBB Accredited Business since

BBB has determined that Trupanion 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 Trupanion include:

  • Length of time business has been operating
  • Complaint volume filed with BBB for business of this size
  • Response to 71 complaint(s) filed against business
  • Resolution of complaint(s) filed against business


Customer Complaints Summary Read complaint details

71 complaints closed with BBB in last 3 years | 29 closed in last 12 months
Complaint Type Total Closed Complaints
Advertising/Sales Issues 7
Billing/Collection Issues 11
Delivery Issues 0
Guarantee/Warranty Issues 5
Problems with Product/Service 48
Total Closed Complaints 71

Customer Reviews Summary Read customer reviews

20 Customer Reviews on Trupanion
Customer Experience Total Customer Reviews
Positive Experience 1
Neutral Experience 1
Negative Experience 18
Total Customer Reviews 20

Additional Information

BBB file opened: July 10, 2008 Business started: 02/01/2000 Business started locally: 02/01/2000 Business incorporated 04/30/2007 in DE
Licensing, Bonding or Registration

This business is in an industry that may require professional licensing, bonding or registration. BBB encourages you to check with the appropriate agency to be certain any requirements are currently being met.

These agencies may include:

Washington Secretary of State
801 Capitol Way S, Olympia WA 98504
http://www.secstate.wa.gov/corps
Phone Number: (360) 725-0377
corps@sos.wa.gov

Type of Entity

Corporation

Business Management
Mr. Darryl Rawlings, CEO Ms. Ronaye Verigin, Vice President of Customer Service
Contact Information
Principal: Mr. Darryl Rawlings, CEO
Customer Contact: Ms. Ronaye Verigin, Vice President of Customer Service
Business Category

Insurance Companies Pet Health Plans

Products & Services

Trupanion sells the following brand(s): Trupanion

Trupanion offers the following product(s): Medical Insurance for cats and dogs.

Method(s) of Payment
ACH, Visa, MasterCard, AMEX, and Amazon Wallet
Refund and Exchange Policy
30 day money back guarantee, if no paid claim has occurred within the first 30 days of enrollment.
Alternate Business Names
Trupanion, Inc Vetinsurance International, Inc VetInsurance Managers Inc

Customer Review Rating plus BBB Rating Summary

Trupanion 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

  • 907 NW Ballard Way Ste 100

    Seattle, WA 98107 (888) 738-7478 (800) 569-7913

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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)

9/13/2016 Problems with Product/Service
9/10/2016 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: I joined Trupanion in March 2016 during which i signed papers that indicated that i would have a 30day period of wait before any insurance claims would be accepted by the insurance company. During the 30days my dog did catch Giardia and his claim was rejected (as expected) however since then Its been 7months and the insurance company continues to reject any Giardia related health issues calling Giardia (a conman aliment in WA) as a "pre-exitsing condition". No amount of reasoning has seemed to resolved this either from the Veterinarian at Bellevue Animal hospital or from me. Not to mention the first time i called the "helpline" they were rude to me because of my accent. the second time i called, the supervisor Adrienne R****** threatned me by sending me a email that claims that my Policy is cancelled. I am filing a lawsuit against trupanion if they continue this type of robbery and if you are going through the same thing please reach me on my email ******************

Desired Settlement: I would like a refund of my Premium that started since March 2016 thats $200 returned This is not just about insurance its about ethics. My April hospital bill was $300 which i paid and my claim was reject and i understood Trupanion's reasoning. TODAY however in July how can the company reject a claim stating that its in the 30day wait period since March. this 30day wait period never ends

Business Response:

 


Date: 8/4/2016

BBB case ID #********

Policy # ************

Complainant: ***** ******

We have received the complaint filed by Ms. ****** and have reviewed the concerns presented here. We have been in contact with her and are currently waiting for her to advise us on how she wishes to proceed with her concerns.

With the Trupanion policy, all claims are adjudicated based on the notations in the pet’s medical records, therefore if a condition such as Giardia, was symptomatic prior to the policy inception or during the five day waiting period for accidents and 30 day waiting period for illness’ Trupanion would have to deem the condition or injury ineligible for coverage, as we would consider it pre-existing and the policy does not cover pre-existing conditions.

The most recent claims reviewed by Trupanion pertaining to Giardia were considered ineligible due to medical records received from Bellevue Animal Hospital;

Bellevue Animal Hospital on 4/07/16, during the initial 30 day illness waiting period: “Roundworms have resolved but now positive for giardia. Not shedding so poss [possible] that pt [pet] is not infected but as he is a puppy do recommend treating with another round of panacur.”

• 4/19/16: “Gastrointestinal: very liquidy diarrhea for 2 days now…”.

• 4/19/16: “All of PE [physical exam] good with the exception of Liquid Diarrhea – light brown in color. Bar [Bright, alert, responsive] although a little quieter than his normal. Ate Breakfast Normally this morning. No vomiting at any point. Had Giardia 2 weeks ago on a fecal – was on a panacur Course”


Trupanion deemed this claim to be ineligible under Section 7.a.1 and 7.b.1 of our policy document:
7.a.1 Illnesses that occur or recur within the first 30 days of the policy enrollment date (or from policy enhancement date)
7.b.1 Illnesses for which any evidence and/or symptoms of their potential manifestation already exist at, or prior to, the policy enrollment date.

Ms. ****** enrolled in the Trupanion policy on 3/20/16, which means Ms. ******’s waiting period for illness expired after 4/19/16. The notations from ******** ****** ******** were present during the stated 30 day illness waiting period and the onset of symptoms began at or near the date of enrollment.

Giardia is an infection that can be treated and resolve. We want Ms. ****** to know that future instances of this condition may be eligible. Trupanion would need to see a clear resolution to the claimed instance of Giardia before we would be able to consider it for coverage in the future.

Upon review of Ms. ******’s phone call with a Trupanion supervisor, she requested to cancel and receive a full refund of premiums. While Trupanion is not able to offer a full refund, as she is paying for the service of insurance should her pet need to utilize the coverage. Should an owner wish to cancel, a prorated refund of premiums based on the cancellation date would be issued. To authorize cancellation, the Trupanion supervisor sent an email to the confirmed email address on file asking Mrs. ****** to confirm her request to cancel in writing. There may have been a miscommunication with the email provided by Trupanion, as Ms. ******’s policy does remains active and intact, until Trupanion receives a reply to the cancellation email to confirm the cancellation request in writing.

We understand Ms. ******’s concerns and are waiting to hear from her to see if she wishes to pursue her claim concern’s further. We wish her and **** the best!

Sincerely,

Kesa- Trupanion

Consumer Response:


Complaint: ********

I am rejecting this response because: I have not recieved any calls or communications regarding this issue. Your company is causing alot of financial problems in my life

 

you should be ashamed of your treatment

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

Consumer Response:

There has not been any action taken from Trupanion side to resolve my issue

Complaint: ********

I am rejecting this response because:

Sincerely,

***** ******

Business Response:

Date: 8/29/2016

BBB case ID #********

Policy # ************

Complainant: ***** ******

Trupanion has received the rejection of our response to Ms. ******. One of our senior supervisors has been in contact with her and we are waiting to hear if she wishes to have us proceed with gathering updated information from her veterinarians in attempt to appeal the giardia claim as well as open a new claim for ****** recent ear infection.

In the meantime, *** ****** has opted to cancel her Trupanion insurance policy. In an attempt to help, our senior supervisor has reached out to Ms. ****** to confirm this is how she would like to proceed. Ms. ****** confirmed that she would no longer like to keep ****** insurance active. Per Ms. ******’s request, the Trupanion policy has been cancelled effective 8/26/2016 and a confirmation has been mailed and emailed to her, advising her of the cancellation date and prorated refund issued.

If Ms. ****** should need any further assistance, she can feel free to reach out to us. We wish Ms. ****** and **** the best.

Sincerely,
Kesa - Trupanion


9/9/2016 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: Request for the last 3 monthes to cancel my policy and they keep reinstating. They continue to request payment and call me over and over. I have emailed several times and called requesting to cancel but they reinstate policy and request payment.

Desired Settlement: Cancel my policy and receive no further harrasment to reinstate policy.

Business Response:

Date: 8/10/16

BBB case ID #********

Policy # ************

Complainant: ***** ************

Trupanion has received the complaint from ***** *********** in regard to the cancellation request. Per Mr. ***********’s request, we will not reach out to him to discuss the matter further. We apologize about any inconvenience the cancellation process may have caused. After review of the policy, we show that the date of the original request for cancellation on 7/29/2016 was honored and no further payments will process.

We believe there may have been a miscommunication in regard to the cancellation process as the phone calls mentioned in the complaint were automated calls regarding past due payments. The policy did remain active while we attempted to allow Mr. *********** the opportunity to bring his account current.

The policy cancellation was finalized the same day his complaint was sent and will result in no further payments on the account. Trupanion has emailed and mailed confirmation of this cancellation request. Trupanion believes this matter has now been resolved and await a response from Mr. ********** as to his satisfaction in this matter.
Sincerely,
Kesa – Trupanion
(855)210-8746


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

I am rejecting this response because: The harassment letters and calls seems to have stopped at  this time, I don't know if BBB contacting them helped in this matter Let's wait and see what happens

Sincerely,

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

9/7/2016 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: I filed a few claims with them that are from my dog's ***** sack infection this year(May). They decline the infection because they are stating this year's ***** sack infection is related to last year's infection (I signed up for the policy early this year). I told them the medical record shows last year's infection was resolved so this year's infection should not be related to last year. I wouldn't take the record into account, they also would take what the vet was stating into account. And on top of them, they were not responding to emails at all. I had sent them several emails and called them 3 times just to submit the appeal form. And now I just got new information that last year's ***** sack infection and this year's ***** sack infection were not even on the same side. one was on the right and one was on the left, these infections were not even on the same area so they are not the same infection. I emailed their appeal specialist again stating them and was shocked to hear from her that she already knew that information. but she still declined the appeal. 1. They were not responding to me at all when I was trying to submit the appeal form, they never declined me to submit my appeal form but to me, not accepting/responding to my appeal form is the same as declining it. How can you decline a customer to submit the appeal form? One of the rep on the phone told me if they do not see any claim number or policy number on the emails customers sent(which I did have those on the emails i sent), they would just delete the email (How can you delete your customers emails without responding?!) 2. At this point, I believe they are declining claims regardless of what the medical record show and what the vet is stating. Which to me feels like I have been scammed. I have proofs the 2 infections are not related and they do not have proof the 2 infections are related.

Desired Settlement: They need to go by their policy, decline/accept claims based on what the medical record is stating and what the vet is stating. And if they want to decline a claim, they should have evidence to prove it and not just saying what they "believe"

Business Response:

Date: 8/30/2016

BBB case ID #********

Policy #************

Complainant: ****** ***

Trupanion has received the complaint from Ms. *** in regards to the outcome of her most recent claims. We understand her concerns regarding the outcome of the secondary review. Based on the most updated information available, we show that an independent third party review is currently being assessed in regard to this claim. This third party review is an opportunity for a neutral specialist to review the details of the case as they pertain to the pet’s condition and make a determination based on their findings. As this third party review is still in process, we are unable to speak to the outcome at this time.
Per Ms. ***’s request, a claims manager has left a voicemail and sent an email to set up a time to discuss the claimed condition further.
We want Ms. *** to know that we understand this is a difficult condition and we hope that her discussion with our claims manager is helpful to address her concerns. Once the independent third party review is finalized, a full report along with the outcome will be sent to Ms. *** via email.
We wish Ms. *** and her dog the very best. Please feel free to reach out to us if we can be of any further assistance with this matter.

Sincerely,

Kesa – Trupanion


9/3/2016 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: I cancelled by policy by phone (Trupanion acknowledges this fact) in January 2016 and was assured by the customer service agent that I would not be billed anymore. Trupanion alleges that they tried to contact me again to automatically "uncancel" my policy, but I have no record of this. Since then they have placed an additional $357.90 in unauthorized charges on my credit card which they refuse to reverse, even though I did not use their services at all during that period and they have record that I said I no longer wanted to pay for the service. Their reversal of my cancellation and unauthorized charges on my credit card for services that I did not use have placed a difficult financial burden on my family.

Desired Settlement: I would like a full refund of $357.90 plus 14.9% monthly APR for UNAUTHORIZED charges on my credit card for a service that I cancelled.

Business Response: Date: 8/26/2016

BBB case ID #********

Policy #************

Complainant: **** *****

Trupanion has received the complaint from Mr. ***** in regard to the cancellation request. We contacted Mr. ***** via phone, August 23rd 2016 to explain the cancellation process. After discussing the policy guidelines for cancellation, we determined proper procedure was followed. We believe the conversation with Mr. ***** helped to resolve his concerns.

The policy cancellation was finalized the day we received the request to cancel in writing, July 26th 2016. This cancellation will result in no further payments on the account. Trupanion has emailed and mailed confirmation of his policy cancellation and prorated refund. We believe this matter has now been resolved and will await a response from Mr. ***** as to his satisfaction in this matter.

Sincerely,

Kesa – Trupanion

Business Response: Date: 8/26/2016

BBB case ID #********

Policy #************

Complainant: **** *****

Trupanion has received the complaint from Mr. ***** in regard to the cancellation request. We contacted Mr. ***** via phone, August 23rd 2016 to explain the cancellation process. After discussing the policy guidelines for cancellation, we determined proper procedure was followed. We believe the conversation with Mr. ***** helped to resolve his concerns.

The policy cancellation was finalized the day we received the request to cancel in writing, July 26th 2016. This cancellation will result in no further payments on the account. Trupanion has emailed and mailed confirmation of his policy cancellation and prorated refund. We believe this matter has now been resolved and will await a response from Mr. ***** as to his satisfaction in this matter.

Sincerely,

Kesa – Trupanion

8/27/2016 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: I purchased this pet insurance and would like to now cancel it. I sent three emails requesting that the company cancel the policy and send me a pro-rated refund and asked that they stop withdrawing the monthly premium from my bank account. My first email was sent to them on August 08, 2016 whereby I asked that they cancel the policy effective midnight on August 09, 2016. My second email was sent on 08.15.2016. My third request was sent on August 19, 2016 where I not only reminded them I had sent two prior requests and told them to stop withdrawing monies from my account, I also threatened to contact the attorney general's office if they did not comply. I guess I am starting with you, the BBB. I called my bank a few moments ago. This company withdrew $57.46 on August 19,2016. How can I resolve this?

Desired Settlement: I want the policy canceled as of August 08, 2016 and a pro-rated refund returned to me. Additionally, I want the $57.46 fully refunded.

Business Response: Date: 8/25/2016

BBB case ID #********

Policy #************

Complainant: ******* *****

Trupanion has received the complaint from ******* ***** in regard to the cancellation request. Trupanion has been in contact with Ms. ***** on the phone today, August 25th 2016 to explain the cancellation process.

The policy cancellation was finalized the date requested by Ms. *****, August 9th 2016 and will result in no further payments on the account. Trupanion has emailed and mailed confirmation of this cancellation as well as details of the prorated refund issued. We apologize for the inconvenience Ms. ***** experienced and believe this matter has now been resolved. We await a response from Ms. ***** as to her satisfaction in this matter. We wish Ms. ***** and her dog the best.

Sincerely,

Kesa – Trupanion

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.

Sincerely,

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

8/17/2016 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: My dog received treatment from the Vet on May 23, 2016 for an infection that was in his folds and under his eye. Trupanion, our vet insurance, denied coverage saying the condition was pre-existing. They said that because he had dermatitis before coverage date of October 2013, that this condition was pre-existing. I explained that an infection that this was clearly a separate episode of dermatitis as it is three years later, and more importantly, an infection that developed in May 2016 could not have pre-existed coverage. However, they still are denying coverage.

Desired Settlement: I want them to pay for the visit. The amount is $273.79

Business Response:

Date: 7/7/2016

BBB case # ********

Policy # ************

Complainant:  ***** *******

 

We have received the complaint filed by Ms. ******* and understand her concerns in regard to her dog’s ineligible skin infection claim. Upon the initial review of the claim, Trupanion found that signs and symptoms consistent with the claimed condition were present prior to her policy coverage beginning. In October of 2013 it was noted in the pet’s medical records that the pet had skin issues. In May of 2016 the pet presented for an infection of the skin in a different location. Based on the definition of pre-existing conditions outlined in the Trupanion policy we found we were unable to extend coverage to this claim.

We discussed with Ms. *******, on the phone and via email on several occasions in late June to explain to her why we were unable to extend coverage and how to appeal the claim to have it re-reviewed.

On June 23, our Appeal specialist spoke with Dr. G******, who is treating the pet, to get clarification about the pet’s issues and we received a formal letter of appeal from him which was attached to the policy on 7/1/2016. We are in the process of having the claim re-reviewed with the additional clarification Dr. G****** has provided.

Because there are many medical conditions that have similar signs and symptoms, we must look at the medical relationship that may exist when there are the same or very similar signs and symptoms that are present both pre- policy and post- policy. If we cannot make this medical disconnection, we must uphold the decision that the claim is ineligible. If we are able to determine that there is a medical disconnection between the signs and symptoms then the claim can be overturned.

At this point in time the claim is being re-reviewed and as soon as the claims team is able to make a decision based on the clarification that Dr. G****** has provided, we will email an outcome letter to Ms. ******* to advise her of the details of the appeal outcome. Since this is still in process, I cannot advise on the outcome or speculate as to what that will be.

We understand that Ms. ******* has been frustrated by this issue and we want her to know that we are working toward a resolution of this claim. We wish her and her family the very best.

Sincerely,

 

Amber S. - Trupanion

1-888-733-2685


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

I am rejecting this response because: 

My vet responded to Trupanions denial as follows:

 

To Whom It May Concern:

 

I am writing on behalf of our mutual clients, **** and ***** *******, regarding your denial of their claim for services relating to ******* right facial skin fold dermatitis diagnosis and treatment.

 

The claim was apparently considered a pre-existing condition based solely on a notation in the medical record from 39 months earlier indicating a finding of facial acne/pustular dermatitis (aka “puppy acne”) on March 6, 2013.  Puppy acne is a common presentation of young dogs; especially brachycephalic breeds who tend to be messy eaters.  That presenting complaint on the ventral muzzle resolved quickly and has not recurred since.  I believe your interpretation of this notation is in error, and that ******* case warrants reconsideration.

 

The presumption that ******* puppy acne in March, 2013 is the same pathology that was identified and treated in a different location on the head in May, 2016 is a ludicrous and medically unsound theory.  While there may or may not have been any association between the two incidences in light of general breed dispositions, this is a clear overreach of interpretation with no firm medical basis to back it up.  The medical evidence of such a relationship between these two clinical presentations simply does not exist.  We all recognize that as a Pug, ***** is likely to have a mechanical predisposition to hygiene-related skin inflammation and infection.  However, if and when these episodes do occur, they are in themselves independent and unrelated to previous incidences.

 

I strongly disagree with the medical basis of Trupanion’s judgment in this case; and I would urge you to reverse your denial of this claim for coverage.

 

I have historically been comfortable recommending Trupanion to my clients as a reliable and fair pet insurance provider.  Cases like this, however, raise serious concern and cause me to doubt my faith in your company’s integrity.  I have been both disappointed and aggravated by Trupanion’s position “creating” pre-existence where there is none, and the baseless and inane arguments your representatives have made both to me and to our clients to defend these indefensible judgments.  I look forward to an honorable and satisfactory resolution to this case for this family, and an opportunity to restore my own faith in your company going forward.  Please do not hesitate to call me if you have any additional questions regarding this case.

 

Thank you very much.

 

Sincerely,

Dr. Raphael G******

Mamaroneck Veterinary Hospital

914-777-0398

 

Thereafter, I received an email from trupanion that said the following

 

Upon review of the records I have found that we unfortunately remain unable to extend coverage for this claim. ***** was noted to have facial pustular dermatitis on his muzzle which continued post-policy, and was noted to recur several times. Since enrollment ***** has also been noted to have recurrent ear infections, as well as pruritus of the face and feet. Given the continuum of clinical signs and their frequency I was unable to fully differentiate the claimed condition as having no potential relationship to the clinical signs noted prior to enrollment.

Please refer to the following policy exclusion(s):
9.B.i Illnesses or injuries for which signs or evidence of their potential manifestation existed within the 18 months prior to the policy enrollment date

Other: Ineligible Items

 

9.D.i We do not cover the costs, fees, or expenses associated with: Examinations;

$71.00

We understand that this is not the outcome you were hoping for, and should you have any additional questions or desire more information, please don’t hesitate to contact us. We are here to help you 24 hours a day, seven days a week.

 

 

as I explained before - I think their response has no merit and is unacceptable to me as a consumer.  does it make sense that if a dog has an infection on his skin and then gets another separate infection years later - that they are related??? imagine if I went to my doctor and said I had a sore throat and then 5 years later went back with another sore throat and the insurance company disclaimed and said that I had a sore throat before so its pre existing. It clearly is improper what they are doing and that is why I am seeking the intervention of the better business bureau.  We appreciate any assistance that you could provide.

 

 

 

 

Best,

 

***** B. *******, Esq., of counsel

EBANKS & *******, LLP

Attorneys for Plaintiffs

20 Vesey Street Suite 503

New York, New York  10007

(212) 766-4411 (office)

***** ******** (mobile)



Sincerely,

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

7/28/2016 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: Policy Number: ************ Claim ID: ******* v. 1 I purchased insurance through Trupanion on March 26th, 2016. The salesperson, informed me that my insurance would cover 90% of my pet's future healthcare, but that there was a 30 day period where claims would not be refunded or covered. On May 16th, 2016, we brought our pet to the vet because she was having pain in her limbs when pressure was applied to them. After we filed a claim through the insurance, the denied our claim on the basis that our pet had a "pre-existing" condition. A few days before our pet was insured, we brought her to the vet because she was sluggish and refused to go on walks. Since this was our first visit at this vet, they recommended that we get Pet Insurance through Trupanion. The insurance company is saying that this is a pre-existing condition and is therefore not covered. On our visit at the vet on March 24th, the vet fully examined our pet and applied pressure throughout her body, but had no evidence of pain ANYWHERE. We went on a trip a few weeks later and left our pet with a relative (who is a licensed vet in South America) and she said that our pet would yelp anytime pressure was applied to her limb/paw. I asked them to re-evaluate my claim, which they did and denied my claim again. Also, the salesperson made no mention of pre-existing conditions not being covered or anything of that sort. I have requested a call transcript from Trupanion on two occasions including today with Molly C.

Desired Settlement: I disagree fully with Trupanion's denial of our claim and would like them to accept our claim and process the refund for our costs.

Business Response:

Date: 7/19/2016

BBB case # *******

Policy # ************

Complainant:  ****** *********

 

We have received the complaint filed by Mr. ********* and have review his concerns presented here. We have been in contact with him and are currently waiting for him to advise us on how he wishes to proceed with his concerns.

Mr. *********’s pet, ****, an 11 year old mixed breed dog had presented at the vet for limping in an unlocalised limb pre-policy on March 24, 2016. On March 26, 2016 **** started a Trupanion policy. Because the Trupanion policy does not cover conditions that showed signs/symptoms before the policy coverage becomes effective, we were unable to extend coverage for the visit on May 16, 2016 where the pet was again seen for limping, falling/tripping occasionally.

Trupanion reviewed this claim on an initial review and again on a secondary review (Appeal) and the original decision that this claim is ineligible as it is pre-existing to the policy stands.

These notes from the pet’s medical records show that there is a history of this issue that began pre-policy and has seemed to continue:

“From Banfield Pet Hospital-La Cienega:

• 01/04/16: O[wner] states that pet has lost some energy.

From Beverly Oaks Animal Hospital:
• 3/24/2016: She does not want to walk, she has a history of lameness in unlocalized limb. Tachycardia, anorexia, lethargy, hypertensive. Recommended blood pressure, bloodwork, ECG. Owners declined all diagnostics.

Post policy, the following notations also appear to be related to the claimed condition:
From Beverly Oaks Animal Hospital:
• 5/16/2016: Limping/falling occasionally – no specific limb per owner. Owner’s cousin is a vet in Peru and was pet sitting and she noticed a similar incident. Radiographs reveal Lumbar IVDD.”

Upon review of the medical records and appeal letter we have found as the current limping/falling over/IVDD cannot be fully differentiated as not being related to or a manifestation of the pre-policy lameness in unlocalized limb, we remain unable to provide coverage for this claim.

Mr. ********* asserts that he was not told by Trupanion’s sales person that the policy does not cover pre-existing conditions, Trupanion routinely advises policyholders of the exclusion to policy coverage, Mr. ********* was emailed policy documents at the inception of the policy. It is the responsibility of the policyholder to review these documents to become familiar with the coverage they have purchased and to contact us if they have any questions. Exclusion of pre-existing conditions is a standard in the Pet Insurance industry.

We understand Mr. *********’s concerns and are waiting to hear from him to see if he wishes to pursue this claim concern further. We wish him and **** the best!

Sincerely,

Amber S. - Trupanion

1-888-733-2685

7/22/2016 Advertising/Sales Issues | Read Complaint Details
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Additional Notes

Complaint: Here is a series of events that occurred: 6/30: Veterinarian visit and enrolled into Trupanion while in the exam room. Upon leaving I was given the certificate and instructed to call Trupanion within 24 hours to activate the certificate as the exam was done. No where printed on this certificate does it state that it must be activated at the time of enrollment. It's states "Activate this within 24 hours of the veterinary exam". I was well within the 24 hours. 7/1/16 0120 a 14 minute call from the time of calling to end with Trupanion regarding the certificate. I was told the $35 would be waived but the immediate start of coverage will need to be verified and I should receive a follow up in the morning via phone. That is half of what the certificate promises. It states $35 enrollment would be waived and the coverage starts immediately. It is confusing why one would be honored and not the other. 7/1/16 1640 I called, as no call was received. Spoke with Shantal who stated that the certificate would not be valid as I needed to call prior to midnight on 6/30. I could not dis-enroll and re-enroll my pets because the certificate would be "voided". A certificate they would not honor would be voided. This is contradictory information. The certificate which is well within the stated time frame. I was instructed that a call to review the 7/1/16 0120 phone recording would ensue to review the conversation and they would honor the stipulations stated in that conversation. I would receive a call within 24 hours with the decision. They would transfer this information to Erica L**, sales manager, and the pool manager for the phone call who's name was unknown at that time. 7/8/16 first notification (7 days later not 24 hours) via email (addressed to the wrong name) I have received regarding that follow up- and not by phone as I was told. No mention of the phone recording review was stated. Trupanion now states it needs to be activated at the time of enrollment.

Desired Settlement: I would like to cancel my policy and written notification was submitted to them today to Erica L** in response to the email she sent today. I notice the charge to the policy was also made after they made the decision that it needs to be at the time of enrollment. I would like a full refund as this is within the 30 days of cancellation period. I also would like Trupanion to correct their false advertisement and state within their advertisement/flyers that the certificates "must be activated at the time of enrollment within 24 hours of the veterinary exam" and not "activate this certificate within 24 hours of the veterinary exam". Further, review of phone recording conversations should be followed as stated to customers. In review of previous complaints, this is a repetitive complaint on behalf of Trupanion.

Business Response:

Date: 7/14/2016

BBB case # ********

Policy # ************

Complainant:  ***** ***********

We have reviewed the BBB complaint submitted by Ms. *********** in regard to her concerns. She enrolled her pets in a standard Trupanion insurance policy online on 6/30/2016 at 5:25 PM and 5:59 PM respectively. Standard enrollments have waiting periods before the coverage begins of 5 days for accidents and 30 days for illness.

On 7/1/2016 at approximately 1:30 AM Ms. *********** called our contact center and advised the representative that she had a promotional certificate (which would waive her waiting periods) that her veterinarian had provided her after her vet visit on 6/30/2016. This certificate was provided after she had already enrolled in a standard policy online.

Ms. *********** was advised by our agent that she would reach out to a manager to see if we could add the promotional code to her policy and would follow up to advise her. On 7/1/2016 at approximately 5PM Ms. *********** called back to follow up on her request. She was informed at that time that because she had already signed up for a standard policy and she was not given the promotional certificate prior to enrolling, but had obtained it after she enrolled, she would not be able to use the promotional certificate. Ms. *********** then requested to cancel her policy and re-enroll with the certificate instead. We advised her that we are unable to honor the promotional code as it requires activation within 24 hours of her veterinary exam and since it was already outside that time frame it would no longer be valid. Aside from that, the purpose of the promotional certificates is to expose people to the benefits of pet insurance and since Ms. *********** had already signed up for the policy coverage, the certificate is not applicable. We must be fair to all policyholders and cannot make exceptions in regard to this matter.

Trupanion’s sales manager has reached out to Ms. *********** by phone and by email to discuss this matter further and Ms. ***********’s only reply was via email to request cancellation. We can certainly honor her request to cancel her policy and issue a full refund as she is requesting cancellation within the first 30 days. We would prefer to discuss this situation with her prior to her cancellation as we feel there is a great value to keeping her pets covered and we would like the opportunity to discuss this with her so that she can have a better understanding of the situation. We understand that Ms. *********** was upset that the email was addressed to the wrong name and that was an honest mistake for which we extend our apologies. If Ms. *********** indeed wants to cancel her policy we will certainly honor her cancellation request.

We apologize for Ms. ***********’s experience and wish her and her pets the very best!

Sincerely,

Amber S. - Trupanion

1-888-733-2685

7/12/2016 Guarantee/Warranty Issues | Read Complaint Details
X

Additional Notes

Complaint: ***** ********: This complaint has been forwarded to you by the State of Washington Consumer Protection Department and may exist in a separage file.Explanation of complaint: I took out a pet medical insurance policy from this company in April.I paid almost $240 a month for two months for three dogs. One of our dogs had a dental cleaning (which is not covered) and two extractions (which supposedly are covered). In addition, a small growth below one of my pet's eyes... the entire cost for the procedures was just short of $1000 plus blood tests costing an additional $300. While I didn't think Trupanion would cover all of it, I did expect the procedure and the eye surgery to be covered. Trupanion denied the entire claim stating that all of the conditions were pre existing. As soon as you make a claim, they become an "agressive adversary" looking for any small detail to deny your claim. I have asked my vet to appeal and (I live in California) want this company to honor their sales pitch or refund my two months of premiums. I cancelled the policy today and am appealing their decision not to honor my claim. As soon as you put in a claim they become an adversary and scour your pet's medical to find a reason not to pay. These type of pet insurers should be required to review a pet's medical file in advance and list specific pre existing exclusions before the consumer starts paying. Right now, you have to pay and then they inform you what is not covered. Complaint as Public Record: Yes Disclosure Notices: Yes

Desired Settlement: I want this company to honor their sales pitch and pay the claims in good faith or refund the two months of premiums and initiation fee. I cancelled the policy so I don't incur further charges and am appealing their decision not to honor my claim. REFUND IS TWO MONTHS OF PREMIUMS AT APROX $236 PER MONTH AND INITIATION FEE - TOTAL REFUND APPROX $500

Business Response:

 

Date: 6/17/2016

BBB case # ********

Policy # ************

Complainant: ***** ******* ********

We have received the complaint filed by Mr. ******** and understand the concerns that have been presented. We are also reviewing the complaint Mr. ******** filed with the Department of Insurance as well. Since the complaint with the Department of Insurance is still under review we are able to advise Mr. ******** with the facts of the situation and once the Department of Insurance complaint has been reviewed we can address his concerns further should he need additional information.

Mr. ******** submitted information that was opened as claim ******* including an invoice from Studio City Animal Hospital dated 5/26/16 and claimed conditions are noted as dental disease and eyelid growth. The invoice submitted pertains to surgery, extractions and medications.

Records from Studio City Animal Hospital note within the policy illness waiting period on 4/22/16 "lower eyelid growth left eye" and prior to enrollment on 8/6/15 "dental disease". Pet presented on 5/26/16 for dental with extractions and removal of eyelid growth left eye.

The claim was processed based on the information provided in the pet’s medical records and found to be ineligible for coverage because the onset of eyelid growth was within illness waiting period and the onset of dental disease is pre-policy.

Trupanion policy sections that support the decision that this claim was inelgible:

9.A.i Illnesses that occur or reoccur within the 30 days following the policy enrollment date are deemed pre-existing conditions and not eligible for coverage.

7.C.i Endodontic treatments and extractions will not be covered if your pet has any signs of dental disease prior to the policy enrollment date or during the waiting periods.

9.B.i Illnesses or injuries for which signs or evidence of their potential manifestation existed within the 18 months prior to the policy enrollment date

While reviewing this claim it appears that a portion of the claim pertaining to an extraction of a fractured tooth could potentially be eligible, however complete pre-policy history is not on file. The claim has been opened as an appeal (secondary review) and is pending records and clarification from the veterinarian. Records and breakdown of the charges on invoice have also been requested from the clinic.

Once the Appeal (secondary review) is completed, the decision letter will be sent to Mr. ******** advising him on the outcome of the re-review of this claim.

Sincerely,

Amber S. - Trupanion

1-888-733-2685


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

I am rejecting this response because: 

 I received your letter June 21, 2016 letter today pertaining to my request for a REFUND of two months of premiums and initiation fee from TRUPANION PET INSURANCE policy ************. I would like to file and post the following reply.




1.         Trupanion states that the exclusions for my pets were indicated in the polciy. However, I was never supplied an actual policy outlining those exclusions at the time I spoke to the sales person.

2.         Secondly, there was no previous knowledge of the cracked teeth until my pet underwent a dental cleaning… all of these items are covered. TRUPANION DID NOT PROVIDED ANY OF THIS INFORMATION AND HAS SUCH A BROAD                         DEFINITION OF WHAT THEY REFER TO        AS “PRE EXISTING” CONDITIONS - THAT NO ITEM WILL EVER BE COVERED.   

3.         Trupanion states that they are reviewing the claim again and that the tooth extractions or at least one of them might be covered. NO CORRESPONDENCE HAS BEEN SENT TO ME REGARDING REOPENING THIS CLAIM.


             I think that the the Trupanion should review the pet records and set what items would be excluded from a given policy in advance. The company could have the pets vet certify such conditions in advance. Then the consumer would                            have the option to purchase the insurance. What exists now, is Trupanion requires you to pay premiums and then reserves the right, using very broad and sweeping definitions, to exclude almost all claims.     

 

            I don’t consider at Pet dental cleaning as an existing definition of dental disease. Almost all pets have their teeth cleaned, nails trimmed, have small growths on their skin… 

            Trupanion takes these normal conditions and connects them at will to any condition the pet might have in the future in order to deny a claim. 


TO RESOLVE THIS ISSUE.

REFUND THE PREMIUM PAID FOR MY THREE PETS (IT’S ONLY TWO MONTHS) AND SET UP FEE - $507.92 (I have cancelled the policy to avoid future charges. )


Sincerely,

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

Business Response:

Date: 7/6/2016

BBB case # ********

Policy # ************

Complainant:  ***** ******* ********

We have received the rejection of our response filed by Mr. ******** and want him to know that we have reviewed his claim concerns using all avenues available to find resolution. We are unable to honor his request for a full refund as we have provided the service of insurance for the pets he had enrolled with Trupanion. He received the same information from his Department of Insurance complaint as well.

We are unable to cover the costs associated with his pet, ******* conditions as the signs/symptoms were determined to be pre-existing to the policy coverage becoming effective and we cannot cover costs incurred by a pet owner when the policy does not cover those costs.

Mr. ******** is asserting that he never received his email policy documents when he enrolled, however he did received the claim outcome emails for his claims and other email correspondence we have sent him, we are unable to determine how this would happen. We recommend that he check his email for the date that he enrolled to see if he can find the original documents that were sent. Our system shows they were sent to him upon enrollment on 4/6/2016 at 4:02:05PM Pacific Time. Our website at Trupanion.com also has a sample copy of the policy for reference and we are available 24/7 by phone as well as by email if Mr. ******** needed to obtain those documents again.

Mr. ******** is asserting that he had no prior knowledge of the cracked teeth that his pet had until the dental cleaning was performed on 5/26/2016. We understand that may have been the case, however, this does not have any bearing on whether the cracked teeth would be eligible. The issue with eligibility of the cracked teeth is that the pet was noted to have dental disease in November of 2014. The Trupanion policy does not cover any endodontic treatments or extractions if the pet has any signs of dental disease pre-policy or during the waiting periods. The dental issues were deemed ineligible for coverage as the date on the invoice for treatment of this condition was 5/26/2016 and was over a year after the dental disease was noted, which makes it pre-existing to the policy coverage.

Trupanion is currently working on an appeal (secondary review) of the claim for the dental issues and we show that an email was sent on 6/7/2016 to advise him that the claim has been received and opened. This is the most up to date information available and Mr. ******** will get an email to advise him of the outcome once the claim has been finalized.

Mr. ******** is in disagreement with the coverage that the Trupanion policy offers and the wording that the policy uses. We understand his concerns around his particular experience, however we are also being fair to all policyholders by using the same policy and guidelines for coverage for all the pets that we provide insurance coverage. We feel that we have made efforts to explain to Mr. ******** why his claims were ineligible and have reached an impasse as we are unable to provide the resolution that he is requesting.

We do wish Mr. ******** and his pets the best.

 

Sincerely,

Amber S. - Trupanion

1-888-733-2685

Consumer Response:


Complaint: ********

I am rejecting this response because:


1. Trupanion states that the exclusions for my pets were indicated in the polciy. However, I was never supplied an actual policy outlining those exclusions at the time I spoke to the sales person. 

2. Secondly, there was no previous knowledge of the cracked teeth until my pet underwent a dental cleaning… all of these items are covered. TRUPANION DID NOT PROVIDED ANY OF THIS INFORMATION AND HAS SUCH A BROADEFINITION OF WHAT THEY REFER TO  AS “PRE EXISTING” CONDITIONS - THAT NO ITEM WILL EVER BE COVERED.   
I don’t consider at Pet dental cleaning as an existing definition of dental disease. Almost all pets have their teeth cleaned, nails trimmed, have small growths on their skin… 
Trupanion takes these normal conditions and connects them at will to any condition the pet might have in the future in order to deny a claim. 

3. While Trupanion states that they are reviewing the claim again and that the tooth extractions or at least one of them might be covered. I am requesting a full refund of the two months the premiums were paid. I think that is a fair resolution

In the future, the insurance commission or other legislative body should require these type of insurance companies to state what they will exclude in advance to provide the consumer with a better understanding of what will not be covered for their specific pet. The company could charge a fee for the review of the pet's records. They already charge an enrollment fee but could increase it to cover their costs. 

 I think that the the Trupanion should review the pet records and set what items would be excluded from a given policy in advance. The company could have the pets vet certify such conditions in advance. Then the consumer wouldhave the option to purchase the insurance. What exists now, is Trupanion requires you to pay premiums and then reserves the right, using very broad and sweeping definitions, to exclude almost all claims. 

In my experience, I never really had insurance for my pets. I have older dogs and a company like Trupanion could go through their records and find any minor detail in order to support the denial of a claim. Maybe they view this a good business but it is unfair to the consumer. I learned about Trupanion through the VCA hospitals and I am going to let tmeh know and any other vetinary businesses about my experience with this company. After reviewing Trupanion on YELP and other websites, I am now aware that they deny claims in the same manner for many people. 

 

 

 

 


 I think that the the Trupanion should review the pet records and set what items would be excluded from a given policy in advance. The company could have the pets vet certify such conditions in advance. Then the consumer would    have the option to purchase the insurance. What exists now, is Trupanion requires you to pay premiums and then reserves the right, using very broad and sweeping definitions, to exclude almost all claims. 
    

I don’t consider at Pet dental cleaning as an existing definition of dental disease. Almost all pets have their teeth cleaned, nails trimmed, have small growths on their skin… 
Trupanion takes these normal conditions and connects them at will to any condition the pet might have in the future in order to deny a claim. 

TO RESOLVE THIS ISSUE.

REFUND THE PREMIUM PAID FOR MY THREE PETS (IT’S ONLY TWO MONTHS) AND SET UP FEE - $507.92 (I have cancelled the policy to avoid future charges. )


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

 

7/8/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: According to Trupanion's own brochure, it says that an annual rate increase can occur, but will never exceed 20% annually. They raised my monthly premium from $147/month to $246/month. Their own brochure said it was a 20% max, but the $99/month increase is a 67% increase. I received an email in March that said there was a change to the policy, but there were six different attachments in the email, which totaled about 10-15 total pages, and on only one of those pages said there was an increase in the premium. In April, I was charged $246 (instead of the normal $147), so I assumed they made a mistake. It turns out they did make a mistake of some sort, as I received a refund check for something, but it was only around $15. Last time I looked into things more, and it turns out they raised my premium starting in April to the $246/month from the previous $147/month. I have it on automatic withdraw, so I didn't pay attention. I emailed them asking for an explanation, and all I received was that there are occasionally premium increases that occur annually. I specifically brought up the amount of the increase, and how in the same email that notified me of the increase, it said there was 20% max on the increase, and this is the response I received: Hello ******, Thank you for your email. The policy sent out is a generic one, which does state the 20% cap. However, with that policy, we do attach a copy of your state specific amendments. In that attachment, it does edit the policy to be specific to your location. In Colorado, we are not able to have a rate cap. That portion of the policy is removed to clarify that. I do apologize for any confusion. For your records, I have attached a copy of your policy and those amendments. Please let us know if you have any questions. I do not find this to be acceptable, as they admitted it is confusing and deceiving, and says the 20% cap clearly

Desired Settlement: I would like to get the premium changed to no more of a 20% increase, and I would also like a refund of the extra amount that was paid for April, May, and June. If you could assist with this, I would appreciate it.

Business Response:

Date: 6/23/2016

BBB case # ********

Policy # ************

Complainant:  ****** ***

 

We have received the complaint filed by Mr. *** and understand the concerns that have been presented. We reached out to Mr. *** on 6/21/2016 and left a message for him to contact us to discuss this matter further but at the time of this response have not heard back from him.

We would like to discuss the concerns that Mr. *** has expressed. The information he was provided by our agent was correct. The Trupanion policy states that an annual review of the rates will occur on the policy anniversary date. The policy documents are provided to the owner via email as soon as they sign up for the policy. Trupanion also notifies policyholders via email at least 30 days prior to any change in their rate, as required by the insurance board in their state. This allows the owner time to contact us to make any deducible changes to adjust their premium before the new rate takes effect.

Trupanion policies vary state by state, depending on what has been approved in the state of the insured. Those policyholders are sent a document with their rate change notification to advise them of the changes their state has approved regarding their policy. This document is called an Amendatory Endorsement. We also include the policy declaration page, the policy document itself and any applicable riders (additional coverage packages).

In the case of Mr. ***, he resides in Colorado and the Amendatory Endorsement that was sent with his policy documents, upon notification of the rate change, advises that the section of the policy that discusses a 20% rate cap, is not applicable in Colorado. The use of Amendatory Endorsements is a common practice in the insurance industry and the document itself states that it is a part of the policy. This is not intended to be confusing or deceiving and Trupanion encourages policyholders to read their policy documents and call us if they have any questions.

We are aware that an error occurred when Mr. ***’ rate change initially occurred and we notified him to advise of the mistake. He was noticed of and charged for a higher rate than he should have been on April 12, 2016. Trupanion made the adjustment to correct the rate and issued a refund check to Mr. *** for the difference. We do apologize for this error and feel we corrected it as soon as possible. Mr. *** was noticed in March that his rate would change from $147.15 to $246.21. On April 12, 2016 the rate change took effect and we notified Mr. *** via email that same day to advise him that his premium should actually be lower at $216.54 and issued a refund check to him for the difference of $29.67.

The rates Trupanion charges are determined by our actuarial data for the claims that are filed for the “like group” of pets. This helps to spread the risk among pet owners in the same like group so that no one pet owner is penalized for having a sick or injured pet. If we see that the rates we are charging for a like group is not covering the costs of the claims we are paying out for that like group of pets, we must make adjustments to the premiums so that we can continue to provide the 90% coverage with no limits on a dollar amount we will cover.

We encourage Mr. *** to contact us to discuss the rate change and his deductible options so that he can lower his monthly costs, if that is his concern. We cannot honor his request to not raise his rate more than 20% as this is something that has been approved by the Colorado Insurance regulators. We also cannot refund Mr. *** for the difference in his previously paid premiums as they are accurate for the pet he has insured in his location. Mr. *** is welcome to adjust his deductible moving forward if costs are a concern and we are happy to assist him in doing so. We are available 24/7 by phone if he would like to make any changes or get additional information.

Sincerely,

Amber S. - Trupanion

1-888-733-2685


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

I am rejecting this response because: It clearly states that the premium will not go up by more than 20%, and that is in their email along with the brochure. It does not say except for Colorado or anything like that. In the email I received, it also did not state how much the premium was changing by. I had to go thru and open 6 different attachments (easily over 8 pages) just to find the section saying how much my premium was changing. This is definitely a deceptive business practice, and I certainly feel that it is intentional. I am sure that I am not the only person who has the payments on automatic withdraw and doesn't have the time to read through every attachment included in every email. To show very clearly that the premiums won't exceed 20%, but then blame me for not knowing that what they emailed me doesn't apply to me seems outrageous. I have had to deal with plenty of false advertising and deceptive business practices in my line of work, so I am very well versed, and this seems like a very plain and simple case of it.

Sincerely,

****** ***

6/12/2016 Guarantee/Warranty Issues | Read Complaint Details
X

Additional Notes

Complaint: I have engaged this Pet Health Insurance company for 5.5 years now, payimg my monthly premium every month on time since my Schnauzer was a 8 week old puppy. I never had too utilize their services till this week. I had contacted Trupanion 2 weeks ago in good faith too advise them I may considered down grading my premium and too advise that I would be taking my pet too the vet prior too doing that.. My billing date for them too take out my payment every month was the 24th of every month. They took out my premium on that day and the next day the lowered my premium and upped my deductible without my consent.. I contacted them and a rep said they had a recorded message saying I agreed to this (which I adamantly did not). I then asked too hear the recorded phone call where I agreed to this change and they said that they could not share this with me..I asked how in good faith can they do this too people? There was no reply to my question all that was said was " someone will review the recorded telephone call and reach out to me in a few days".. Please read the reviews on this company.. They are based in the US but also have Canadian offices as well (I am in Canada)..all I am asking is that they return my previous policy and make good of what I was paying for the last 5.5 years..I even offered to meet them 1/2 way I would pay 500.00 deductible (old deductible was $300.00) if they met me half way and of course they said no..I have the names of the representatives I spoke with and also their e-mails to me.. Pleas advise what action I can take to rectify this situation..

Desired Settlement: I want Trupanion to honor the previous plan and deductible of $300.00 which I had paid faithfullu for 5.5 years

Business Response:

Date: 6/10/2016

BBB case # ********

Policy # ************

Complainant:  ****** **** *****

 

We have reviewed the BBB complaint submitted by Ms. ***** and have been in contact with her to resolve her concerns. We spoke to her on June 8th to advise her that we have been able to honor her request to return her deductible to the previous amount as we have verified there was a miscommunication between our agent and herself.

We believe that we have resolved this issue with Ms. ***** in a satisfactory manner and that she has a better understanding of her policy and the way that deductible changes work.

 

Sincerely,

Amber S. - Trupanion

1-888-733-2685


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.

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

6/10/2016 Billing/Collection Issues | Read Complaint Details
X

Additional Notes

Complaint: I have had Trupanion Insurance for my dog since June 2014. My dog had one surgery in June 2014 that was not covered because I got insurance after the fact. My dog then went in for a second surgery one year later June 2015 that had nothing to do with the first surgery. Trupanion denied my claim saying it was a preexisting condition. Although my dog's Neurosurgeon wrote two letters stating that this was not a pre-existing condition, Trupanion still denied it. I then appealed and my dog's Neurosurgeon sent another letter to them stating it was not a pre-existing condition and further explaining to them why. They still denied it. I have read many reviews on yelp and on this site stating the same exact thing happened to them with trupanion insurance company. I have sent many emails to them going back-and-forth trying to get my claim covered. They keep prolonging it and sending me to different departments in their company

Desired Settlement: I would like them to reimburse me for the $6800 that went on to my CareCredit credit card for my dog's surgery June 3, 2015 ASAP. Fortunately, I had a 0% financing for 12 months on the CareCredit credit card. The end of that 12 months is June 3, 2016. If it is not paid off in full by June 3, 2016 the interest for the last 12 months will be added onto my bill.

Business Response:

 

Date: 5/27/2016

BBB case # ********

Policy # ************

Complainant: **** *******

We received the complaint that Ms. ******* has submitted and reviewed the information that pertains to her concerns. Ms. *******’s dog had a surgery pre-policy in June of 2014 to treat her pet, *******. ******* was injured when his housemate jumped on his back.

In June 2014 radiographic results of generalized intervertebral disc degeneration and other protrusions consistent with IVDD were found and noted in the medical records.

In June of 2015 the dog sustained another injury when his sister jumped on him. This time it was noted that the pet’s MRI revealed the cervical (neck) discs were extruding from the vertebrae.

This injury was determined to be consistent with Invertebrate Disk Disease (IVDD), a progressive disease that affects the pet’s spinal column. The claim was re-reviewed on a secondary review called an Appeal and we again found the claim to be ineligible.

The claim went through a third and final review with an independent third party, a specialist in the field of Orthopedic surgery who also upheld Trupanion’s decision that this claim was adjudicated correctly and asserts in his decision letter: "…if a dog is suffering degeneration of its intervertebral discs prior to policy inception and suffers herniation of one of those discs, I believe that such dog is predisposed to herniation at other discs, immediately adjacent or distant, form the first herniation. Although the IVDD extrusion events are separate in time and anatomic location, the underlying disease process explaining their occurrence is identical and was present throughout the period of time prior to and after policy inception."

IVDD is a degenerative disease process and the condition claimed is consistent with IVDD, as signs of this degenerative disease are documented prior to full policy coverage it is ineligible since there was no insurance policy in place at that time. The second injury in June of 2015 has been determined to be medically related to the pre-policy injury as the underlying medical diagnosis of IVDD was already made. Since IVDD is a degenerative disease process and progresses with time, the second injury is related to the first making it also pre-existing to her policy coverage and ineligible for coverage.

We understand that Ms. ******* feels that these issues are unrelated, but the medical evidence is contrary to her belief. We are unable to provide coverage for the costs associated with the treatment of the pet’s injury in June 2015.

We wish Ms. ******* and ******* the best.

Sincerely,

Amber S. - Trupanion

1-888-733-2685


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

I am rejecting this response because: you went through a third party that is believed to be in your pocket. Your "third party" is neither a practicing surgeon or practicing vet. They are all professors at universities. That is completely unacceptable! Why was I not able to pick my own third party from a list of *******'s neurosurgeon's PRACTICING equals? You have already received several letters from Dr ***** informing you that there is no evidence of it being the same issue as the first surgery. In fact, he has produced and sent you evidence PROVING it is not a preexisting condition. I have read many reviews on your company, and it seems you like to claim "PREEXISTING" for quite a lot of cases using your so called third party. This is both unacceptable and negligent behavior! I am expecting payment in full! And it seems a little piculuar that you have done nothing to resolve this with me until I contacted the BBB

Sincerely,

**** *******

Business Response:

Date: 6/8/2016

BBB case # ********

Policy # ************

Complainant:  **** *******

We received the rejection to our response from Ms. ******* and hope to help her understand that she has exhausted all of her options to have her claim re-reviewed. The Independent Third Party Review (ITPV) process is the third and final review that Trupanion offers and the decision made by the ITPV specialist is binding on Trupanion. This information is stated in the policy document that was sent to Ms. ******* when she enrolled her pets.

In my previous reply I have explained how the diagnosis of Invertebrate Disk Disease (IVDD) was made by the treating veterinarian upon the initial injury. The second injury is also an injury of the spinal column which implicates IVDD as a contributing factor since it is a degenerative disease process. 

Ms. ******* is disputing the expertise of the specialist and I wish to explain that the specialists chosen to review the claims for the ITPV are chosen based on their expertise in the area of veterinary medicine that is in question. These specialists are not employed by or affiliated with Trupanion and are only compensated for the time they take to review these cases. The qualifications of this specialist were sent to Ms. ******* along with the detailed report of their findings. We want these reviews to be unbiased which is why the veterinarians involved in the pet’s actual treatment are not involved in this review process. The second review process (the appeal process) does allow the treating veterinarian to provide information and/or clarification on the condition and if the owner is unsatisfied with that outcome, we would then initiate the ITPV process as a third and final review. All of the re-review options have now been exhausted and the decision made by the ITPV specialist that this claim cannot be overturned will be upheld. For this reason we are unable to honor Ms. *******’s request for reimbursement for this claim.

We did reach out to Ms. ******* on 3/3/2016 by email as we were advised that she wished to discuss the outcome of the second review (the appeal) with us. She was advised of the ITPV process and that it was a final and binding review. We were most recently contacted again on 5/19/2016 when we received the BBB complaint.

We realize that this claim outcome has been unfavorable for Ms. *******, however Trupanion must adjudicate claims based on the policy and that has been done in her case. We wish her and her pets the best but we are unable to extend coverage for this claim.

Sincerely,

Amber S. - Trupanion

1-888-733-2685


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

I am rejecting this response because:
You did not allow me to choose what third-party I would be most comfortable with. The email sent on March 3 was sent to the wrong email As stated in the email sent by trupanion on 5/19.  I never agreed to a third-party   Select it's solely by Trupanion!  I states before, I request a full refund of $6800
Sincerely,

**** *******

6/5/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I signed up for Trupanion and was under the impression that they would cover emergencies/injuries because that's what I was told by their customer service rep. Between the Second and Third week into my policy, my dog was struck by a child on a bike and sustained a snapped Crucial Ligament Injury. I supplied all of the necessary documentation, set up a surgery time with my vet and waited for their response. They denied the claim stating it was a "degenerative disease" and they don't cover that until after 30 days into the policy. Even though she sustained this injury during an accident Trupanion views it as a "degenerative" disease. I filed an appeal, included more information as well as offered a video of my dog the day before the injury proving she was completely fine. My vet filled out extra paperwork stating that the injury and being struck was the cause of said injury, and they denied it again. Meanwhile, they continued to charge my credit card for $93.00 per month. When I called and spoke to a claims rep, she stated that in order for them to potentially approve the claim I would have to go get MORE xrays ($180+) and they would have to "send it out to be diagnosed" and that there could not be "any signs of reformation of the injury." At this point we're almost two months into this OF COURSE theres going to be reconstruction of the injury, my dog was healing! I was extremely upset, told the rep that what she was telling me was not what I was told at the start of them taking my money. I was also extremely peeved that 45+ days into their "review" of the claim no one could pick up the phone and call to tell me that "hey it would be a good idea to get some more xrays done," instead 5 different people laid eyes on this claim and no one said anything. This company does not care about you, they do not care about your animal, they will tell you whatever you want to hear in order to take your money and then do nothing to solve the problems of misinformation

Desired Settlement: I was told by a "refund specialist" that I would receive a complete refund for the total of $218.46. I got a check for THREE DOLLARS! Absolutely unacceptable. I stuck to my end and paid my bill on-time, they flaked out on their responsibilities therefore a full and immediate refund is expected. I purchased the insurance specifically because I was told by a claims rep injuries were covered, even this specific scenario, I was assured by a rep that Trupainion would help cover this, in fact, they did not and come to find out, they have a very liberal view of what constitutes an "injury" with the specific purpose of not paying on legitimate claims. I am over $500 deep into this (not including the charges from Trupanion) and still have a $1500 surgery that I'm paying for. Had they covered the claim, I would have happily continued to pay $92/mo for the service for the lifetime of my dog, what is not ethical is misleading and straight out lying to customers.

Business Response:

Date: 5/12/2016

BBB case # ********

Policy # ************

Complainant:  ********* ********

We have reviewed the BBB complaint submitted by Ms. ******** in regard to her dog’s Cranial Cruciate Ligament (CCL) injury that was unable to be covered by her Trupanion policy and the concerns she has expressed for the refund she received when she cancelled her policy. We were contacted by Ms. ******** about this situation by phone on May 3rd when she requested to discuss her concerns with a supervisor. No one was available at that time and we advised her that she would get a call back the next morning. We have made efforts to reach her via phone twice on May 4th and again by email on May 9th. We would like the opportunity to discuss this matter with her further and see if we can help her understand why the claim was adjudicated and found to be ineligible.

We would encourage Ms. ******** to contact us to have a discussion about the claim outcome. The claim specialist left a voice message as well as emailed direct contact information so that Ms. ******** can contact her directly.

 

Sincerely,

Amber S. - Trupanion

1-888-733-2685


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

I am rejecting this response because:  there is nothing to discuss.  I was lied to when I purchased the insurance.  I was told in clear language that any and all accidents were covered and in fact, they are not.  It is also the first line of the agreement, "All accidents are covered."  Due to the very liberal termonolgy that I was given after the fact, it's up to the discretion of Trupainion to determine what is and what is not considered an "injury."  My dog was injured, I have video and witness accounts as well as a police report.  I was told that in order for Trupanion to "maybe" cover it, I would incur upwards of $200 more worth of services (that aren't covered) as well as another two to three week delay while it's "under review."  Unacceptable and not at all what I was told when I paid the $125 registration fee.   The supervisor that I spoke to is one that I have already spoken to and I have a message on my voicemail stating, "since there was no dollar amount refund discussed, we feel that the three dollar refund is sufficient." I will consider this matter closed upon full receipt of the $218.46 refund, anything less than a full refund is not only theft it's outright fraud.  

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

Business Response:

Date: 5/25/2016

BBB case # ********

Policy # ************

Complainant:  ********* ********

We understand that Ms. ******** is rejecting our response to her complaint. We cannot assist Ms. ******** with her concerns if she will not discuss the situation with us. In her response to our reply Ms. ******** states that there is “nothing to discuss” and this leaves Trupanion in a difficult position since we are not being given an opportunity to assist her in resolution of the concern.

We are unable to refund Ms. ******** for the amount that she is requesting as she was paying for the service of insurance in the event that a claim was eligible under the terms of her policy. We found that her pet’s injury was not an accident but the result of an illness degenerative joint disease which was suspected by her veterinarian and noted by the radiologist who reviewed her pet’s x-rays. We are not disputing that her pet sustained an injury to its leg, however, we are unable to provide coverage for the injury due to the evidence on the x-rays that the pet was already showing signs of degenerative joint disease.

Ms. ******** asserts many things in her second response that are untrue and I wish to correct them here.

Trupanion’s policy does not state that “all accidents are covered.” The first line of the actual policy appears on page 4 and states: “We provide the insurance described in this policy in return for your timely and successful payment of monthly premiums and subject to the terms and conditions set forth in this policy:

  1. We cover: The actual costs you incur for the veterinary treatment of your pet for unexpected illnesses or injuries with no claim payment limits.”

The policy continues to describe the coverage that we offer in detail throughout the remainder of the policy document.

Ms. ******** believes that she paid a $125 registration fee. Trupanion has a one-time enrollment fee in her area of $35.00. In addition to that amount the first billing includes the pet’s insurance premium which is approximately $90.00, so the total she was charged for the first month is the total of those amounts and is about $125.00.

The refund we issued was correct based on the prorated premium that was unused at the time of cancellation. Trupanion provides a service of insurance and that is what the monthly premium pays for. The premium is the amount charged each month regardless if a claim is filed or if that claim is eligible. If a claim is eligible then per the policy terms we would reimburse the owner 90% of the eligible costs after the deductible is met. We are unable to refund for past premiums paid for an insurance policy.

We were unable to discuss these concerns with Ms. ******** and would welcome a discussion about this matter with her in greater detail if she wants to understand our position on the situation in more detail.

Sincerely,

Amber S. - Trupanion

1-888-733-2685


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

Additional Notes

Complaint: trupanion accepted my dog for insurance with their company. I paid the premium since march 10. she happened to have a claim the end of april which involved a life or death issue requiring surgery. I contacted trupanion and filed all the necessary claim forms and the adjuster confirmed they would preapprove her surgery. I took her to the vet to have the surgery and treatment necessary and then submitted all the claims. I was contacted the company almost every other day to check on the claims. they would never tell me any other information besides the claim is processing. I asked to talk to managers and got no specific response from them. every time i talked to them i told them she was having more treatment and i needed to make sur ethe claim was covered because i was taking her for continued treatment. i finally called again yesterday and demanded to talk to a manager and they told me the dog was too old to be covered by the policy. i asked why they couldn't tell me before yesterday because i had relied on their preapproval to determine the expense of the veterinary bills my dog continued to incur. i told them its nowhere on the website i could find about there being an age restriction. i have 3 other dogs insured with them and have had at least one dog insured in the past. i was never aware of an age restriction. at any rate, i told them when i got her two years ago and she was a shelter dog with an unknown age? surely no one can predict a certain age for a shelter dog. the vets i took her to noted her age as what i guessed?? this claim should be paid based on them accepting the contract, taking the premium and saying the claim was preapproved. i relied on the preapproval to take her for treatment after that date. if i would have known in the beginning they would not insure her due to her age, i would have sought other insurance that would have taken care of her in this unforeseen emergency.

Desired Settlement: i want my dog chica's claims paid as i relied upon them preapproving her case before i sought any treatment. i contacted them almost daily to ask if there were any problems with the claim and they would never tell me until 3.5 weeks later, after i took her for the necessary treatment. if they were not going to accept the contract for her age, i thik a month and a half is plenty enough time for them to have notified me so i could get other insurance that would have paid her claim for this unforeseen emergency.

Business Response:

Date: 5/31/2016

BBB case # ********

Policy # ************

Complainant:  ***** *****

We have reviewed the BBB complaint submitted by Ms. ***** and reviewed her concerns. We extend our apologies for the late response to this matter. We have discussed the concerns brought forth in this complaint with Ms. ***** on 5/18/2016, the same date her BBB complaint was submitted. By 5/23/2016 we were able to resolve her concerns in a satisfactory manner.

We believe that Ms. *****’s concerns have been resolved at this time. We contacted her and left a phone message earlier this morning to apologize for the late response to her BBB complaint and to let her know she can contact us if she has any other concerns.

Sincerely,

Amber S. - Trupanion

1-888-733-2685


Business Response:

Date: 5/31/2016

BBB case # ********

Policy # ************

Complainant:  ***** *****

We have reviewed the BBB complaint submitted by Ms. ***** and reviewed her concerns. We extend our apologies for the late response to this matter. We have discussed the concerns brought forth in this complaint with Ms. ***** on 5/18/2016, the same date her BBB complaint was submitted. By 5/23/2016 we were able to resolve her concerns in a satisfactory manner.

We believe that Ms. *****’s concerns have been resolved at this time. We contacted her and left a phone message earlier this morning to apologize for the late response to her BBB complaint and to let her know she can contact us if she has any other concerns.

Sincerely,

Amber S. - Trupanion

1-888-733-2685


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. trupanion accepted and acknowledged how they treated me was wrong and handled my claims accordingly and reinstated their policy. if i would have gotten a call from a claims manager earlier than 3.5 weeks after my initial claims, i may not have been treated as badly as i was. in the end they acknowledged their shortcomings and took care of me.

Sincerely,

***** *****

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. trupanion accepted and acknowledged how they treated me was wrong and handled my claims accordingly and reinstated their policy. if i would have gotten a call from a claims manager earlier than 3.5 weeks after my initial claims, i may not have been treated as badly as i was. in the end they acknowledged their shortcomings and took care of me.

Sincerely,

***** *****

5/25/2016 Billing/Collection Issues | Read Complaint Details
X

Additional Notes

Complaint: This company continues to send me written and email correspondence about payments for their services. I told this company from the day they denied my claim for my pet that they are liars and I no longer wanted their service. I specifically told the agent to cancel the service. I am seeking legal action regarding the money that was already paid to them and the misinformation from the original sales agent. I specifically asked certain questions before obtaining this service.

Desired Settlement: I want no further contact from this business and I also still want a refund for the monies paid into the policies that did not do as promised.

Business Response:

 

Date: 5/16/2016

BBB case # ********

Policy # ************

Complainant: ******* ********

We have reviewed the BBB complaint submitted by Ms. ******** and contacted her to discuss the cancellation process. Ms. ******** responded by email stating that she wanted the policy to be cancelled and we complied with her cancellation request. In reviewing her past contact with us, she advised us that she would be cancelling her policy and when the agent assisting her asked if she could assist Ms. ******** further, Ms. ******** ended the call. We are unable to honor that date as her cancellation request date because she did not state that she wanted to cancel the policy and she did not allow us the opportunity to assist her in the cancellation process.

We have processed her cancellation effective May 12, 2016 as that is the date of her BBB complaint requesting the cancellation of her policy. Because the policy was past due at the time of cancellation we are unable to issue any prorated cancellation refund.

Ms. ******** requested in her complaint that she wanted a full refund of her insurance premiums. We are unable to issue a refund for the premiums that Ms. ******** has paid for the insurance coverage on **** and ***** as she was paying for the service of insurance. Trupanion was unable to reimburse for her claims as they were pre-existing to the policy. Had there been a claim that was eligible under the policy, Ms. ******** would have been reimbursed.

Ms. ******** has been advised of this information via email correspondence as she was not willing to discuss the situation by phone. It is our understanding that this issue has been resolved. We wish Ms. ********, ***** and **** the very best!

Sincerely,

Amber S. - Trupanion

1-888-733-2685


4/22/2016 Guarantee/Warranty Issues | Read Complaint Details
X

Additional Notes

Complaint: Before even signing up for this service I specifically asked about covered for conditions that were prone to my breed of dog that I purchased. The gentleman told me that it was covered. I specifically asked about signs or symptoms and was told in those instances the major event i.e. surgery would be covered but the doctor visits and exam costs would not. I submitted my claim and it has now been denied for the exact same thing that I specifically asked about.

Desired Settlement: I would like a refund of all of my payments from the very beginning of these policies. I had insured both of my pet under this policy.

Business Response:

 

Date: 4/22/2016

BBB case # ********

Policy # ************

Complainant: ******* ********

We have reviewed the BBB complaint submitted by Ms. ******** in regard to her concerns for the ineligible claims she filed for her pet Onyx. Ms. ******** has asserted that she asked specifically about this condition before she enrolled but we are unable to verify that in reviewing the calls she had with us when she enrolled **** or her other pet, *****, who was enrolled about 1 month prior.

In reviewing *****’s enrollment call, the agent Ms. ******** spoke to discussed the policy coverage and stated that we do not cover pre-existing conditions. The agent also stated that we do not have breed restrictions and are able to cover claims for medical issues that Cane Corso’s are prone to, as long as it is not noted in the pet’s medical records prior to enrollment. He advised that if a condition is discovered while her pets are covered under the policy, then it would be eligible.

**** was enrolled on 11/19/2015 and had a 5 day waiting period before accidents would be eligible for coverage and a 30 day waiting period before illnesses would be covered. This means that on 12/12/2015 when the prolapsed nictitans gland (Cherry Eye) was noted in ***** medical records, he was not yet through his illness waiting periods. That waiting period ended about a week later on 12/19/2015 which made his claim ineligible as he was not yet covered for illnesses under the policy.

Ms. ******** was made aware that her policy for **** had waiting periods and was provided a copy of the policy as well as a declaration page that detailed her waiting periods. There was no discussion of any medical issues that were present or being treated at the time of ***** enrollment.

We completely understand that Ms. ******** is unhappy with the outcome of this claim. We must be fair to all policyholders and adjudicate claims per the terms and conditions of the Trupanion policy. We are unable to honor Mr. ********’s desired settlement to refund her for all of her premiums for both pets as she is paying for the service of insurance coverage in the event an accident or illness occurs. Trupanion then adjudicates claims filed based on the policy and in this case we were unable to assist with ***** condition as it occurred before his coverage was in effect. If Ms. ******** has any specific questions about her policy coverage we are always here to help. **** and *****’s health is important to all of us here and we hope to continue our relationship for as long as it works for Ms. ********.

Sincerely,

Amber S. - Trupanion

1-888-733-2685

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

I am rejecting this response because: what I was specifically told by the agent was that the office visits themselves would not be covered but if surgery was needed it would be. Also the claim was for both eyes and only the right eye showed swelling. 

Sincerely,

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

3/12/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I just received by e-mail Trupanion's new privacy policy. It states they can collect my age, marital status, occupation, SSN, assets, income, and beneficiaries, credit history, etc. While they don't sell this, they can disclose "as allowed by this privacy policy or required by law." Then they list who they share with, e.g. life, automobile, and property insurers, etc. And they share with "a number of third-party internet advertising companies." I have had my dog insurance with them for over six years. They take the monthly premiums from my VISA card. They have my vets name & all relevant info on my dog. My goal is to take excellent care of my dog & never need them. There is absolutely NO reason they need any of the other information. If they don't receive payment from VISA, they can simply cancel my policy after appropriate notification. In an age of identity theft I find it outrageous their collecting of so much personal info, an invasion of my privacy. In addition, I tried to Opt Out from the advertising & couldn't without allowing Cookies, i.e. giving away my IP, etc. to the Opt Out. I didn't sign up for pet insurance to be targeted by e-mail &/or phone by other companies. They are a highly rated company. I have gotten several friends/acquaintances to sign up with them; but I think their so-called "privacy policy" is unethical & crosses the line. And it is outrageous they shared info to advertisers requiring me to Opt Out rather than allowing me to Opt In.

Desired Settlement: For them to make sure that I am not in any advertisement registry, that is, they Opt me out. For them to change their privacy policy to only include information directly relevant to my pet's insurance and share only when ABSOLUTELY need to. In other words, I want to continue insuring my pet without an invasion of my privacy, without increasing the risk of identity theft, and without having to deal with telemarketers and spammers. I am a senior citizen and have been on the Do Not Call List since it began & still can't take a nap without my phone ringing. Then I have to take the time to report them to the Do Not Call List which does little to no good. I forward ALL spams to the governments "Report Spam" ************ which also does little to no good. So, I don't want a company I deal with to make things worse. If this doesn't work my next steps will be to contact the Federal Trade Commission and after that several newspapers who have written stories about related problems.

Business Response:

Date: 3/11/2016

BBB case # ********

Policy # *****

Complainant:  **** *. ********

We have received the complaint filed by Mr. ******** and understand the concerns that have been presented. We spoke with Mr. ******** and have addressed his concerns regarding our Privacy Policy. We feel that we have come to an understanding with Mr. ******** and have taken his suggestions for how to clarify the Privacy Policy on future versions.

We hope that Mr. ******** feels satisfied after our conversation and that he has a better understanding of the Privacy Policy as it stands and knows that we are committed to making changes to improve our customers’ experience. We are grateful to have Mr. ********’s input as we feel the voice of our customers is important to our business.

Sincerely,

Amber S. - T********

1-888-733-2685

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. However, it remains to be seen if they actually carry out what they promised. I hope they do.

Sincerely,

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

3/7/2016 Problems with Product/Service | Complaint Details Unavailable
2/24/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I inquired to them about kennel reimbursements and when I first joined 4 years ago I was told they offer it. When I inquired two weeks ago again they told me no I was incorrect that doesn't exist. I was upset and said fine I'll call and cancel. I didn't hear from them in email or over the phone until this past Wednesday on 2/17/16 and a man named Joe said he will not cancel this if I don't call to cancel it. I received an email stating its cancelled because I said I didn't want it anymore. I told hem the situation and how I got a phone call and still have the voice message of joe telling me he wasn't cancelling it until I called and they replied with your subscription is cancelled contact us if you have more questions. I responded to that with I did contact your company again and received no contact back about my situation.

Desired Settlement: I just want them to give me back my health insurance for my loved pet without any charges for them cancelling it on me.

Business Response:

Hi *******, 

 

I am sorry for the confusion and the cancellation. I have reinstated your policy. Your premium is $36.34 with a $500 deductible and is due on the 3rd of each month. When the policy was cancelled a refund of your prorated January premium was issued, if you receive this check please do not cash it. I will issue a stop payment on that check the policy is not cancelled

 

I hope you and ***** are doing well. 

 

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.

Sincerely,

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

2/4/2016 Billing/Collection Issues | Read Complaint Details
X

Additional Notes

Complaint: We started using Trupanion a year ago. Unfortunately my little 4 year old broke her foot and we filed ALL the appropriate claims paperwork. Since then they REFUSE to take care of our claim!! I keep calling and they keep stalling. I am so done beyond words!! I understand they do not have a good record and there have been a lot of complaints. Add me to your list. I want the money back paid out to the vet for her health care and I will not accept anything other than that. If we have to hire an attorney, then we will do so. I thank you in advance for your prompt attention to this matter. Respectfully, ***** *****

Desired Settlement: I want the claim paid for!!!! We have done everything we were told to do and everything is above board.. No other outcome will be accepted.

Business Response:

 

Date: 1/27/2016

BBB case # ********

Policy # ************

Complainant: ***** *. *****

We have reviewed the complaint filed by Ms. ***** and it appears that all of her open claims were processed and finalized on 1/20/2016.

We understand that Ms. ***** was concerned about the length of time her claims took to process. In looking into this concern it appears that we had encountered issues with collecting the required medical records from the clinics her pet had visited and that delayed the claims process causing us to close the claims due to lack of medical records.

Ms. ***** spoke to supervisors at Trupanion to get assistance with her concerns and it appears she was advised of why we had closed her claims originally- we had not been able to successfully obtain the necessary medical records. Once we received clarification on the records from her clinics that the pet did not have any medical records from the dates requested, we were able to reopen the claims and process them.

We apologize for the delay that Ms. ***** experienced in having her claims processed, it was certainly not our intention to delay the processing of her claims. It is our hope that she has found a satisfactory resolution now that her claims have been completed. Ms. ***** has requested her policy be cancelled and we processed her cancellation request on 1/26/2016. We wish her and her pets the very best.

Sincerely,

Amber S. - Trupanion

1-888-733-2685

1/5/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: Trupanion has increased premiums in my area by over 50% after the first year of coverage. I asked for actuarial data, business reasoning, and/or statistical basis for the change in premium. I contacted customer service and neither the agent nor supervisor could provide any factual basis for the change in cost without any increase in coverage nor requested changes to the plan. I believe this service to be a scam.

Desired Settlement: I feel as though I've potentially wasted a year of premiums for a company that changes the terms of our contract without warrant nor explanation. Coverage for my animal will now cost me more with another company because now my dog has reached maturity and cannot qualify for any discounts. Ideally, insurance should be capped at maximum increases and detailed in the contract as well as clearly communicated to the purchaser so they can make an informed decision regarding the purchase of the product/insurance. I want my year of premuims returned as this company appears to be scamming it's customers.

Business Response:

 

Date: 12/17/2015

BBB case # ********

Policy #************

Complainant: **** *********

We have reviewed the BBB complaint from **** ********* in regard to the policy rate change. We spoke with the other policy holder ******* ***** 12/15/2015 and explained how and why rates can change. The fact that rates can change is also detailed in the policy documents that are sent out to each policyholder at the time of enrollment.

This policy is issued in the state of California, our rates are approved by the Board of Insurance in California. To be approved in California, the Board of Insurance must determine our rates are fair and not excessive or arbitrary. One part of our policy that California did not approve is our self- imposed rate cap. Since there isn’t a rate cap in California we have added an amendment to the policy in the state of California.

Even without the rate cap our policy is still valuable and you are getting 90% coverage on eligible conditions without any caps or limits on the coverage. We reimburse on the actual veterinary bill, and do not use a schedule of benefits to determine coverage. We want to continue to offer 90% coverage, so we must adjust the premiums to provide the coverage without any limits on the dollar amount we can reimburse.

We adjust premiums for many reasons, a few examples are breed, sex, age at enrollment, and zip code. This information that was provided to ******* ***** on 12/15/2015. There is no additional information that we can provide to her in regard to the rate change.

Our customers can change the deductible to adjust the monthly premium. The only way to lower the monthly premium is to take on a higher deductible. ******* ***** was advised of this option on 12/15/2015 and declined.

**** ********* requested a refund of all paid premiums, and we cannot offer this and refund her for the insurance she has already been provided.

We hope this explanation helps. We encourage **** to contact us if she has any further questions or decides to explore other deductible options. We can be reached 24/7 at 1-888-733-2685.

Sincerely,

Amber S.

Trupanion

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

1/4/2016 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: ********I sent this to the company: Mr. R******* I would like to start off by saying I have been a faithful Trupanion subscriber for 5 years. I enjoyed the service that you have provided for both of my dogs, however, with the most recent events, I am disappointed and disgusted by your company's behavior. My monthly payment to Trupanion was around $40 a month, and in either 2014 or 2015, I received an email indicating my policy would increase to over $72 a month. At first a was a little annoyed by my plan almost doubling in price, but I never had much of need to use it outside of my dog needing special food because she couldn't process a protein in regular dog food. I kept the policy and continued to pay my monthly bill. About 4-6 months ago, my mixed breed English bulldog came down with some type of rash, sores, and infections. We have been in and out of the vet during that time, and to no avail, there is no identification of what the issue or cause is. We recently went to a dermatology clinic for my dog, and they took a few skin biopsies to help figure out what is going on. I am a little worried as the Vet indicated that she and the other doctor were "stumped". About 2-3 weeks ago, I received an email stated that my monthly bill is increasing from $72.34 to $168.12 a month! An increase more than twice I was paying before! This is insane. To say that I am shocked is an understatement. I am utterly disgusted, frustrated, and offended that Trupanion would double my monthly bill. I have spoken to many Vet's in my area, and they all say no one is paying that much to have pet insurance, not on my breed, or any other breed. I would like you to provide me with the data that supports the facts above, that you use to increase my bill from $72.34 to $168.12. In my opinion, Trupanion has increased my bill because I am using it frequently due to dog's condition. However, Trupanion states it has nothing to do with the frequency of using the plan.

Desired Settlement: I would like my bill to stay at the $72 monthly fee. I have only supplied a piece of the email. There is policy information that I supplied in the initial email to Mr R********

Business Response: We have reviewed the BBB complaint submitted by ***** *********** on the annual rate change notification. We understand that a rate increase is not ideal and we want to assure ***** we do not change premiums without reason. Our policy offers 90% coverage of eligible costs based on the actual invoice. We do not have caps or limits on what we pay for eligible conditions. Since our policy has such great coverage we must adjust premiums when necessary to continue offer the same great coverage.
Our rates and policy are reviewed by each state to be fair and not excessive or discriminatory. *****’s rates are determined based on many factors including the pet’s age at enrollment, breed, gender, spay/neuter status and zip code. Premium changes cannot be attributed to the covered pet’s individual claims. We do not share our detailed actuarial data with policyholders as that is proprietary information and involves thousands of pricing factors. We are hopeful this information is helpful to ***** to help understand how we determine the cost of the policy.
The secondary concern that ***** has is in regard to the policy verbiage about the rate cap. *****’s policy includes a document called an amendatory endorsement which is a standard insurance document used to customize the policy based on what has been approved by each state where the insurance in offered. The California Amendatory Endorsement was included with the policy documents that were sent to ***** at enrollment and at each policy anniversary date when the rate notification is sent out.
That document states:
“CALIFORNIA AMENDATORY ENDORSEMENT
THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ THIS DOCUMENT CAREFULLY AND KEEP IT WITH YOUR POLICY.
This endorsement, which is attached to and made a part of the policy, modifies insurance provided under the following:
Trupanion Pet Health Insurance Policy
1.      Paragraph B. ii. 4.b of section 1. INSURING AGREEMENT is deleted in its entirety.”
The above referenced paragraph B.ii.4.b. is written into our basic policy and states: “This annual adjustment will never exceed 20% in any given year.”
As stated in the California Amendatory Endorsement, that paragraph is deleted from the California policy. California did not approve a 20% rate cap for the policy which means that Trupanion will price the policy without a cap and so the premiums could change by more than 20% in a year if that is what the actuary data reflects for that group of like pets.

We can’t negotiate the rate for the policy,  but we can change the deductible to a more comfortable payment. We think it is important to point out that since ***** has been enrolled she has had many covered conditions, many of which are ongoing. We hope that ***** has seen the value in the policy coverage and has a better understanding of how we adjust premiums.  We are always available via phone or email to discuss options for a deductible that may help reduce the monthly costs and still keep pet protected. We are available by phone 24/7 at 1-888-733-2685

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

I am rejecting this response because:

Here is some updated Information from the policy. It clearly states that the policy monthly payment cannot no more than 20% in a year. The email that I just received has my monthly payment increasing by 135%. Attached below is the language from their policy:

 

According to your policy, it states the following:

b. MONTHLY PREMIUM: Your monthly premium is found on the
Declarations Page. The premium amount is determined by the
following enrollment factors:
(1) Age at enrollment;
(2) Breed;
(3) Gender;
(4) Local cost of veterinary care, (i.e., by postal/zip code);
(5) Therapeutic pet food discount, as applicable;
(6) Deductible choice;
(7) Working pet activities;
(8) Rider A choice; and
(9) Rider B choice.
c. CHANGES TO YOUR PREMIUM: Your premium will not change due
to your pet aging or your pet’s individual claims experience. However,
your monthly premium may change (up or down) during the life of the
policy as a result of changes in the overall cost of veterinary care for
your enrollment factors. Such changes will never occur more than
once per year and will not exceed 20%. If your premium changes, we
will notify you in writing, by regular mail or by email (to the last
addresses made known to us), at least 30 days before your change is to
take effect.

 

Thank you

 

*****





Business Response:

Hi ***** ***********, 

Thank you for your message. ***** should have received a letter from us regarding your DOI complaint and this complaint regarding your rates. Please refer to the letter we sent you for details on your rate. You are always welcome to request the approved filing from CA using the tracking number we sent. California DOI approves our rates and they do not allow us to cap our rates. 

 

Thanks 

 

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.

I have not had an opportunity to review the materials you have sent me. I appreciate you sending me the information and I am hopeful this will help clear up some information on my issue. 

I do understand now that California does not have a cap to increase rates.  Although that doesn't seem fair to a consumer, it appears there is nothing I can do to challenge this policy.  

Again, I will review the materials and thank you for sending it to me.

Sincerely,

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

12/17/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: I am a customer of Trupanion Pet insurance. I was sent an annual Trupanion Premium Update recently and was so upset! Last year my monthly premium was $85/monthly for my pet. If you read their Policy (which was e-mailed to me), it clearly states that your premium may be adjusted every year on your pets anniversary date. It also states "this will not never exceed 20% in any given year". However, the email stated my monthly premium was being increased to $155!!! That is over a 90% increase. When I called to discuss it with a representative I was told there is an amendment for NYS. The amendment reads that "your insurance policy is deleted in its entirety and replaced"... If the policy is deleted why is the policy emailed to the customer? The website and policy are sent leading the customer to believe that there will not be a greater than 20% increase. There is no asterisk or fine print in the policy that warn the customer that this varies by state/location. That is extremely underhanded and downright fraudulent. Perhaps they should be an HONEST company and put an asterisks in the policy or notify customers that certain states have different regulations. They notify customers that 20% is the maximum increase annually, yet with this ammendment there is no cap or explanation. It's quite convenient that they'd put that in a separate attachment. Perhaps they're just hoping customers don't notice and continue to pay. I am so upset that they would be this sneaky and not see anything wrong with it.

Desired Settlement: I would like the company to hold true to their policy and not increase my monthly premium by more than 20% annually, as that is what the policy is. It is advertised this way and they should honor that.

Business Response: Date: 12/8/2015
BBB case # ********
Policy # ************
Complainant: ***** ******
We have reviewed the BBB complaint submitted by Ms. ****** in regard to her policy documents and specifically the verbiage in the *** **** Amendatory Endorsement. An amendatory endorsement is a standard insurance document which alters the policy wording based on changes a state’s insurance board requires. Ms. ****** was provided with a copy of this document via email along with her policy and declaration page at enrollment and when the Annual Rate Notification is sent out as well.
The *** **** the Amendatory Endorsement states:
“THIS ENDORSEMENT CHANGES YOUR POLICY. PLEASE READ THIS DOCUMENT CAREFULLY AND KEEP IT WITH YOUR POLICY.
This endorsement, which is attached to and made a part of the policy, modifies insurance provided under the following:
Trupanion Pet Health Insurance Policy
1. Paragraph B.ii.4. of section 1. YOUR INSURANCE AGREEMENT is deleted in its entirety and replaced by the following:
4. CHANGES TO YOUR PREMIUM: Your premium will not change due to your pet’s individual claims experience. However, your monthly premium may adjusted (up or down) during the life of the policy as a result of changes in the overall cost of care for your enrollment factors. Such changes will never occur more than once per year. If your premium changes, we will notify you in writing, by mail or by email (to the last addresses made known to us), at least 30 days before your change takes effect.”
(The New **** Amendatory Endorsement includes other amendments which do not pertain to this complaint so we have not included them in our response.)
The 20% rate cap listed in our standard policy verbiage is removed by the New **** Amendatory Endorsement, as this portion of our policy was not approved for our New **** policyholders.
We completely understand that Ms. ****** is unhappy with how the information is presented to her as a policyholder. We are sorry to have disappointed her, but it is a standard insurance practice to use amendatory endorsements when a policy is amended. If Ms. ****** has any specific questions about her policy coverage and her rate we are always here to help. Bully’s health is important to all of us here and we hope to continue our relationship for as long as it works for Ms. ******.
Sincerely,
Amber S. - Trupanion
1-888-733-2685

12/8/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: This sounded great - deductable was based on injury/sickness not yearly deductable. Two months after resucing a GSD, he started limping in the back. Went to vet - xrays and Dasquin perscribed. Trupanion did not cover - even though it is all still in my deductable and they would not have to pay anything. Said it was because two months before when I took him in for his first check up I said he was limping in the front. Wow, like the front leg really has something to do with the hips/back. Even the vet said the limping was from going from kennels to a back yard. Just muscle ache which passed within a couple weeks. After appealing and being charged for another month the appeal was denied - said I took him in for preventative care? Even the lady at the vets said they have had problems and would not recommend until the insurance actually dealt with the vets directly. When I called to cancel I was told how great they were if there is an injury or illness. I am sure they are, but I am positive they would find a way to not cover it. Such a waste of money and time. I can not stand companies that lie. They really do not have a conscience. They just want your money.

Desired Settlement: Refund me money paid to this company since August 2015.

Business Response: Date: 12/4/2015
BBB case # ********
Policy # ************
Complainant: **** ******
We have reviewed Ms. ******** BBB complaint, the two claims in question, and the two subsequent appeals.
The first claim ******* from 10/13/2015 was determined ineligible and then re-reviewed on appeal. The ineligible decision and appeal decision were determined because the claimed conditions and treatments were direct policy exclusions. The exam fee, flea and tick preventive medication, and x-rays were noted in the pet’s medical records as preventive measures. From the medical history: “O [Owner] presented P [Pet] for x-rays of hips to see if P [Pet] may have hip dysplasia for preventative purposes.”
Hip Dysplasia coverage was not assessed at this time as it was not diagnosed. Because x-rays were performed as a preventive measure to check for Hip Dysplasia, they are ineligible for coverage under the Trupanion policy:
“Section 9 (C.): What We Do Not Cover- Preventative Care: Preventative care, including but not limited to vaccinations or titer tests, flea control, tick control, heartworm medication, dental care and prophylaxis (defined as scaling, cleaning and polishing of the teeth), deworming, nail trimming, or other grooming expenses.”
The second claim in question: 1473031 from 10/15/2015 was determined ineligible on the first assessment, but was overturned after it was appealed. The medication Dasuquin was determined eligible (upon appeal) to treat the condition of spondylosis deformans which was discovered on 10/13/2015.
It is unfortunate that Ms. ****** decided to cancel ******** policy. ******** condition of spondylosis deformans was covered, but we were not able to cover the x-rays since they were noted by her veterinarian as preventative.
We also are not able to refund Ms. ****** for the premiums she paid to have coverage for her pet since the policy inception in August 2015. Insurance regulations prevent us from refunding premiums when a valid policy was in effect. Ms. ******** claim for the medication was eligible and applied toward the $250 deductible she had on the policy. The items we excluded from coverage were within the scope of ineligible items within our policy.
We wish Ms. ****** and Pepper the best in the future.
Sincerely,
Amber S. - T********
**************

Consumer Response:


Complaint: ********

I am rejecting this response because:

In November on at least 3 occassions I explained in detail to the customer service reps, who in early November talked me out of cancelling the policy and appealing, that I told the vet that ****** was limping in the back and I suspected hip problems.  Ended up being back problems.

Strange how Trupanion says going to the vet because of a problem is not covered, yet after appealing, say it is still not covered, but the medication to treat it is.

This is insurance scamming at its finest.

I should be refunded all payments or at least from November when I was talked out of appealing.

 


Sincerely,

**** ******

11/27/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: I was trying to obtain pet insurance for my dog, I was informed by the Vet of this company I was told that with a Vet Certificate # it would waive any waiting periods and would cover my dogs injury. When I called into join up the customer service representative said with the Vet Cert. # she would be cover I doubled check that with him before enrolling. Shortly after my first claim was filed It was rejected the explanation was "sorry but you were told wrong information""we will correct this with our employee" After seeing other complaints on this company MANY people run into the same problem when something goes wrong they reject claim with some excuse. I feel the company is very misleading and will lie to you to get you to sign up.

Desired Settlement: The company needs to be exposed for there misleading and lying ways

Business Response: Date: 11/19/2015
BBB case # ********
Policy # ************
Owner: *** ******
Pet: ****
We have reviewed Mr. ******’ complaint and although he is not asking for anything specific, we would like to address his concerns and explain our policy and clarify our certificate coverage.
We reviewed the enrollment call and Mr. ****** did not mention that his pet had any issue(s) that he was seeking coverage for specifically. Our policy does not cover any pre-existing conditions and this is made clear in our policy.
We obtained medical records to process Mr. ******’ claim for ****, it is noted that **** had been experiencing issues with the back left leg for about a month prior to enrolling. Since this is a pre-existing condition we are unable to cover the costs associated with treatment of that condition.
Here is an excerpt from the pet’s medical record which was the reason for the claim being ineligible and specified in the claim outcome letter:
11/2/2015: “P [pet] not putting pressure on back L [left] leg. Been going on about a month. O [owner] been trying to keep P quiet… PE [physical exam]: Toe touching, swollen L stifle, medial buttress… pain on palpation… Dx [diagnosis] R [ruptured] ACL [anterior cruciate ligament] L… Discussed confinement, Rm [Rimadyl] 8 wks [weeks], discussed Sx [surgery]”
Mr. ****** was told on the phone after activating the certificate that his coverage would start immediately and that he had no waiting periods, which is correct based on the information we were provided at the time of enrollment. However, the absence of waiting periods does not mean that we will cover any claim that is filed. We are still bound by our policy, which specifies that we do not cover pre-existing conditions. We provide policy documents to our customers and it is their responsibility to review the details of the coverage. It is also the customer’s responsibility to contact us with questions about the coverage.  We define pre-existing conditions in the policy under section 9.B.i  “Illnesses or injuries for which signs or evidence of their potential manifestation existed within the 18 months prior to the policy enrollment date.”
Mr. ****** also states that his veterinarian advised him that he could activate his certificate and we would cover his dog’s injury. Unfortunately, this information is not correct and we will reach out to the veterinarian to clarify our policy to ensure they are providing accurate information about our coverage.
We do not cover conditions pre-existing to the policy. We apologize for the experience that Mr. ****** had and we wish the best for him and for **** in the future.
Sincerely,
Amber S.
Trupanion
**************

11/24/2015 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: I have been a customer of Trupanion for a few years now and filed a claim which was approved on October 23, 2015. The payment of $2478.38 was suppose to be deposited directly into my bank account 5-7 business days later. I still have not received the money and have contacted Trupanion repeatedly asking for conformation on my original bank routing and account information. I was told it was encrypted and to resubmit it. I resubmitted the information last week. In my conversations and emails with phone reps there has been no record of the ACH direct deposit being returned it seems odd that this large amount of money would be floating around out there unaccounted for? I then asked that a supervisor able to read the encrypted info confirm its accurateness and was told they were to busy to return my call. Finally, I got a call back from a phone rep saying I had to contact ***** ***** Bank with the tracking number to follow up. I did that and ***** ***** said it was Trupanion that needed to do the inquiry. I called them back and informed them of what ***** ***** said. Last Friday afternoon I was told by a helpful phone rep that a supervisor called ***** ***** but could “only leave a message”. Over the weekend I sent an email asking Trupanion that they confirm the original ACH was cancelled per my conversataion with their phone rep (still wanted information on where that deposit went) and confirm that the new ACH deposit was forthcoming and when it would arrive in my bank account and so far as of today 11/18/15 I have received no response whatsoever. I feel that Trupanion has been unresponsive to my repeated requests for information as to where my reimbursement is and bordering on indifferent to coming across with any “real” and useful information. I feel this is an example of "deceitful business practices" in their dealings with this insurance reimbursement

Desired Settlement: I am asking for the agreed upon refund to be paid immediately and to be informed what happened to the original ACH deposit as requested.

Business Response:

Ok, we will wait for your reply. 

Thanks, 

 

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.

Sincerely,

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

11/17/2015 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: I called Trupanion on Thursday October 29 to close my account. I was told that no one there knew how to or was authorized to close an account, but that I would receive a call back when someone showed up that knew how. It has now been a week and I have not received a call back. I called Trupanion again today, November 4, and was told again that there is no one there that knows how to close an account and that I would be receiving a call back. They also told me that someone tried to call me and left a message yesterday, which is a lie. I have not received any calls or voicemails and will be willing to fax you a copy of my call logs to prove that that is a complete lie. And if a call was made and a message left, it certainly wasn't to me. I do not believe I will ever get a call back since it's apparent no one works there that knows how to close an account. This is the second time i've tried closing my account and have not been able to. Instead, Trupanion has charged me again for a service I specifically stated I do no wish to continue. I also asked when I can expect a call back, to which I was told that it would be some time in a few days depending on how much work they have to do prior to calling me or how much staff they have on hand because they are busy.

Desired Settlement: I want my account closed, I do not want to be charged again, and this most recent charge on 11/2/15 needs to be refunded.

Business Response: Date: 11/05/2015
BBB case # ********
Policy # ************
Owner: ****** ***
Secondary Owner: ****** ***
Pets: ***** * and *******
We have looked into the matter that ****** *** brought to our attention. Mr. *** called Trupanion and requested to cancel the policy on October 29, 2015. Mr. *** was advised that a cancellation agent was not available to cancel the policy but the customer service agent would send a request to the cancellation team and we would call to go over the cancellation process in the next few days.
On November 3, 2015 an agent called the primary phone number and left a message to contact us to discuss cancellation procedures. I reviewed the outbound call to confirm that the call was completed. 
We do not know who the primary phone number belongs to, but we are obligated to call the number in our records.
On November 4, 2014 Mr. *** called us but again, no cancellation agents could cancel his policy at that time. We verified the best contact number, this was the other number listed on the policy (presumably Mr. ***** number) and we advised him that we would contact him as soon as possible to finalize the cancellation.
On November 5, 2015 our cancellation agent called and left a message on the phone number Mr. *** provided. The cancellation agent also sent an email to the email address on file asking for a reply to complete the cancellation request in writing. We require a written request to cancel a policy in their state. On the same day we received an email from Ms. *** confirming her desire to cancel the policy.
This policy has been cancelled effective October 29, 2015 (the owner’s original request date) and a prorated refund was issued for the unused premiums.
A confirmation of cancellation with these details was also emailed to the email address on file.
We would like to apologize to Mr. *** and Ms. *** for this frustrating experience. We do our very best to handle these requests as quickly as possible and unfortunately we failed in this instance. We can assure them that we always cancel the policy on the date the original request was made and a prorated refund is issued for any overpaid premium.

We wish Mr. and Ms. *** and **** and ***** the very best in the future, please accept our sincere apologies.
Sincerely,
Amber S.

11/6/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: When I signed up I was informed that my 5lb chihuahua puppy's original broken leg would not be considered "pre-existing" because she was fully healed and had documentation from not only her vet, but from a 3rd party independent professional stating her leg was healed 100%. Then a few months later, the leg was accidentally broken by our 80lb dog while playing. When I called in, the lady on the phone said the leg should be covered no problem, because the original break was healed 100%. And then they denied the claim a couple of days later, stating it was indeed pre-existing. They refused to pay for what ended up being a very expensive amputation, because the leg broke so far down the foot, there was concern that it could not be plated/pinned successfully. And I didn't have the $5,000 to try that. So I had to opt for amputation, for a total of close to $2,000. This is BAIT AND SWITCH. I never would have signed up with their company had they not said it wouldn't be considered pre-existing. I appealed the decision, and of course, they denied it again. Then I appealed one more time, and they sent it out for what they call a 3rd party impartial decision, but it's not impartial at all. They have a staff of professionals that they pay for their opinion. So of course the decision was held up. Trupanion is unethical. They shouldn't be allowed to cheat people this way.

Desired Settlement: I want them to reimburse all of my expenses, minus the $200 deductible I signed on for.

Business Response:

Wednesday, October 28, 2015

Policy # ************

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

Pet: *****

Enrollment Date: 4/3/2015

Upon receipt of Ms. *******’s Better Business Bureau complaint, a review of her policy was done to determine the nature of her concern.
Ms. *******’s 11 month old, female Chihuahua dog, *****, was enrolled with Trupanion on 4/3/2015. ***** had a fracture to her left front leg prior to enrollment where a plate and screw were surgically inserted to fix the leg fracture, this occurred 3/11/2015 while the dog was playing with her larger dog.

Ms. ******* enrolled with Trupanion on 4/3/2015 through our website. We do not have any record of a conversation with Mr. ******* prior to her enrollment or at all until 8/11/2015 when she called to change her payment method. On 8/20/2015 she called to inquire for coverage for *****’s leg that was broken (a second time) while playing with her larger dog and she was advised that we cannot guarantee coverage over the phone, that the only way to know if it would be eligible for sure would be to file a claim or a pre-approval. Based on the notes on the policy the agent clarified this information with an internal department that handles claim questions and advised Ms. ******* that coverage would depend on whether this fracture was a new fracture or a complication of the prior fracture.
Ms. ******* filed a pre-approval for the leg fracture which was not able to be completed prior to the surgery she had scheduled to amputate the leg, as there were delays in getting the pet’s complete prior medical records and radiographs that were needed to determine eligibility. Ms. ******* proceeded with the amputation surgery and her initial pre-approval claim for the leg fracture was completed as ineligible because the second leg fracture was seen as a complication from the original leg fracture.
The outcome letter for the pre-approval details the information from *****’s medical records that were used to make the decision on eligibility:

“Bone fracture (Fracture) - Ineligible
Upon review of *****’s claim, it appears the left front radius and ulna fractures are a complication of the fractures dated 03/11/15 as noted:

Noted prior to enrollment: From Ingle**** ****** ********* • 3/11/15- “non-weight bearing lame LF [left front], mild to moderate soft tissue swelling proximal to the carpus…Rads: distal L radius and ulna are fractured and proximally displaced…Strongly recommend referral to orthopedic surgeon for repair. This type of fracture does not heal well with conservative treatment like splinting…Radiograph report: Case history: P [pet] presents for acute non-weight bearing lameness LF [left front]. O [owner] states that pet was playing outside this am with their larger dogs…grade 5/5 lame LF [left front], mild to moderate swelling proximal to the L [left] carpus. Findings: There is an interdigitating transverse fracture of the distal radial and ulnar as described. Recommend surgical repair given the breed involved and the type of fracture. Although no Physeal injury is noted at this time; delayed repeat radiography is recommended not only to assess fracture healing but to assess for occult trauma to the physes.

” From ********** ******* ****** of Arizona. • 3/12/15 “Presents for left R/U [radius/ulna] fracture…Assessment: Distal L [left] transverse R/U [radius/ulna] fracture. Plan: recommended open reduction and internal fixation with a bone plate for best chances of healing well…

” From ********** ********** ********* • 3/13/15

“Fx [fracture] repair set up for Tuesday” Post policy, the following clinical signs are noted to continue:

From ********* ****** *******:

  • 8/20/15 “Patient was playing with other dog in household and owner heard a yelp about 30 minutes ago…Left forelimb-non-weight bearing with valgus deviation of distal forelimb. Assessment: left forelimb-lateral deviation of distal left forelimb-fracture…viewed radiographs with owner - informed owner that fracture appears to be in the place as previous fracture in March 2015- discussed that there also appears to be areas of bony lysis on lower (distal) part of the radius- not certain if area is where screw was seated but discussed that there appears to be no healing that has occurred between March and today- discussed that when bone heals properly a callous forms- no callous is seen…

” • 8/21/15 “Radiograph Report: Relevant History: had fracture repair in March 2015 for distal radial and ulnar fracture-was repaired at another facility. Owner stated that was playing with other dog in home late this afternoon when leg broke again. Findings: Markedly displaced, closed transverse distal left radial and ulnar fracture at distal plate screw. Conclusions: The prior fracture had healed but the distal screw hole can act as a stress riser and the plate can cause some osteopenia. Recommendations: Repair is possible with plating. Plate removal may be indicated after bony Union to reduce the risk of refracture.

” As 03/11/15 fracture is not claimable as per section 9.B.i we are unable to extend coverage for this claim.

Upon review of the records I have found that prior to enrollment, ***** is noted to have a fracture of the left front leg that was surgically repaired with plates and screws. She presented post policy on 8/20/15 for limping on the left front leg in which the radiograph report showed that the previous fracture had healed but that the current condition could be a complication of the previous plate/screws as the previous screw hole can act as a stress point and the plate can cause some osteopenia. Our policy is based on clinical signs. We are not able medically disconnect the current condition from the clinical signs noted prior to enrollment as it appears that *****’s current condition is a complication of the fracture that occurred prior to enrollment. As such we are unable to extend coverage for this condition.”


Based
 Based on the information in the medical records listed above, we have determined that this issue is a complication of an injury that was pre-existing to her policy coverage and ineligible based on our policy coverage criteria. Information about this coverage exclusion can be found in our policy in section 9.B.i: “Illnesses or injuries for which signs or evidence of their potential manifestation existed within the 18 months prior to the policy enrollment date.” And in section: 9.D.vi: “We do not insure the costs, fees, or expenses associated with complications of or diagnostic tests for illnesses and injuries excluded or restricted by this policy.”

After this review Ms. ******* had an appeal of the claim started where a complete re-review of the claim was done and we came up with the same findings, the post policy leg fracture was a complication of the pre policy leg fracture because the screw used to repair the leg caused a stress point in the bone.

Based on the information in the medical records listed above, we have determined that this issue is a complication of an injury that was pre-existing to her policy coverage and ineligible based on our policy coverage criteria. Information about this coverage exclusion can be found in our policy in section 9.B.i: “Illnesses or injuries for which signs or evidence of their potential manifestation existed within the 18 months prior to the policy enrollment date.” And in section: 9.D.vi: “We do not insure the costs, fees, or expenses associated with complications of or diagnostic tests for illnesses and injuries excluded or restricted by this policy.”

After this review Ms. ******* had an appeal of the claim started where a complete re-review of the claim was done and we came up with the same findings, the post policy leg fracture was a complication of the pre policy leg fracture because the screw used to repair the leg caused a stress point in the bone.

Ms. ******* then elected to have the claim reviewed a third and final time through our Independent Third Party Review process. These reviews are done by a specialist in the field that they are experts in. Ms. ******* calls attention to the fact that the specialists are compensated for the time to review these cases. I do wish to clarify that they are not employed by Trupanion and have no reason to make a decision based on anything other than the facts of the case they are reviewing as they are paid for their time to review the case, regardless of the outcome.

Ms. ******* has received a fair and thorough evaluation of her claim each of the three times it was reviewed for coverage. She paid for the service of insurance coverage and this claim was not eligible under the terms and conditions of her policy with Trupanion. We are unable to refund Ms. ******* for the cost of the policy simply because we were unable to cover her claims related to this issue. She canceled her policy on 10/7/2015 and we issued a prorated refund for the remainder of what she had already paid for through the end of her billing period in the amount of $37.76.

We wish Ms. ******* and ***** the best in the future.

Sincerely,
Angela – Trupanion
**************

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

I am rejecting this response because we were in fact told that because *****'s leg had been declared 100% healed prior to the second break by an impartial third party as evidenced in her file via report, it would not be considered pre-existing by Trupanion.  I've When I disputed this decision, Trupanion sent their decision to a NOT impartial third party for confirmation (they pay the professionals who make their final determinations on whether or not a decision is upheld or reversed). I have several professionals who state that her leg was completely healed and it shouldn't have been considered pre-existing.  That the way the second break occurred, it would have broken whether or not there was the first break earlier in the year or not.  The first break is not relevant to the second break.  When an 85lb dog jumps up and lands on the leg of a 4lb dog, the leg will break. 

Trupanion needs to live up to their obligation and pay all costs aside from the $200 deductible I signed up for.  If you would like a copy of the document that states *****'s leg was 100% healed prior to the second break, please don't hesitate to let me know and I'll get that from her vet for you.  Trupanion likes to take excerpts from multiple pages and put them together so that the wording suits their purposes. They haven't given a 100% accurate accounting of anything yet.  Including the fact that I'm not a "Mr.", and no "Mr." has ever had any contact with them. 

Sincerely,

****** *******  

Business Response:

Date 11/05/2015
BBB case # ********
Policy #************
Owner: ****** *******

Pet: “*****”

Ms. *******’s concerns are in regards to being misled upon enrollment, however, our records indicate that her policy was enrolled online and not via telephone. We searched our incoming phone records and we did not receive any calls from you from the numbers in our records during the month of April (enrollment month).  We cannot approve her request for a couple of reasons – we are not able to corroborate her account of the discussion at enrollment and we’ve received a confirmation that the metal hardware from the first break contributed to the second break. Regardless, we are saddened about the situation and wish ***** and ****** the best.
Sincerely
Angela – Trupanion

p.s. Ms. *******’s actual phone numbers were not included because of the BBB requirement to omit any personal identifying information.

Consumer Response:


Complaint: ********

I am rejecting this response because: There very well may not be a record of my call. I often set my phone to No Caller ID for business purposes, and don't take the time to return it to Caller ID displayed for personal calls. There have been several incidences of there being no record of my calling into Trupanion, despite the fact that I most certainly had a phone conversation with someone there, yet when I call in again, the next person can't find any record of the conversation that was had prior to that call, and we had to go through the entire rigamarole again. Unfortunately, the Trupanion phone record system isn't perfect. 

So while I appreciate your attempt to validate my claim utilizing phone records, unfortunately, you're not going to be able to do so. Unless of course you can prove that your system has never missed a call in its entire history, which isn't possible, because it's missed more than one of my calls. 

Please live up to your end of the contract, and pay the medical bills for ***** immediately.  You are responsible to make deliver on what your employees state. 

Sincerely,

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

9/8/2015 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I submitted claims for my pet **** to Trupanion who is trying to say that his issues could be caused by a pre-existing condition from June 6, 2014. **** kidney's values were low. I am not understanding why Trupanion is not covering the blood work, urinalysis, x-ray, medication or the ultrasound. ****'s blood work shows he no longer has low kidney values. How is Trupanion stating what happened to **** is related to a pre-existing condition and not pay anything? Additionally, does the emergency room doctor or record indicate the pre-existing condition and the lethargic, vomiting 1 time were associated. I had 6 ongoing claims *********, *********, ********** *********, *********, and ***********

Desired Settlement: Would like to be reimbursed for medication, blood work, urinalysis, x-ray, ultrasounds and hospital stays in order to get fluids.

Business Response: Wednesday, August 26, 2015

Policy # ************

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

Pet: ****

Enrollment Date: 9/21/2014

 

Upon receipt of Ms. *********’s Better Business Bureau
complaint, a review of her policy was done to determine the nature of her
concern.

Ms. *********’s 7-year-old mixed breed male dog, ****, was
enrolled with Trupanion on 9/21/2014. Claims for “Lethargy, Decrease in
appetite, Vomiting (Emesis), Acute renal failure syndrome, Kidney stone,
Bladder stone (Urinary bladder stone)” were submitted for the dates of service
of 8/1/2015, 8/2/2015, 8/3/2015, 8/4/2015, 8/11/2015, 8/13/2015 as claim
numbers: 1367453, 1365003, 1368176, 1381498, 1381495 and 1381492 respectively.
With these claims we determined, based on ****’s medical records, that this
condition was showing signs/symptoms prior to her policy coverage becoming
effective. Ms. ********* coverage for illness became effective after 30 days on
10/21/2014. Her dog **** was showing signs/symptoms of urinary issues beginning
12/4/2013 in which medical records indicate: “Urinating blood… tx [treat] as
UTI [urinary tract infection] O [owner] will watch for urination make sure he
is able” The symptoms continue: 12/20/13- “Finished Clavamox, still seeing sm
[small] amt [amount] of blood in urine, per Dr. D, ok to refill.” 06/06/14-
“blood in urine… Increased frequency of urination and hematuria for 1 week. Dog
has had UTI before… Quick U/S [ultrasound] of bladder: Extremely thickened
bladder wall; 1-2 bladder stones… Rad: 2 medium-sized bladder stones” 09/15/14-
Urinary s/o [A prescription diet to treat urinary issues] was purchased.

After enrollment, he was still noted to have urinary concerns:
“08/01/15- “not his usual self… He has been on SO [A prescription diet to treat
urinary issues] since a cystotomy last year for calcium oxalate stones. He has
been lethargic and not wagging his tail since last night. Again on 08/04/15-
“Mobile U/S [Ultrasound] today: renal dilation with small pelvic renoliths, one
urolith in the bladder. Dilation of proximal ureters and urethra”

Based on the information in the medical records listed above, we
have determined that this issue is pre-existing to her policy coverage and
ineligible based on our policy coverage criteria. Information about this
coverage exclusion can be found in our policy in section 9. B. I : What We Do
Not Cover: Pre-Existing Conditions: “illnesses or injuries for which signs or
evidence of their potential manifestation existed within the 18 months prior to
the policy enrollment date.”

Ms. ********* does have the option to appeal her claims with
clarification being provided by her veterinarian to help provide a medical
disconnection between the currently claimed conditions and those the pet
experienced prior to policy coverage. Ms. ********* has asked to skip this step
in the process to have these claims reviewed by an Independent third Party,
which we have attempted to explain cannot happen until she completes the
standard appeal process. If Ms. ********* wishes to submit information to start
an appeal, we are more than happy to re-review her claim, but the proper appeal
process must be completed.

At this time, Ms. ********* has requested to cancel her policy
for **** and her other pet. We have attempted to reach Ms. ********* to discuss
the appeal process again before we finalize her request to cancel the policy,
as once a policy is cancelled, we are unable reinstate her coverage and she
would be unable to continue to have this issue covered, If her appeal were to
be submitted and overturned.

We thank Ms. ********* for her feedback and wish her and ****
the very best in the future.

Sincerely,

Amber – Trupanion

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

 

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

I am rejecting this response because:No where in the policy does it state I will not receive repayment for test to diagnose the issue, to include blood work, x-rays, or ultrasounds.  Also the issues I brought **** into the vets office were not consistent with the pr-existing issues.  Where in the policy does it state that the test needed to diagnose would not be paid due to a pre-existing condition. I also asked for a 3rd party vet to look at the issue and Trupanion has not done that even though that is a part of the policy.  

In reference to the cancellation of the policy, I did cancel because so far I have paid almost 1,800.00 to insure two of my pets.  I filed a claim on **** **** and was told I was 3.00 dollars away from meeting my deductible and for **** they claim it is a pre-existing condition.  I can put money away in an account for my pets to take care of the vet bill instead of paying this company 114.00 dollars a month only to tell me I am not going to get reimbursed.  
Additionally, although you are informed that I cancelled the insurance, I did what was asked of me to cancel the insurance responded to e-mail and indicated I wanted the policy cancelled.  Trupanion is still trying to collect the insurance premium from me.  I called today and spoke with BAO from Trupanion to find out why the company is still trying to take money out of my account when I cancelled the insurance.  He told me I had to speak to his supervisor.  When I ask why he stated to cancel the insurance.  I am so frustrated and upset with Trupanion.  I reject the reason they gave you for denying my claims on ****.

Sincerely,

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

Business Response:

Date: 09/04/2015

BBB case # ********

Policy #************

Owner: ****** *********

Pet: ****

 

We have reviewed Ms. *********’s concerns and would like to assure her that we have reviewed ****’s case carefully and have considered all avenues to find a fair resolution.

As stated in the previous response, we did advise Ms. ********* of the policy section which details that Trupanion does not cover the costs associated with pre-existing conditions. This would include the costs of bloodwork, x-rays and ultrasounds used to diagnosis the condition. Because our policy states that pre-existing conditions are determined on the signs/evidence that the condition existed 18 months prior to the policy enrollment, we are unable to cover the costs of the diagnostic testing she had done to diagnosis the condition. Based on the medical records, the pet was exhibiting signs consistent with the condition that was diagnosed, prior to the policy enrollment.

Section 9. b. 1. What we do not cover - Pre-Existing: “Illnesses or injuries for which signs or evidence of their potential manifestation existed within the 18 months prior to the policy enrollment date.”

Ms. ********* was advised that Trupanion cannot proceed to the third party review process without first going through a secondary review process that we call the appeal process. This is also detailed in the policy:

 Section 5. e. Our Claim Process - “In the event of a disagreement concerning the coverage of a claim, you may request a review of Trupanion’s denial pursuant to our voluntary denied claims review process. If Trupanion affirms denial of your claim, you may further request that your claim be reviewed by an independent third-party veterinarian (ITPV) to adjudicate whether the medical reasoning for denial is justified. The following scenarios are not open to ITPV adjudication: direct policy exclusions, timing of coverage, and policy wording interpretations. The ITPV’s decision will be final and binding on Trupanion.”

We can proceed with the request for ITPV for the insured, however, we do usually ask for medical clarification that can better support the claim before going for secondary review.  We welcome any additional supporting documentation Ms. ********* or her Vet wishes to submit for this process.  The claim(s) will go for secondary review first, before going for ITPV. If there is additional documentation to be supplied, we will need to be advised of this and await a response back from Ms. *********.

I spoke to Ms. ********* to advise her of this on August 31, 2015. At that time she advised me that she just wanted to cancel and that she understood the risks of cancellation, including no option to reinstate the coverage. I advised her that we would finalize her cancellation request that day and honor her original cancellation request date. I also advised her that she would not be billed again. She understood.

Ms. ********* has stated that Trupanion continued to attempt collection of her premiums after she requested cancellation which is not true. Her payment date has always been the 21st of the month. Our premiums are auto drafted in the early morning hours of the payment date. When she called in to request cancellation on August 21, 2015 at 2:59PM PST the premium had already attempted and failed to clear. There were no further payment attempts on her account.

I contacted Ms. ********* to go over the risks of cancellation and to discuss the option to appeal her claims and left a voicemail message for her on August 25th and again on August 28th. She called and spoke to a customer service agent named Bao on August 29th who advised her that she needed to speak to a supervisor. This was because we had been trying to reach her to discuss the steps to take to appeal the claim before she cancelled her policy.

Ms. ********* had the experience that she did with Trupanion, we would love to be able to help every pet that we have a policy for, however we must adjudicate claims based on our policy verbiage and be fair to all policyholder by doing so.

We wish Ms. *********, **** and her other dog, **** **** the very best.

Sincerely,

Amber – Trupanion

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

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

I am rejecting this response because:
Trupanion was not totally honest. I believe they were deceptive on what was covered and how payment would be received concerning not only **** but **** **** as well. I have to pay up front for their care and believe I can start a savings account versus giving away money and not be reimbursed. I am not concerned about their fairness to others I am concerned that I paid almost 1800 to Trupanion and another 1800 out of pocket only to be told ****'s condition is not covered. Even the emergency room doctor states I should fight the decision because there is no evidence that ****'s condition was caused by past medical issues. I am truly disappointed in the insurance and the decision that was made. 
Sincerely,

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

8/5/2015 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I signed on with Trupanion to cover my 4 dogs. One of my dogs suffered a tumble approximately 4 weeks ago and that resulted in an injury to her leg. The injury was SOLELY caused by the tumble, and prior to that was fine. Trupanion is refusing to cover the emergency visit related to this injury and they are refusing to cover the surgery stating that a leg surgery she had back in 2013 is grounds for them to deny the claim based on a "pre-existing" and bilateral condition. The injury to the right leg had ABSOLUTELY NOTHIGN to do with her surgery in 2013 on the other leg. They have worded their contract in such a way as to provide them a legal loophole to deny any/all claims on the part of their clients. This is unfair business practice, it is done in an effort to scam their customers, and provides them the ability to NOT have to pay out on large cost claims. I believe the way they have worded their contracts that make even a SNEEZE a couple years back an excuse to deny coverage, is grounds enough for a class action lawsuit. MANY other customers have had this experience, you have only to go to Yelp or other online sites to see the many claims NOT honored by Trupanion. Having them come here to simply restate their fraudulent policy exclusions is NOT an effort in GOOD FAITH to assist the client...it is just their doubling down on their verbiage that provides them the loophole to take monthly premiums from their customers and NEVER have to pay. Please ask them to disclose the number of claims denied because of "pre-existing conditions" and then look into those to see how many of them are based on ridiculous and unrelated illnesses or events to the claim being submitted by the clients.

Desired Settlement: Follow through on, and cover the claim I submitted for my dog's emergency visit and surgery costs (at 90% as stated when they want you to buy their insurance), or reimburse me ALL my paid premiums since I enrolled in my policy.

Business Response:

Policy #************
***** *****
Pet:  ********
Enrollment Date: 10/14/14
Upon receipt of Ms. *****’ Better Business Bureau complaint, a review of her policy was done to determine the nature of her concern.
Ms. *****’s 4 year old mixed breed female canine, ********, was enrolled with Trupanion on 10/14/14. Prior to enrollment on 05/07/2013, ******** experienced “left hind lameness” according to her records from ****** ******** for Small Animals at ***** that was consistent with cranial cruciate injury.  Surgery to correct the CCL injury (a TPLO) was performed on 05/08/13.
Recently, ******** experienced an injury to her right hind leg that resulted in a TPLO surgery for a cruciate injury. Trupanion was unable to extend coverage to this condition because Trupanion looks at cruciate injuries as “bilateral” – the exact exclusion in the policy reads:
9.b.iv: The cost of treatment of bilateral conditions presenting on one side of the body, if that condition was a pre-existing condition on the other side of the body, such as luxating patella or anterior cruciate ligament (ACL ) or glaucoma, within 18 months of the policy enrollment date;
Since ******** had a ruptured CCL (CCL and ACL are synonymous) on her left hind leg in May of 2013, and then enrolled on 10/14/14, this places her initial injury within the 18 months prior to policy enrollment and therefore we are unable to extend coverage for the ACL rupture on her right side that occurred in May 2015.
Policy documents are provided to a policy holder upon enrollment via email and are also always available online.
Trupanion managers have been able to talk to Ms. ***** and are currently reviewing whether or not an appeal is the best option for ********’s claim. Trupanion will guide Ms. ***** into next steps should that be the case.
Trupanion strives to pay claims that meet the criteria set forth by our policy wording. We understand that it is a frustrating experience to receive an ineligible claim, but in order to remain fair and just to all policy holders we have a duty to adjudicate claims in the same manner for all those enrolled with us.
We thank Ms. ***** for her feedback and wish her and ******** the best in future.
Sincerely,
Malari – Trupanion
************

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

I am rejecting this response because:  The surgeon who performed surgery on ******** for her right hind leg, has clearly challenged Trupanion on what is or is not a bi-lateral condition.  ***** is recognized in the U.S. for it's excellence and research, and their expertise in these matters.  They are not just a veterinary hospital but also a veterinary school (university).  Over 80,000 patients are seen every year and hundreds of students go through their doors as well.  The surgeon who wrote the attached is their chief surgeon and a professor.  We are challenging Trupanion's expertise in even determining what constitutes a bi-lateral vs. a unilateral condition.    They need to pay this claim.  Both of ********'s legs were closely examined back in 2013 and there was absolutely nothing wrong with her right hind leg --- and having a slow, progression to lameness on her left hind leg is not a "pre-existing condition" to a "trauma" suffered on her right rear leg only a month ago.  Frankly, Trupanion has worded their policies so vaguely and broadly as to allow themselves loopholes to get out of having to honor paying out legitimate claims. Their stock answer, over and over to people who file complaints with the BBB should be evidence enough of their fraud.  They care nothing for their clients, they simply double down on their ridiculous, unresearched and unsubstantiated verbiage around medical terms and conditions they know absolutely nothing about.   When an expert such as the leading orthopedic surgeon who wrote the attached appeals letter for me, tells them they are ludicrous and fraudulent, you would think they would finally, and humbly, pay out on this claim. But not Trupanion --- because as another former client and lawyer said so succinctly about this company --  "For Trupanion, the Name of the Game is to Deny Your Claim."

I have asked Trupanion to contact me via email so I have a paper trail of everything they say.  They insist on trying to get me on the phone so nothing is recorded and they can just give me the "aww shucks maam" speech.  They need to put into writing a valid argument for their position and not just another cut and paste of their stock policy verbiage into the email as if that will be acceptable...I repeat --- we are challenging their claims of what constitutes a "bi-lateral" condition vs. unilateral.  Where are their veterinary experts who can support their position and provide a scientific, fact based rebuttal to what my dog's surgeon has put forth? 

Continuing to just respond to BBB complaints with the same tired old cut and paste should not be acceptable to the BBB and it is certainly not acceptable to me.



Sincerely,

***** *****

Business Response:

Thank you for the reply, *****.
I understand that this situation has been frustrating. A denied claim is certainly never the outcome that we want for our customers.
Our on-staff veterinarian had a very productive conversation with the surgeon who performed the surgery for your pet, Hermoine. He now understands our policy and how Trupanion views cruciate ligaments. This outcome is not a matter of medical nuance, since a bilateral CCL is specifically excluded in the policy language if the first CCL has occurred within the 18 months prior to policy enrollment.  A copy of the policy is available online or we are happy to email or mail you one.
I apologize that our agents have reached out to you via phone as opposed to email. We have found that often times a phone call can be more productive and more personal in these instances however we certainly want to respect your wishes.
Our policy is the legal document that outlines our coverage. What Trupanion considers to be bilateral is not up for debate. The policy applies to all those insured under it so that we may assess and adjudicate claims fairly.
We wish Hermoine a swift recovery.
Best wishes,
Malari – ************
Trupanion

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

I am rejecting this response because:    The way Trupanion worded their letter above makes it appear that my surgeon is in agreement with their and their veterinarian's view of what constitutes a "bi-lateral" condition.  My surgeon challenges their view of what constitutes a bi-lateral condition, and, in fact, claims that what ******** had was a uni-lateral condition.  He is one of the leading surgeons in the United States on crutiate tears, don't you think he would know what a bi-lateral vs. a unilateral condition is?  Please read his two page letter attached to this BBB complaint.   Trupanion continues to push THEIR bi-lateral condition verbiage in their policy to try to cover their refusal to pay out, but its all just smoke an mirrors meant to confuse the BBB and possible new customers.  Their pointing over and over again to verbiage on bi-lateral conditions is irrelevant.  My dog's injury was NOT a bi-lateral condition, but a uni-lateral condition that came about as the result of a trauma injury to otherwise VERY healthy right leg.    NO matter now Trupanion tries to spin their rejection of my claim and link it to unrelated bi-lateral verbiage in their policy, their rejection of my claim is, and always will be, a failure on THEIR part to follow through on a promise to cover their client costs by 90%.  They covered NOTHING, after almost a year of my paying them premiums for all four of my dogs every month.  They refused to reimburse me for the premiums I have paid saying that my "well, your dogs were covered."  REALLY?   Well, then, Trupanion, where is the coverage?  Because I have shelled out over $4,500 on my dog's emergency visit for her trauma, and the associated surgery, and have not received from you even one red cent.  And it was my very first claim!   I'd say that was NO coverage.  So what do they say?  Well, we can reimburse you for the amount of premium you have paid since you said you want to cancel your policy.  TWO WEEKS.  Seriously, it's laughable how terrible this company is.  The BBB should be giving this company an F when it comes to making good on, and resolving client issues.  They could care less.    Trumpanion is a FOR PROFIT company that is intent on only one thing -- to make a fortune on scamming their clients out of their hard earned money each month without every having to pay out for a single thing.   I'm sure their leadership team are living large on the profits, and laughing all the way to the bank.  Buyers BEWARE.   Run, don't walk away from Trupanion!   They are just scam artists.



Sincerely,

***** *****

8/4/2015 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: My dog had some dermititis a few times and ear infections a few times before his policy began, all of which seemed to clear up and it was not an ongoing problem. A few months after the start of the policy he started having severe skin dermititis and yeast problems. Eventually it was found that he has a thyroid condition. When I first called them about a claim they said that every instance of a skin issue or ear infection was a seperate illness and that I had a $500 deductible per illness or occurance so these were seperate instances and the $500 deductible would have to be met for each one before any money would be paid. Then we found out about his thyroid condition and the vet said his yeast issues were more than likely due to that. So I filed a claim for all of his vet visits for the yeast infections on his skin and in his ears and also for the thyroid condition testing and treatment. Now Trupanion is saying that since he had dermititis before and an ear infection before, it's all a pre-existing condition and nothing is covered. So basically they said that if in a few years my dog gets thyroid cancer or any condition that can somehow be linked to his thyroid, that it will not be covered because it's a pre-existing condition because he had dermititis before. After reading some of the complaints filed before and their responses, I really wish I would've read them before I ever got this policy because I certainly would not have. I work in the pet industry and I will do everything in my power to inform all my pet industry colleagues and pet owners I know of Trupanion's shady business practices and that they should not buy their product. To say some of these conditions are pre-existing is the same as saying since I had acne as a teenager the skin cancer I developed is not covered because it's pre-existing.

Desired Settlement: I would like my dogs vet expenses over the cost of my deductable to be paid or I would like my policy cancelled and the total of every monthly premium I paid to be refunded. It was never Trupanions intention to cover any of my vet expenses and I feel they are practicing deceitful business tactics.

Business Response:

First Response
Policy# ************
Owner: ******** ********
Pet: *****
Enrollment Date: 10/2/13
Upon receipt of complaint from Ms. ********, a review was done of *****’s policy to determine the nature of the complaint.
Ms. ******** is disputing the outcome of *****’s recent claims. The claims for ***** for “Pododermatitis, Seborrhea, Licking, Otitis Externa, Allergy (Allergic), and hypothyroid (hypothyroidism)” were denied as pre-existing. Based on *****’s medical records from ******** ****** ******** prior to policy enrollment:
From ******** ****** ********:
• 1/2/13: “Check skin” “DTM [dermatophyte test medium] (negative)” “Skin scrape (negative)” “Prescribed HA [hypoallergenic diet]” Vetalog and Cerenia were administered.
• 1/14/13: Purina HA Form canine [diet] prescribed.
• 2/19/13: Purina HA Form canine [diet] prescribed.
• 3/13/13: “Staph dermatitis”
• 3/22/13: Purina HA Form canine [diet] prescribed.
• 3/29/13: “Staph dermatitis”
• 4/22/13: “…staph dermatitis – right hind paw lick granuloma”
• 8/8/13: “Check ears… otitis externa”
• 9/9/13: “Yearly vaccines and check toe… mild discharge both ears” “swollen left hind digit 4-5… radiograph – no significant findings” Ketoconazole was prescribed.
From ****** ********* ****** ******* ***.:
• 9/8/13: “Presented for limping on left hind limb… Licking at left hind constantly… moist interdigital dermatitis with yellow discharge all 4 feet. Worse on left hind digit 4-5… lameness left hind food, painful left hind digit 5 – Rule/out secondary to trauma, fracture, dermatitis other. Interdigital dermatitis x4 feel – Rule/out bacterial, malassezia yeast, allergic, other”
And post policy from ******* ********** *******
From ******* ********** *******
• 2/10/14: “Check skin (see previous records)… multiple crusting lesions along back, chest, ventrum, muzzle and around eyes. Skin red and itchy” Apoquel, Malaceb Shampoo and Simplicef were prescribed.
• 8/12/14: “Recheck pay… left hind foot… bright red skin – moist seborrhea” “Continue Simplicef as prescribed by EAH”
• 11/10/14: “History of skin trouble, some pyoderma between skin and large pads or rear paw”
• 12/2/14: “Left ear – purulent material red inflamed and painful”
• 12/22/14: “Check skin licking a lot…mild waxy debris both ears… yeasty feet, crusty lesions on dorsal spine, perianal region… Assessment: Allergies with secondary pyoderma”
• 2/3/15: “Check hot spot on back… Talk to owner about checking blood work and thyroid. Possible allergy testing.”
• 2/20/15: “Progression check yeast infection, now licking left rear paw on skin and ears... severe seborrhea… pododermatitis” Tramadol and Hydroxyzine were prescribed. Thyroid test was performed.
From ********* ****** ******** of Santa Rosa
• 3/1/15: “Check left ear. Possible ear infection… left ear swollen shunt, unable to pass otoscope… some bacteria and yeast”
As these signs were documented prior to enrollment and noted to recur post policy, there can be no coverage for this claim.
We recognize that it is not intuitive for a pet owner to make an association between otitis (ears), skin lesions/rash, and pododermatitis (paws), and hypothyroidism; however a veterinary professional is aware of the link as allergies/atopy is a common problem among cats and dogs.
Trupanion understands the frustration and emotion that is involved in receiving a denied claim and it is definitely not our intention for this to be Ms. ********’s experience. In order to continue offering insurance at a reasonable rate without unnecessary and unfair inflation, we can only pay claims that meet the standards set forth by our policy. Ms. ******** may appeal this outcome with a letter of clarification from her veterinarian. The appeal would need to medically disconnect the pre-policy signs and symptoms that are consistent with this current condition. The appeal team at that point would re-assess the claim outcome.
We hope that *****’s condition is manageable and wish both he and Ms. ******** the well wishes in the future.
Malari F*****
************** *** ****
E: *************@trupanion.com

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

I am rejecting this response because: I do understand the connection between ears and skin and a thyroid condition. The conditions he had previously were completely different strings of bacteria and were cleared with antibiotics. The vet is not even 100% sure it is a thyroid condition that is the source of his current condition and we are waiting on the results of a biopsy. If it was not in fact his thyroid then the testing should be covered since it would then have nothing to do with a pre-existing condition. Just because a dog may be prone to infections that does not mean that all infections he may get are connected in any way. An infection someone would get in their toenail would have nothing to do with a sinus infection they may get later. His condition is worsening despite being on thyroid medication which is leading us to believe this infection is caused from a different acute source. That would obviously mean it would not be caused or connected to any pre-existing condition or ear infection that he may have had in the past. I want all of his expensed covered or I want the total of all premiums I have paid to be refunded to me.

Sincerely,

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

7/31/2015 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I purchased pet insurance for one of my dogs. AFTER the insurance was purchased, I had taken my dog to the vet regarding certain issues she was having. The issues were cleared up. The issues came back. In May, my dog suddenly became very ill and ended up going to an emergency vet. The vet determined she had had some type of seizure most likely and said she would not recover. I made the difficult decision to have her put to sleep. This horrible company refuses to pay any part of the claim and says that euthanasia is covered but not if part of an earlier cause. How is euthanasia going to be attributed to anything when that is a pet owner's choice as to whether or not to do so?

Desired Settlement: I either would like my ONE AND ONLY CLAIM to be paid or I want a full refund of ALL premiums I paid.

Business Response:

Upon receipt of Ms. ******* complaint, a review was done of her policy to identify the nature of her concern. Ms. ***** submitted a claim for the euthanasia of her pet, *****. The circumstances of this claim are very sad and our hearts go out to Ms. ***** during this difficult time.
We have reviewed the claim in question, claim #*******. The claim was deemed ineligible as the condition that ***** was euthanized for had been present and showing signs and symptoms since prior to policy inception date of 07/06/14.
When a pet shows signs or symptoms of a condition prior to policy inception, any claims related to this condition would not be eligible under the pre-existing exclusion of our policy 9.B.i:
Exclusions:
9.B.i Illnesses or injuries for which signs or evidence of their potential manifestation existed within the 18 months prior to the policy enrollment date.  
As this claim was adjudicated correctly, abiding by the criteria set forth by our policy we cannot refund the premiums either. From the date of enrollment through the date of cancellation, ***** had coverage under our policy, though no claims were submitted.
Ms. ***** has the option to appeal the outcome of her claim if she feels like the reason for the euthanasia was not related to the pre-existing neurological disorder. A letter of clarification provided by the veterinarian can be submitted and then reviewed by our Appeals team. A claims specialist went over this option with Ms. *****, and she is welcomed to pursue it if she wishes.  
We are very sorry to hear of *****'s passing.

With Sympathy,

Malari - Trupanion
************

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

I am rejecting this response because:


At at the very least, euthanasia should be covered because it is a DECISION made by the owner, for whatever reason! 
Sincerely,

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

7/10/2015 Guarantee/Warranty Issues | Read Complaint Details
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Additional Notes

Complaint: Filed a claim with this company three weeks ago for my cat getting his teeth cleaned, during which he had to have 5 extractions. On their form they ask for anywhere your pet had been seen, so I put a vet clinic my cat had seen 5-6 years ago, for taking a pill that he got hold of. When I submitted the claim, they called me, I explained that this visit was years ago, and for taking a pill, not for his teeth. They said, at that point, that they would not need the information considering time lapse, and they would be paying my claim soon. 3 weeks later, still nothing. So we called tonight to see what the hold up was. We are NOW being told, that if we don't get these records, nothing will be paid. We have been paying for these policies for at least 3 years, and have never yet turned in a claim. NOW, we have to provide all records or nothing will be paid. When we called before the surgery, they said they would pay for extractions and anesthesia. Immediately after the surgery, when we found out the amount of extractions and the 3 hours it took to do the procedure, I called again, to verify what was to be paid. Because I put, on their form, a clinic my cat saw several years ago,having nothing to do with what we are expecting payment, and now payment will not be forthcoming. NO! Sadly, I am now seeing that dog owners are very happy, while cat owners, not so much? A little animal prejudice perhaps???

Desired Settlement: We expect Trupanion to reimburse us for the services rendered. They are expecting records from a company who saw my cat several years ago, which I will be calling to get for this company. They need to explain on their form, that any place they put on the form,and have a time limit, they will be requesting records from and if they are not provided, payment will not be forthcoming. Once I am able to provide them with the records, I expect payment immediately. Once I receive payment, depending on the reimbursement, if they are actually paying for the services they told me they would pay for, I will determine if we are keeping this service. Sad thing, we heard great things about Trupanion, but so far, I am not impressed at all. Our first time we use this service, and we are getting nothing but static, and no communication with us at all. A quick email telling us, two weeks ago, they were requesting further records, nothing since. Communication would have been nice!

Business Response:

Policy #************
****** ***** *** **** *******
Pet:  *******
Enrollment Date: 02/02/2013
Upon receipt of Mr. *****’ Better Business Bureau complaint, a review of his policy was done to determine the nature of his concern.
Mr. *****’ 8 year old Siberian male feline, *******, was enrolled with Trupanion on 02/02/13.
Two claims were submitted for *******, Claim #1215733 for “Dental Check Up Prior to Cleaning, gingivitis” – which also had charges for a Mast Cell Tumor on it; Claim #******* for “Dental Surgery, gingivitis – feline resorptive lesions (dental x-rays), small pink nodule – excisional biopsy- fine needle aspiration showed Mast Cells”. 
Upon receipt of these claims, medical records for ******* were collected, as is standard protocol for a Trupanion Claim. Occasionally, the record collection process can take a little while – there can be extenuating circumstances such as technology failures that can delay a process. The good news is that we only ask for records on the first claim, and once received, future claims go by a lot smoother.  Once we received complete records, we were able to finalize *******’s claims.
Trupanion was able to extend coverage for the Mast Cell tumor. The initial charges were processed under claim #1215733 and $153.00 was applied to the $300 per condition deductible.  The only ineligible item on this claim was the exam for $65, which is a direct policy exclusion and not something that offer coverage for.
On claim #1215745, we were able to extend further coverage for the Mast Cell Tumor. $147 was applied to the remaining deductible for that condition and we paid to policy holder $278.78.
The second condition on this same claim was for “Gingivitis and Resorptive lesions” which was also eligible for coverage– We were able to apply $300 for the deductible, and then after the deductible was satisfied, we paid out $94.10.
We were not able to cover the teeth cleaning itself, which is considered preventative/routine, in the amount of $268.80, nor could we offer coverage for the microchip implantation in the amount of $37.80, as that is also considered preventative/routine.
Trupanion does not offer coverage for routine and preventative care as described under section 7.c in our policy:
7.c. Preventative Care – Preventative Care such as, but not limited to, vaccinations or titer test, flea control, tick control, heart worm medication,  dental care and prophylaxis (meaning cleansing of the tooth surfaces), deworming, nail trim, or other grooming.  
Policy documents are provided to a policy holder upon enrollment via email and are also always available online.
We thank Mr. ***** for his feedback and wish him and his family the best in future.
Sincerely,
******
Trupanion
************

Business Response:

Thank you for your response.
Trupanion was able to cover the charges associated for both of *******'s recent claimed conditions, the dental issue as well as the mast cell tumor removal. With our policy however, we have to apply a deductible to separate medical conditions. The deductible was satisfied for *******'s dental issue and about halfway satisfied for the Mast Cell tumor condition. When there are charges on an invoice that apply to both conditions (like anesthesia for instance), we pro-rate the charge equally among the conditions. If for some reason, a policy holder believes that we have split the charges inappropriately, we offer an appeals process once clarification is received from the veterinary hospital to allow for a reassessment.
Trupanion does not offer coverage for general dental cleanings.
Unfortunately, when a policy holder cancels with us, we are unable to reinstate as it is outside insurance regulation. We can certainly start a new policy should they wish to, but it is true that anything that occurred previously would be considered pre-existing and not eligible for coverage.
We are sorry that this has been your experience.
Sincerely,
******- Trupanion

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

I am rejecting this response because:Simply stating corporate talking points doesnt resolve issue with neither My wife or myself. The main purpose for joining the BBB is to state that you the company are willing to do whatever you, the company can do to please your customers. The BBB is not a mandatory business that a company has to join, the BBB is a company that business join to use in their sales pitch that indicates that they the company's main concern is their customers ( it is a hook) to show that they the company are better than the rest. I have worked for company s who were members of the BBB in fact I was Quality adviser for one of these company's who used the BBB, and I can tell you any company who really believes in the BBBs philosophy, stands by the credo of Rule#1 the customer is always right. Rule#2 If the customers wrong refer to rule #1. The BBB stands for a company going over and above the call of duty. I believe Trupanion just uses their BBB status as a selling point only, and doesn't really believe in the customer comes first credo. I wish I had recorded the conversation where Trupanions rep said to my wife that ALL of the anesthesia would be covered, they do have the call and if they really believe in the truth they would listen to their own recorded conversation, and even though their employee did not give the correct information (thats on their employee) they would do the right thing and do what they said verbally on the phone and not follow corporate speak. Shooting from the hip saying what they think the customer wants to hear,then quoting contracts is deceptive at best. I'm also sure if someone looked into this company they would find a pattern of this, what better way to cut cost than to make a customer so upset that they cancel only to have from that point on, any and all past medical concerns to be preexisting. I simply will not except trupanions response as they clearly show in their actions that they are NOT a sincere member of the BBB and just using their membership as a selling tool. Shame on Trupanion.

Sincerely,

****** *****

6/28/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: My complaint against Trupanion has to do with refusal to cover a food allergy. They categorized my dog's food allergy as a pre existing illness when it wasn't diagnosed by our Vet, Dr. *****, well after we obtained the insurance. And they even acknowledged this fact.  Our first Vet visit we took him in to be examined for issues affecting his underarms and other areas, which could have been related to contact allergies or even exposure to chemicals like nicotine. We were uninsured at the time. After this first visit, we obtained Health Insurance for our dog. It was later on when he was officially diagnosed with "food allergies." We spent a few thousand on him trying to establish what the problems were, specifically a total of about 10 claims, all the while, expecting to be covered. Trupanion denied the claims calling it a "pre existing" condition which meant that it was diagnosed before we got insurance. I emailed Trupanion twice on this issue and received no response.  Our Vet, Dr. *****, appealed this issue directly with Trupanion, which was also denied. They claimed that bc our dog had itching on his first visit, and even though our vet told them it had not been diagnosed until way later- They still said they qualified it as a preexisting condition. They refuse to cover these claims. This is horrible bc they are refusing to reimburse our claims even though a diagnosis had not been made. They are being allowed to ignore the facts. Please assist. Thank You, ******* *** ************

Desired Settlement: I would like all our claims to be reimbursed as it should have been in the first place.

Business Response:

Policy #************
******* ***
Pet: ********
Enrollment Date: 05/15/2013

Upon receipt of complaint, a review of Ms. ***** policy for ******** was done to better understand the nature of her concern.
Trupanion recognizes that it is frustrating to receive an ineligible claim. Something to understand about our policy is that we review the eligibility of claims based off when signs and symptoms of a condition manifest, not when a diagnosis is made. In the policy, it states:
B. PRE-EXISTING CONDITIONS:
i. Illnesses or injuries for which signs or evidence of their potential manifestation existed within the 18 months prior to the policy enrollment date.
 
Because ******** showed signs and symptoms of his allergic condition prior to enrollment is why Trupanion cannot offer coverage for his allergic condition.
I am sorry to hear that your emails were not responded to, that is certainly not the experience that we want for you. If you ever have questions regarding your policy and are unable to reach us by email, I encourage you to call us at ************ to talk to a Care representative. We are open 24 hours a day, 7 days a week.
I hope that ********’s condition is manageable and I hope that he is feeling better. Though I hope that ******** remains healthy, I hope that we can help with his next condition.
 
Best Wishes,
****** – Trupanion
************  

6/26/2015 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: Insurance agent falsified coverage. Soon after our dog had surgery for CCL leg injury, we inquired with Trupanion to acquire an insurance policy in case our dog incurred a second injury in the other leg. The agent said that the policy will provide coverage for any surgery. Turns out, the agent lied when our dog had injured his other leg. They do not provide coverage for second CCL injury.

Desired Settlement: Trupanion should refund charges if they do not practice fraudulently mislead policy coverage. Description of coverage is not easy to interpret.

Business Response:

Policy #************
***** ***** *** ***** *****
Pet:  ******
Enrollment Date: 09/04/2014
Upon receipt of Ms. ******* Better Business Bureau complaint, a review of her policy was done to determine the nature of her concern.
Ms. ******* 3 year old mixed breed male canine, ******, was enrolled with Trupanion on 09/04/2014. Upon enrollment, Ms. ***** called in and spoke to a Care representative on 09/05/2014. In this call, she explains that ****** recently had a torn cruciate ligament and that he required surgery. Since Ms. ***** had enrolled ****** with Trupanion just the day before, the Care representative let her know during the call that nothing related to this injury would be eligible for coverage with Trupanion.  Ms. ***** confirmed that she understood.
Trupanion looks at cruciate injuries as “bilateral” – the exact exclusion in the policy reads:
7.b.2: The cost of treatment of bilateral conditions presenting on one side of the body, if that condition was a pre-existing condition on the other side of the body (such as luxating patella or anterior cruciate ligament (ACL) weakness);
Since ****** had a ruptured ACL on his right hind leg in September of 2014, and then enrolled in after the injury, this places his initial injury within the 18 months prior to policy enrollment and therefore we are unable to extend coverage for the ACL rupture on his left side that occurred in March 2015.
Policy documents are provided to a policy holder upon enrollment via email and are also always available online.
Trupanion managers have been able to talk to Ms. ***** and help to clarify why Trupanion is not able to offer coverage for ******’s claims.
Ms. ***** has cancelled ******’s policy with Trupanion as of 03/30/15.
We thank Ms. ***** for her feedback and wish her and ****** the best in future.
Sincerely,
****** - Trupanion
************

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

I am rejecting this response because: We enrolled ****** with Trupanion knowing full well we had to pay for ******s initial surgery and requested that we obtain coverage in case of a recurring injury in his other leg.  They misled us to believe that he would be covered on his other leg.  We did not try to obtain coverage for his initial injury from Trupanion.  In any case, there is a misunderstanding and we request a refund.

Sincerely,

***** *****

Business Response:

With receipt of Ms. ******* initial complaint, a review of information provided to her upon enrollment was reviewed, including the early enrollment calls. Upon enrollment, it was explained to Ms. ***** that anything related to the pet's cruciate injury would be ineligible for coverage. At enrollment, a policy that outlines our coverage is sent via email (the policy is also always available online for our customers). Trupanion makes every effort to be as transparent and forthcoming as possible and that is why our policy clearly lists out that cruciate injuries are considered bilateral conditions and if a pet has an injury on one side prior to enrollment, the other side will not receive the benefit of insurance. This is the reason that we were unable to extend coverage for ******'s current cruciate injury.
We wish ****** the best of health in the future.
****** - Trupanion
************

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

I am rejecting this response because:  We immediately sought coverage after ******'s initial CCL injury since he was at risk for the same type of injury on his other leg.  This was clearly expressed when we inquired with Trupanion.  Plus, we were referred to Trupanion by ******'s pet surgeon - who told us ****** is at risk again for the same injury and had recommended Trupanion for coverage.

The Trupanion rep did not say that ****** will not be covered for a second CCL injury, instead, we were told that ****** would be covered for any surgery.  For this misleading response, I am seeking a refund in our policy.  Had we been told that ****** will not be covered for second CCL surgery, we would not have acquired a policy with Trupanion.

Sincerely,

***** *****

6/8/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: MY dog ********** had multiple growths removed totalling 1350.00trupanion applied a deductable of 400 to each growth. Failing to make any payment, when they advertise 90% payment on your claims.This is fraud

Desired Settlement: Payment at 90% with the 400deductible as advertised.

Business Response:

Policy #************
**** ******** and ***** *******
Pet:  *********
Enrollment Date: 07/02/2010
Upon receipt of Ms. ********** Better Business Bureau complaint, a review of her policy was done to determine the nature of her concern.
Ms. ********** 13 year old mixed breed female canine, ********, was enrolled with Trupanion on 07/02/2010. A claim was submitted for “Lumps” for the date of service as 02/05/15 under claim #*******. Within this claim, there appears to be 5 different masses: one lipoma on the chest, one on the left hind leg, a dermatofibroma on right front leg, apocrine cyst right front leg, and a hamartoma on the right rear leg. As all the masses are different, they are completely different conditions. We have biopsy results to confirm that those are all different conditions; as such Trupanion is unable to apply these conditions under one deductible.
Our deductibles are “per medical condition” meaning that for each new medical condition, a new deductible is applied. This information can be found under section 9.f of our policy:
9.f: Deductible- the monetary amount that you pay for each condition. Once the deductible is met for a specific condition, the policy will then pay out for all future losses subject to all other terms and conditions.
Trupanion representatives have discussed our deductible application over the phone with the policy holders and discussed the option of appeal.  An Appeal was initiated by Trupanion who reached out to the veterinarian and left a message.  Policy holder **** called into Trupanion on 05/20/15 and advised that she would follow up with her veterinarian regarding an appeal. At this time, an appeal has not been started.
Trupanion offers a variety of deductible options ranging from $0-$1000. Ms. ******** chose the $400 deductible range for pet *********. She is able to change her deductible for future, unrelated conditions should she wish to do so.
We thank Ms. ******** for her feedback and wish her and ********* the best in future.
Sincerely,
****** –Trupanion
************

4/27/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: I had pet insurance through Trupanion and last year I sent an email asking them how do I go about cancelling the policy. They called and left a message saying that I needed to call and speak to a representative to cancel it. I decided not to cancel so I didn't call back. Last week I went onto their website so I could print out a claim form since my dog requires surgery and I see that Trupanion cancelled the policy, without speaking to me directly, no email, no regular mail came in. I had no idea it had been cancelled. If I was told that I needed to talk to a representative to cancel the policy how could they cancel it without speaking to me first? I called them and was told that they attempted to contact me and since I didn't respond within 15 days the policy was cancelled. I didn't call back because I changed my mind, how was I supposed to know they would automatically cancel it without any notice?

Desired Settlement: I want the policy to be renewed and be able to put in a claim for her surgery. If I open a new policy they will just deny the claim saying it was a pre-existing condition and won't cover it.

Business Response: Tell us why here...Date:  04/16/15
Policy Number:  ************
BBB Case Number:  ********
Policy Holder: *** **********
Pet Name: ******
Enrollment Date: 07/20/2011
Cancellation date: 05/19/2014
Upon receipt of Ms. **********’s complaint, a review of her policy was done to determine the nature of her concern. In Ms. **********’s complaint, she expresses that she had not intended to cancel her pet, ******’s policy in April/May 2014.
We reviewed her policy and found that Ms. ********** had emailed Trupanion on 04/22/2014 the following: “Hi, I need to cancel my dogs policy, should I call or can I email someone?”.  In response to this, Trupanion reached out to the customer by phone on 04/23/14, 04/26/14, and 05/6/14 as well as by email on 05/6 and then sending the cancellation confirmation email on 05/09/14.
As Trupanion never heard back from Ms. **********, her original emailed request to cancel was respected and her policy ended with us on 05/19/14 (the end of her billing cycle). The cancellation confirmation that was sent to Ms. ********** advised her that her policy with Trupanion was cancelled and also advised that she had fifteen days to reinstate should she wish to.
At this time, monthly billing was also terminated.
Unfortunately we are unable to reinstate policies for pets who have cancelled. Ms. ********** is welcomed to start a new policy for ****** should she wish to.
Sincerely,
****** ******
Customer Resolution Lead
************ EXT 1330

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

I am rejecting this response because:  It's absolutely ridiculous that they would cancel a policy without speaking to me personally.  I don't care what the company says, I only received ONE phone call saying that if I wanted to cancel the policy that I would have to call and speak to a representative.  I didn't call back because I had changed my mind.  I NEVER received a letter saying that the policy was cancelled.  For the life of me I cannot understand how they could cancel this without my knowledge.  Now even if I open a new policy I'll be told she won't be covered for anything for months or I'll be told that since she is over 10 years old I won't be able to get a new policy. So I can't win.

Sincerely,

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

4/12/2015 Advertising/Sales Issues | Read Complaint Details
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Additional Notes

Complaint: I was given a certificate for pet insurance from the seattle humane society for 30 days. The company then sent me an e-mail stating I could extend the coverage AT NO ADDITIONAL FEES. However- when I called them- I was told that "the e-mail is misleading- we charge a $25 service fee to begin coverage. I think this is fraud.

Desired Settlement: I want them to refund the $25.00

Business Response:

Policy #************
******* *****
Pet: ******
Enrollment date: 02/11/2015

Upon receipt of Ms. ***** complaint, a review of her policy was done to establish the nature of her concern. Ms. ***** was given a Shelter Certificate which allows for 30 days of coverage with no obligation to buy. Any time during the 30 days, Ms. ***** is able to convert her Shelter Certificate into an enrolled policy with Trupanion. There is no cost or fees associated with the Shelter Certificate, however, once enrolled with Trupanion into a policy, there is a one-time $25 Membership fee along with your first months premium.
The Membership fee is a one time fee that all new policy holders are charged either upon initial enrollment or once a trial certificate is converted. The fee is to help cover costs associated with setting up a new account, and to cover the costs of the Pet ID tag and our 24 hour lost pet hotline. This is a one-time only fee.
We hope that this explanation helps to clear up any confusion surrounding our Shelter Certificate and our enrolled policy.
Best Wishes,
****** ****** -Customer Resolution Lead
************ EXt ****
*************@trupanion.com

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

I am rejecting this response because:  I have an email that says very clearly NO ADDITIONAL COSTS!!!!  Not "No additional costs except a one time service fee"

Sincerely,

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

Business Response:

************
******* *****
Pet: ******


03/23/15 - Second Response

Thank you for your response.
It is true that there is no additional fees with the 30 day certificate that was given to Ms. ***** by the shelter where she adopted her pet. Had she wished not to continue the 30 day certificate, she would have never been charged any amount.
The membership fee that she if referencing is separate from the 30 day certificate. The membership fee is charged to all new enrollments, whether they initially had a 30 day certificate or were just a standard enrollment with no certificate.
The membership has no connection with the certificate.

We thank Ms. ***** for her feedback and apologize for any confusion that this may have caused.

Best Wishes,
****** ******
 Customer Resolution Lead
************ EXT ****
**************@trupanion.com

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

I am rejecting this response because:

Did you see the e-mail I was sent???? It did NOT reference my 30 day trail.  It clearly states that if I wish to CONTINUE the coverage there will be no additional costs!!!
Obviously if I let the coverage lapse there would be no additional charges.
This is VERY false advertising and you should be ashamed of your tactics!


Sincerely,

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

3/26/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: At my Veterinarian's recommendation, I purchased health insurance policies for both of my dogs. On January 2, 2015 my Maltese, "*****" jumped off a bed and injured his right rear ACL. I am in a unique position to be able to diagnose his injury because in April, 2014 ***** tore his left rear ACL and the injury looked identical. After paying for the very expensive surgery in April 2014, the Vet stated I should get pet insurance - the co-pay is only 10% of the bill. Trupanion is REFUSING to pay the claim, stating that it it a "pre-existing" condition (it is not, it is an injury resulting from an accident). ***** DID tear his ACL on his left rear leg in April 2013. Post operatively, I took him to the Vet twice a week for therapy to speed his recovery. This period was closely monitored by both my Vet (Dr ******) and the Veterinary Orthopedic Surgeon (Dr. *****). I was told ***** had made a full recovery. There was no cause for concern. Had ***** had a "bilateral condition" as you put it, the Veterinarians would have been negligent not to tell me. They did not tell me, because no other condition existed. It was my Vet who gave me the TruPanion brochure and urged me to get coverage so I would not be strapped with a large medical bill.

Desired Settlement: Pay the bill.

Business Response: Policy #************
***** ******
Pet: *****
Enrollment Date: 12/25/2014
Upon receiving Ms. ******** complaint to the Better Business Bureau, a review of her policy was done to determine if a resolution could be reached to gain clarity of the nature of the complaint.
In Ms. ******** complaint, she expresses that the injury to her pet's (*****) leg was not pre-existing to the policy inception date as it was "an injury resulting from an accident". She also expressed that ***** had a pre-policy tear to his left ACL in April 2013.

Ms. ****** submitted a claim for her Maltese canine, *****, for the date of service of 1/3/15. Claim #******* was a "Pre-Approval" for the condition of "Right Cruciate Repair" which was denied by Trupanion based on the policy exclusions:

9.A.i Illnesses that occur or recur within the first 30 days from the policy enrollment date are deemed preexisting conditions and are not eligible for coverage
&
9.B.iv The cost of treatment for bilateral conditions presenting on one side of the body, if that condition was a pre-existing condition on the other side of the body, such as luxating patella or anterior cruciate ligament (ACL) or glaucoma, within 18 months of the policy enrollment date

In *****'s medical records from ******* ****** ********, it reads:
4/4/14: "Dog is limping on LH left hind leg. He is getting worse... Dog is holding LH left hind leg up. Drawer movement present. ACL anterior cruciate ligament ligament rupture...Rec recommend sx surgical ACL anterior cruciate ligament ligament repair."
4/7/14: Surgical repair of Left Hind ACL anterior cruciate ligament injury.
1/3/15: "Acute right rear non wt weight bearing lameness... R right rear drawer sign. Torn ACL anterior cruciate ligament." As these signs were documented prior to enrollment and continued into the illness waiting period, there can be no coverage for this claim.

***** had an injury to his left cranial cruciate ligament prior to policy inception with Trupanion and because of the "bilateral conditions" exclusion (9.b.iv) it is not considered eligible. Also, since *****'s injury to his right cruciate ligament occurred during his 30 day illness waiting periods and as Trupanion reviews cranial cruciate injuries as an illness and not an accident, we were unable to extend coverage to the claim for *****'s most current ACL injury.
We understand how heartbreaking it can be to receive an ineligible claim when your pet is ill or injured and our hearts go out to Ms. ****** and ***** during this time, however, in order to be fair and just to all policy holders, we must adjudicate claims based on the criteria that is outlined in our policy.
We wish ***** a swift recovery.
Sincerely,
****** ******
Customer Resolution Lead
************ *** ****
*************@trupanion.com

Consumer Response: (The consumer indicated he/she DID NOT accept the response from the business.)
Trupanion stated that the dog's injury was "pre-existing", as he had torn the ACL of his left hind leg in April 2014. My Vet recommended I buy this insurance to protect against future large bills. If this was a "pre-existing" condition, the Vet would not have given the dog a "clean bill of health" (that would be malpractice!) Additionally, if the dog HAD a pre-existing condition, the VET would know that the insurance would NEVER cover the claim. The policy states that it goes into effect in 30 days, EXCEPT in the case of an ACCIDENT (then it is in effect in 5 days). This little dog jumped off the bed 4 feet off the floor. The dog is 7 inches tall. This was an ACCIDENT! I have asked for a refund of my premiums (I canceled the policies for both dogs), I have yet to see a check or a credit to my Visa account. The trupanion representative I spoke to told me they would NEVER cover an ACL injury when there had been a previous one, EVEN IF IT WAS YEARS LATER! It is still considered pre-existing! Can you imagine the gall they have charging outrageous premiums and REFUSING TO PAY CLAIMS! I want to warn everyone NOT to do business with this unscrupulous company.

Business Response:

Policy #************
***** ******
Pet: *****
Enrollment Date: 12/25/2014
 
Trupanion values our relationships with veterinary professionals across the United States and Canada, and many recommend Trupanion to their clientele, however many veterinarians may not know the exact details of the policy’s exclusions and how they may apply to insured pets.
Trupanion looks at ACL injuries as “bilateral” – the exact exclusion in the policy reads:
9.B.iv: The cost of treatment of bilateral conditions presenting on one side of the body, if that condition was a pre-existing condition on the other side of the body, such as luxating patella or anterior cruciate ligament (ACL) or glaucoma, within 18 months of the policy enrollment date.
Since ***** had a ruptured ACL on his left hind leg in April of 2014, and then enrolled in December of 2014, this places his initial injury within the 18 months prior to policy enrollment and therefore we are unable to extend coverage for the ACL rupture on his right side that occurred in January 2015.
Trupanion can confirm that Ms. ******** policy for both of her pets has been cancelled, and a full refund was issued to Ms. ****** on February 11, 2015. If Ms. ****** has not received this refund, she should contact Trupanion directly at *************
We thank Ms. ****** for her feedback and wish her, ***** and **** the best in future.
Sincerely,
****** ******
Customer Resolution Lead
************ *** ****
*************@trupanion.com

3/26/2015 Advertising/Sales Issues | Read Complaint Details
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Additional Notes

Complaint: We have been paying our monthly premium fees to Trupanion for about 5 years without filing a single claim, trusting that our policy terms would be honored. We have 2 pets covered by Trupanion. Recently, we received notice that the premium for the younger dog would not go up this year but it would be raised $10/month for the older dog. According to the advertising and policy terms, "Trupanion's insurer, ****, will not increase premiums due to the pet aging" and instead will be based on the cost of veterinary care in the area. We think this policy is fair but were confused why 2 dogs living in the same household would receive such as drastic difference in rate increases. In particular, we were concerned that they were raising the price for the older dog, since we had invested so many years of monthly fees already. Unfortunately, our concerns were confirmed in an email exchange with a Trupanion representative. This representative explained, "Several factors dictate a particular pet's premium, including age, breed, gender, spay/neuter status, etc. So, pets with different parameters can see different rate adjustments. In other words, a 5-year-old French bulldog could experience a significantly different rate change than a 10-week-old French bulldog living in the same house." From any interpretation, this statement indicates that price is based on the aging of pets, which is direct contradiction to the Trupanion policy.

Desired Settlement: Refund, with appropriate interest, of all monthly premium fees paid to Trupanion over the course of the last few years.

Business Response: Date:  2/26/2015
Policy Number:  ************
BBB Case Number: ********
Policy Holder: ******** *******
Pet Name: “****” and “******”
Enrollment Date: 3/21/2011 and 12/3/2013
Upon receipt of Mrs. ********* complaint, a thorough review of her policy was done to determine the nature of her concern.  
One of our representatives, ***** *********, exchanged emails with Mrs. *******, which ultimately led to the complaint being filed.
On 2/19/2015, ***** explained, correctly, that the factors involved in determining our premium include age, breed, gender, and zip/postal code. Later on 2/19/2015, Mrs. ******* replied asking why age was a factor, when Trupanion's advertising states that we do not increase rates based on the fact that your pet is getting older.
On 2/19/2015, ***** replied, clarifying that rates are evaluated based on age of enrollment, not their current age. So for instance, a 10-year-old pet that initially enrolled as a 1-year-old is evaluated as a 1-year-old, not a 10-year-old.
Mrs. ********* pets were enrolled at 2 different age brackets. “******” was enrolled in the youngest age bracket possible, 8 weeks to 12 months old. Her other pet, “****”, is enrolled as a 1 year old. This means that ****** will likely always have a slightly less expensive price, because he was enrolled earlier in his life. This does not mean their rates will increase, just that they will continue to be priced at their respective age brackets. 
Our actuarial team looks at factors such as age of enrollment, but further they consider breed and gender, and consider the risk of insuring that particular “group” of pets. So for ****, the older dog, enrolled at a later point in her life, we look at the overall costs to insure Cavalier King Charles Spaniels in her age bracket (1 to 2 years), and the fact that she is a female (and may have different health issues), in the 90077 area. 
Because ****** was enrolled as a puppy, our actuarial team looks at male Cavalier King Charles Spaniels in the 90077 area, which is a cheaper group of pets to ensure overall, so our rates adjust accordingly.
In March, ****’s rate is scheduled to increase to $51.43. This reflects an adjustment by our actuarial team to bring **** closer to her group of like pets since the last March anniversary date.   
Also consider that **** also has a $150 deductible, whereas ****** has a $300 deductible, which makes causes ****’s premium to be higher at the moment. We can always adjust ****’s deductible to a higher amount, which would actually bring her policy to a premium closer to ****** at the same deductible. So currently, at a $300 deductible, **** would have a $45.23 premium, whereas ****** is at $41.31. However all rates are subject to change.
Lastly-all of our rates are reviewed by the state insurance commission board of California, to ensure that they are fair, not excessive, and non-discriminatory. What we state in how we factor our premiums have been vetted and reviewed by the board for accuracy.
We apologize for any confusion regarding this pricing policy, and hope we have addressed any concerns.
Sincerely,
*** ******** 
Client Resolutions Coordinator
************ *** *****
************@trupanion.com

3/19/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: Trupanion is the biggest waste of time and money we have EVER spent. We purchased insurance for our oldest dog last year (December 8, 2014) and once it was purchased, I called our vet to make an appointment for updated vaccinations for our dog and mentioned we should maybe have him looked at more closely since he was getting older and we noticed he started to get a little stiff when playing outside in the cold. The vet tech then explained their great rehab division and that we could make an appointment with the veterinarian Dr. **** to have a full evaluation done on our dog, as is very common for older dogs to slow up a little as they age. Trupanion took that ONE phone conversation we had with a scheduling vet technician and used it as their "proof" of a pre-existing condition and so now will not cover anything involving our dog's now diagnosed arthritis. Our dog did NOT have any previous medical issues or diagnosis of arthritis or any other kind of problems, yet Trupanion thinks it is acceptable to slap the "pre-existing" condition label on the dog because of a side comment I made while making an appointment. How is it that a casual phone conversation with a vet technician is now all of a sudden evidence of a medical diagnosis? I was not aware that either myself or the vet technician were certified medical personnel capable of diagnosing a pet with a medical condition... pretty sure that is what we pay the veterinarian for?? An observation by a pet owner does not equal a pre-existing condition and nowhere in their disclaimer regarding pre-existing conditions does it state they can use a conversation by non-medically certified people to determine pre-existing medical conditions.

Desired Settlement: A reversal of the denial to cover any of the costs associated with our dogs now diagnosed arthritis condition and a written apology for the emotional distress they have caused my husband and I over this whole issue. We were encouraged to purchase pet insurance from this company by our vet and we got quotes from them in February and in August of 2014 before we finally decided to buy in December 2014. We have paid them in full each month through direct billing for the services they are alleging they provide and we have been denied service we paid for.

Business Response: Date: 02/20/2015
BBB Case #********
Policy #T***********
Name: ******** *******
Pet: ******
Enrollment Date: 12/8/2014
Cancellation Date: 02/06/2015
Claim # *******
Upon receipt of Ms. *******'s BBB complaint, a review of her policy was done to determine the nature of her concern. In her complaint, Ms. ******* expresses frustration over and disputes the outcome of her pet ******'s recent claim. Claim #******* for "Severe Bilateral Shoulder and Stifle OA (osteoarthritis), moderate carpal OA, lumbar spinal pain" was deemed ineligible on first review. An appeal letter was received from Ms. ******* and her veterinarian and reviewed in appeal, but the condition remained ineligible.
****** was enrolled into a standard policy on 12/8/14 - a standard policy has a five day accident waiting period and a thirty day illness waiting period. Any accident or illness that shows signs or evidence of their potential manifestation during the waiting periods or prior to policy inception is considered ineligible. This can be referenced under Section 9.A.i & ii, as well as 9.B.i of Trupanion's policy.

A. Waiting Periods:

I. Illnesses that occur or recur within the first 30 days from the policy enrollment date are deemed pre-existing conditions and are not eligible for coverage.
II. Injuries from an accident that occurs within the first 5 days from the policy enrollment date are deemed pre-existing conditions and are not eligible for coverage.

B. Pre-Existing Conditions:

I. Illnesses or injuries for which signs are or evidence of their potential manifestation existed within the 18 months prior to the policy enrollment date.

As we base our claim outcomes on when signs or symptoms of a condition first occur, and not when a diagnosis is made, the claim for ****** was denied. In ******'s medical records from ******** ****** **** of Colorado:
12/8/14: "Pt (patient) is now on Trupanion with the extra package to cover rehab- discussed O (owner) calling Trupanion with her questions on what they will cover for ******. O (owner) notice when it is cold outside and pt (patient) plays in the snow for long period of time he becomes stiff in HL (hind leg) and all around- very mild and only during cold season."
1/22/15: "Female O (owner) thinks cold affects HL (hind leg) and makes pt (patient) stiff. In am and pm pt (patient) is stiff HL (hind limb), almost crawling/very slow. Then pt (patient) goes outside and will run full boar without pain, when comes back inside isn't stiff. Will run in yard very intense with no issues, off and on for the last 2 months (has been issue prior but more noticeably)"
As these signs were documented to have started prior to enrollment and continue through the 30 day illness waiting period, there can be no coverage for this claim.
As medical records are a legal document, we are bound to adjudicate claims based on the information provided by them. Although ****** was not examined on 12/8/14, it was reported by the policy holder that ****** was demonstrating symptoms of stiffness. This is supported by the fact that the policy holder booked an appointment with the Rehabilitation department at this time. Noted on 1/15/15: "Called owner to reschedule for the 22nd." Also during this appointment, it is noted that symptoms had been present "off and on for the last 2 months (has been issue prior but more noticeably)". As the illness eligibility date for this policy is 1/7/15, this places the onset of symptoms prior to the illness eligibility date.
Also in the medical records, it is noted on 1/22/15 that the Right hind limb has "stifle moderate medial buttress, painful hyperextension....mild crepitus," and the Left Hind limb has "stifle- severe medial buttress, painful hyperextension, mild palpable effusion.....Assessment: Overweight, Osteoarthritis- stifles, hips, shoulders, carpi". As the stifles are noted to have moderate-severe buttressing, this finding supports that this has been an ongoing condition for ******, and not an acute trauma. As the symptoms reported on 12/8/14 are supported by the timeline noted on 1/22/15, and the clinical findings found during the Rehabilitation Initial Consultation, the condition predates the policy inception/illness eligibility date, and is ineligible for coverage.

We understand how heartbreaking it can be to receive an ineligible claim when your pet is ill or injured and our hearts go out to Mrs. ******* and ****** during this time, however, in order to be fair and just to all policy holders, we must adjudicate claims based on the criteria that is outlined in our policy.
We wish ****** a swift recovery.
Sincerely,
****** ******
Customer Resolution Lead
************ *** ****
*************@trupanion.com

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

I am rejecting this response because:  This pathetic attempt to hide behind the "legal jargon" of YOUR definition of a pre-existing condition is absolutely the most pathetic thing I have ever seen a company do.  I will be publicizing your horrible company and have already contacted local news affiliates about this story and they are very interested in your lack of concern and hiding behind a very well written exemption clause.  Pre-existing conditions have NEVER in my entire life been based on an "observation" and only when diagnosed by a medical professional.  I made a side comment to a vet technician about observations of my pet in the cold.  He has never, and was never diagnosed with any sort of medical condition regarding arthritis prior to his appointment on January 22nd.

I do not accept you lackluster "heartfelt" sympathies regarding our pet because your company is anything but pet friendly.  Go ahead and hide behind your ridiculous legal clauses if it makes you feel better.  Truth is you do it so you don't have to help pet owners when they need it the most and God forbid you actually have to shell out some $$$ to help a pet when they have a medical diagnosis actually covered under your insurance.  We should have known better than to trust an insurance company who promised so much but delivered absolutely nothing when it came down to needing their services.

Sincerely,

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

3/11/2015 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: Changed billing without notification. Contract to date has specified amount yet Trupanion charged more.

Desired Settlement: Refund for over charges.

Business Response: BBB Case #********
Policy #************
Name: ***** **** **** ******
Pet: *******
Enrollment Date: 05/02/2013
Cancellation Date: 01/13/2015

Upon receipt of ********** BBB complaint, a review of her policy was done to determine the nature of her concern.
In her complaint, *** ***** states that Trupanion "changed billing without notification". On 04/02/14, a letter was emailed to *** ***** stating that on the date of 06/02/14 her premium would be increasing. The premium increase was a standard rate review and the factors associated with her account indicated that her premium needed to be adjusted. Trupanion notifies their policy holders thirty to sixty days prior to a rate adjustment.
Our records reflect that *** ***** called into Trupanion on 04/03/2014 and adjusted her deductible (which adjusts the premium) on her current premium pricing - not on the upcoming change that was to take place on 06/02/2014. We believe that this is where the confusion lays - We believe that *** ***** was intending to change her deductible for her upcoming rate increase, and did not realize that by changing the deductible prior to the rate change, she would still experience the rate change on 06/02/014.
We are sorry to hear that this incident caused frustration for *** ***** and hope that this explanation helps to clear up any remaining concerns.
Best wishes,
****** ****** - Customer Resolution Lead
*********** *** ****
*************@trupanion.com

1/26/2015 Problems with Product/Service
1/14/2015 Advertising/Sales Issues | Read Complaint Details
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Additional Notes

Complaint: They offer a free 30 day trial. They also promise an answer to a claim in 7 days. They promise if you care for your pet, and an accident occurs, they will cover it. They accused me of insurance scam because my pet had an accident in the first 30 day trial period. They didn't give me a response to my first claim until after 30 days. Didn't get a check for over 6 weeks. I had a 1 year old dog that my regular veterinarian agreed had to pre existing conditions. The ER doctor and two board certified veterinarians also agreed it wasn't pre existing, but they still denied the claim.

Desired Settlement: I expect them to approve the claim.

Business Response: Initial Business Response /* (1000, 5, 2014/08/11) */ First Response BBB #XXXXXXXX Policy #TUXXXXXXXXXX Owner: ***** ******* Pet: ****** Enrollment Date: 05/01/2014 Upon receiving this complaint from the Better Business Bureau, a review of the policy was to determine if a resolution to the policy holder's concerns could be reached and to gain clarity of the nature of the complaint. In the complaint, Ms. ******* expresses her opinion that her pet's condition of "Bilateral ACL complete tear and meniscus" was not pre-existing to the policy, but a new accident that occurred during the 30-day trial certificate. Ms. ******* did not agree with the original review of the claim and sought an appeal. Trupanion's appeal team processed and reviewed all available information plus additional information provided by Ms. *******. However the appeal ruling upheld the denial as per Trupanion's policy exclusion 9.B.i and 9.D.vi: 9.B.i: Illnesses or injuries for which signs and evidence of their potential manifestation existed within the 18 months prior to the policy enrollment date.; 9.D.vi: We do not insure the costs, fees, or expenses associated with complications of or diagnostic tests for the illnesses and injuries excluded or restricted by this policy. The appeal was then reviewed in the Independent Third Party Veterinarian process and the denial was upheld by Dr.****** ** ****, Diplomat, ******** ******* of ********** ******** under the same denial reasoning of 9.B.i and 9.D.vi (as detailed above). Often, it is not intuitive to relate a canine's cranial cruciate rupture as an illness as opposed to an accident. According to Dr. ****, in dogs cranial cruciate ligament rupture (CCLR) is very common. Unlike its counterpart in humans, this injury or disease is characterized by a slowly progressive degeneration of the cranial cruciate ligament rather than an acute rupture. In ******** case, the left CCL had ruptured by the examination of 05/07/2014 while the right CCL was still in its early stages of degeneration. Bilateral tears are common. Acute CCL tears are rare in dogs and they would not be accompanied by osteoarthritis during the first week after occurrence. The presence of osteoarthritis in the left stifle of this dog proves chronicity; therefor the claim remained denied in the Independent Third Party review process. Trupanion has had Dr. ****** ******* DVM, MBA and the Director of Veterinary Services, review and discuss the outcome of ******** claim with ******** veterinarian and Ms. ******* herself to explain the reasoning behind the denial. ****** did receive the benefit of a 30 day Trial Certificate, which was activated on 05/01/2014. We try our absolute best to process claims in a timely manner, however claims are occasionally delayed due to information requests for medical records - once received, claims are processed in a timely matter. We apologize for any delay in the processing of ******** claims as they were not intentional. Trupanion paid claim #XXXXXX for Lameness on 05/13/14. This claim was approved as a preapproval using the exam information at the time. The radiographs were then received from that visit to show chronicity in that joint and subsequently a disease process that started prior to the policy inception. The charges that were preapproved and guaranteed were covered and subsequent charges were not eligible as they related to the preexisting chronic condition that was diagnosed on the radiographs taken on the initial claim. Trupanion feels like they have offered every available avenue to allow for a fair and just review of the ******** claimed condition. Trupanion understands how heartbreaking it can be for our policy holders when their pets are sick or injured and our hearts go out to Ms. *******. Our goal at Trupanion is to offer the very best coverage industry wide and compassionate ******** service. We remain dedicated to offering the most comprehensive policy and all claims to be reviewed in a fair and just manner for all policy holders. At this time, Trupanion considers this case closed. ************* Research and Resolution T:XXX-XXX-XXXX Ext: **** E: *************@trupanion.com Initial Consumer Rebuttal /* (3000, 7, 2014/08/21) */ (The consumer indicated he/she DID NOT accept the response from the business.) The explanation for Trupanion's denial confirms they are a company build on fraud. They are completely ripping off the American animal lover. Trupanion advertises they are a pet insurance for ACCIDENTS. They don't cover basic exams, vaccines, or dental cleanings. They cover ACCIDENTS. They also verify you take your pet to the veterinarian regularly for exams. Your pet MUST be seen by your veterinarian in the last 6 months or your claim is denied. Your pet must be current on vaccines, or your claim is denied. They want to make sure you are a responsible pet owner, and these accidents could not have been prevented. So if you're a responsible pet owner and current on vaccines, which I am; seen by the veterinarian in the last six months, which I did; then how can this accident be predicted? In Trupanion's response, they state "this injury or disease is characterized by a slowly progressive degeneration of the cranial cruciate ligament rather than an acute rupture. In ********* case, the left CCL had ruptured by the examination of 05/07/2014 while the right CCL was still in its early stages of degeneration." By their own words, when I took ****** into the emergency the left CCL ruptured. By their own claim they should allow coverage to surgically repair her left CCL. Once again, this company tracks down any and all paperwork to make sure you're a good pet owner. That was not only confirmed on paper, but verbally by my veterinarian. In their response they admitted to speaking to ********* veterinarian. That veterinarian was also angered because his opinion was ignored. Trupanion also spoke with the emergency veterinarian that verified this was an accidental injury. In Trupanion's response, they state "Acute CCL tears are rare in dogs and they would not be accompanied by osteoarthritis during the first week after occurrence" So they deny claims based on rarity. This bias, subjective, narrow minded statement just proves that the claim was going to be denied the minute the report landed on their desk. They had no intention of approving the claim. The telephone call with Dr. ****** ****** was extremely insulting. In that phone call she alluded to the fact that I was a bad pet owner. I wasn't "outside watching my pet at all times" while playing in the fenced in yard, so the injury could have taken place there. She also insinuated that I was committing insurance fraud and many scam them so she can't trust people. I informed her that many insurance companies commit insurance fraud and deny claims so they can save their company money. She also got angry at me because I didnt know the name of the receptionist who checked us into the ER that night. The girl checked us in and incorrectly wrote the presenting complaint wrong. The manager from The Emergency Clinic apologized for it and corrected. Trupanion later that day, called them interrogating them to get the name of the receptionist. Your company has resorted to harassing receptionists who make errors on check in at busy emergency clinic. The case went into appeal because Dr. Petryk admitted that night that ******'s claim was denied based on her surgery radiology report 3 weeks later. When I asked, "why wasn't the denial based on her initial radiology report on 5/7/2014?" She admitted she never had it. So instead of harassing receptionist's errors, *** ****** needs to examine her own paperwork errors before making a denial. Trupanion has the power to deny every claim based on pre existing condition. Cells are growing and dividing daily, even cancerous ones. If I could predict when my pet was going to be suddenly ill, or injured I wouldn't need pet insurance. If I come home and my pet can't walk, I take him to a veterinarian, as every good pet owner would do. If the vet tells me there is no way I could have known prior to that day my pet wouldn't be able to walk, it's an accident. If I have to take my pet to the veterinarian once a month for blood work and x-rays, for the rest of his life to be able to predict what future accidents will take place, than why do I need accidental insurance? Final Consumer Response /* (4200, 11, 2014/09/21) */ (The consumer indicated he/she DID NOT accept the response from the business.) Unfortunately, Trupanion is a high priced accidental insurance that cannot reply to my valid points. They are only able to repeat the same response over and over again to EVERY single denied claim. They are unable to individualize any claim. As I've proven already, they denied my claim before even reviewing the initial radiographs. They deny claims before they have all the data. I submitted all my factual details, and evidence in my prior statements. I will only add new information to further prove their corrupt corporation. Based on ************** 5 minute Veterinary Consult" By ************ Cranial Cruciate Ligament Disease, states that on physical exam "acute rupture results in non-weight bearing lameness, joint effusion, and the affected limb held in partial flexion while standing." My dog is a 1 year old, female, spayed, and not overweight. She is regularly seen by 2 veterinarians that are both A.B.V.P certified. When her "Acute Lameness" occurred, she was immediately seen by an emergency veterinarian. Then, she was examined by 2 orthopedic surgeons; both are DVM, MS, and ACVS. Personally, I am a Registered Veterinary Technician that has been licensed, and practicing for over 15 years. I find it professionally insulting that I would be unaware of previous illness going on with my dog. My dogs get blood work and x-rays on a regular basis for monitoring. My dogs come to work with me, and are seen by veterinarians daily. Once again, your company clearly only allows a certain number of claims a year. I obviously was not the lucky contestant picked from your magical hat. Final Business Response /* (4000, 19, 2014/12/29) */ Date: 12/19/14 BBB Case #: XXXXXXXX Ms. ***** ******* Policy #: TUXXXXXXXXXX Pet: ********** Enrollment date: 05/01/2014 We understand that the condition may not have been something visible in ********* daily disposition and we honor that Ms. ******* acted quickly to appropriately care for ****** as soon as the condition presented. However the presence of osteoarthritis is evidence that this condition is not an accident, but an illness. We process claims based on our policy documents and a pet's medical records. We must adjudicate claims fairly for all those enrolled with Trupanion. There is no "set number of claims" that we process a year - customers are welcomed to send in as many claims as they need to for review and we will process them fairly and in accordance with our policy. We wish Ms. ******* and ****** the best in the future. Sincerely, ****** ****** Research and Resolution T:XXX-XXX-XXXX EXT **** E: *************@gmail.com

1/12/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: Became of member of Trupanion in June 2014 after vet highly recommended their pet ins product. In September 2014 we filed our first of 2 claims for an emergency visit for our then 6 month old puppy who had developed severe Colitis. Both claims were denied for "pre-exisiting Condition" with the company stating because our puppy had been seen in June of 2014 prior to our policy being instated for diarrhea. That visit was for symptoms related to round worm which was confirmed by our local vet a few days later when all of the worms passed. Essentially the company is stating if my dog ever has diarrhea or vomiting as part of the symptoms on a claim he will not be covered because it was pre-exisiting. The 2 visits were completely separate and not for the same cause!! In the future if my dog is vomiting due to eating something poisonous he won't be covered. Having diarrhea or vomiting prior to policy being created is a pretty broad pre-exisiting condition and will essentially void his policy.

Desired Settlement: I would like the 2 claims under file #XXXXXXX to be paid ASAP. We spent over $700 on vet fees for 2 visits and were told all claims were 90% reimbursable. Trupanion policy #TUXXXXXXXXXX

Business Response: Initial Business Response /* (1000, 7, 2014/12/17) */ First Response Policy# TUXXXXXXXXXX Owner: ****** ******** Pet: ****** Enrollment Date: 06/19/2014 Upon receipt of complaint from Ms. ********, a review was done of ******'s policy to determine whether all steps toward a resolution had taken place. Ms. ******** is disputing the outcome of claim #XXXXXXX for "Vomiting, rule out colitis vs. inflammatory bowel disease vs. bowel intestinal overgrowth". This claim was originally denied as "pre-existing" due to ******'s medical records from ******* ****** ******** which states prior to policy inception: 06/11/14: Owner rescued recently on 05/17 from puppy mill, dewormed with panacur, drontal. Flagyl- finished course. Picky appetite, has had d+ (diarrhea) since she has had her, Rectal: brown diarrhea, Parvo snap (negative), Fecal (negative), Diarrhea (R/O (rule out) secondary to parasitism), owner to start Albon pending coccidian - will d/c (discontinue) in case (-)(negative) fecal. 06/15/14: LMOM (left message on machine) Fecal was negative for eggs & worms, call if there's still concerns. Unfortunately ******'s condition continues post policy: 09/25/14: Chronic D+, now V+ (vomiting), goes through cycles of D+ right now for 2 weeks, owner found V+ tonight, previously tested for parasites, Parvo, etc., Assessment: Open: Rule out IBD (inflammatory bowel disease) vs. food allergy vs. neoplasia vs. infectious vs. PLE (protein losing enteropathy) vs. SIBO (small intestine bacterial overgrowth) vs. EPI (exocrine pancreatic insufficiency) vs. other, Recommend Abd (abdominal) U/S (ultrasound) +/- GI biopsies +/- GI Malabs. Panel. 10/02/14: Chronic cycles of D+ since adoption, some days D - some days constipated - occ. V+, Since on Z/D & Flagyl - stool is formed/no V+/gained wt. A negative fecal was run on 6/11/2014 and as such we have insufficient medical evidence to state the condition on that date was due to parasitism. As the diarrhea was documented to have started prior to enrollment and continued post policy with no medical differentiation from the claimed condition, there can be no coverage for this claim. After original denial, an appeal was completed as well as a "veterinary to veterinary" conversation between Trupanion's veterinarian, *** ***** ******** and *** ****** of ******* ****** ******** in November 2014 to explain the reason for the denied appeal. Quoted from Dr. ***** ******** in his assessment of the claimed condition: The puppy had diarrhea for 1 month after rescue, and a "picky appetite"; arguably this could have been due to parasites. After a thorough worming (Panacur, Flagyl, Albon) the diarrhea persisted intermittently until the pup was seen again on 9.25 when at that time it was described as "chronic diarrhea" plus vomiting. You explained that the use of the word 'chronic' is open to interpretation, though at that time the rDVM (regular veterinarian) suggested potential differentials of varying degrees of chronicity, which persuades me that this was not just a temporary or recent problem. Since that time the puppy has done, and is doing, very well on Z/D and Tylan, and has gained weight. It is probably this latter fact which tipped the argument since it appears the puppy needs either dietary manipulation and/or chronic antibiotics to do well. Of course the issue will be seeing what happens to it when not on any controlling diet/medications, but I am having huge difficulty separating the pre-existing GI problems from the ones which have chronically followed the inception of insurance (typically, as I explained, we try to find ways to pay the claim, rather than the inverse, by being able to dissociate pre- and post- symptoms). I am certainly willing to look at these claims again if and when the dog is not on any potentially 'masking' treatments, and the policy-holder should know this. On 12/16/14, Trupanion reached out to Ms. ******** and offered to push appeal forward into our third and final appeal process called Independent Third Party Review (ITPV) - During the call, ****** let us know that she would like to pursue this, but would like to supply supporting documentation. Trupanion advised Ms. ******** that we would await her supporting documents before sending the claim for ITPV. Trupanion understands the frustration and emotion that is involved in receiving an ineligible claim and it is definitely not our intention for this to be Ms. ********'s experience. In order to continue offering insurance at a reasonable rate without unnecessary and unfair inflation, we can only pay claims that meet the standards set forth by our policy. We hope that ******'s condition is manageable and wish both he and Ms. ******** the best health in the future. ****** ****** T:XXX-XXX-XXXX EXT **** E: *************@trupanion.com

12/29/2014 Problems with Product/Service | Read Complaint Details
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Complaint: denied claim by putting all skin conditions as pre-existing condition, when new condition was something different from pre-existing two year old episode

Desired Settlement: want coverage for medical condition

Business Response: Initial Business Response /* (1000, 5, 2014/12/10) */ First Response Policy# TUXXXXXXXXXX Owner: *** ************ Pet: ******* Enrollment Date: 12/12/12 Upon receipt of complaint from Dr. ************, a review was done of ******** policy to determine whether all steps toward a resolution had taken place. Dr. ************ called in and spoke to a Care Representative on November 26, 2014 to discuss the outcome of *******'s recent claims for "Fever, Rash, and Skin Lesions". During this call, *** ************ was advised of the reasoning behind the denial and then was advised of our appeal process. *** ************ opted to pursue the appeal option. A Care Representative emailed ****** ******** of North Myrtle Beach to begin the appeal process. At this time, we have not yet received an appeal letter. *******'s claims for "Fever, Rash, and Skin Lesions" were denied as pre-existing. Based on ******** medical records from ****** ******** of North Myrtle Beach prior to policy enrollment: 8/20/12: "check ears - shaking head - check skin, has hotspots... check feet, very red and irritated. All 4 feet b/t between pads erythemic, focal areas of alopecia dorsal neck & rear legs. Skin scrape - neg negative. R/O rule out allergic derm dermatitis" Vetalog given, Ciprofloxacin, Mometamax dispensed. 9/7/12: "check ears... still have light tan exudate & moist. Ear swab - yeasts... skin scrape left forearm - neg negative. Moth eaten ventral body & legs." Cephalexin, Mometamax dispensed. 10/9/12: "R right ear canal still erythemic. Ear swab - yeast." Easotic dispensed. 12/3/12: "Ear swab - yeast. R right canal erythemic. R/O rule out otitis externa." TrizUltra, Mometamax dispensed. 12/13/12: "check growth - check top of head noticed a week ago had big red head - now flat & scabby... 1 cm centimeter round excoriated dermal lesion on top of head... AD right ear = canal clean, narrowed, mild erythema... Ddx differential diagnoses otitis externa, histiocytoma... continue cleaning, medicating R right ear daily." Post policy, the following notations also appear to be related to the claimed condition: From ****** ******** of North Myrtle Beach 1/22/13: "o owner would like ears rechecked today due to hx history of infection - p patient also chews bottom of paws excessively - front R right paw is red & irritated... chews feet - all 4 red. Scotch tape RF right front palmar - 3 yeasts/hpf per high power field. Ear swab - rt right ear yeasts +++. Dexamethasone injection given." Keto Tris and Amoxi dispensed. 7/10/14: "check ears - shaking head per o owner. O owner says keeps licking inside pads of right front paw - always red. check paw... erythemic paws; flaky skin on back. R/O rule out: allergies. Switch to d/d" 8/16/14: "check ears. O states dog has excessive wax in ears, a little pink inside... AD right ear mild erythema and tan ceruminous... ear cytology = rare yeast." Epi Otic, Easotic dispensed. 8/29/14: "Owner noticed crusty lesions popped up this week - on his back & behind... crusty, odorous, epi epidermal collarettes on back & trunk. R/O: secondary bact. bacterial inf infection or fungal." 10/16/14: "O owner says inside all paw pads they are red, and sores on belly... biopsy - R right medial thigh and R right axilla... Convenia... ulcerated lesions (round epi epidermal collarettes) under R right axilla & R right med medial thigh; abdomen covered in epi epidermal coll. collarettes." 10/17/14: "blood for allergy test drawn." 10/20/14: "Red lesions all over... palmar and plantar moist erythema, erosion rt right axilla & inguinal... R/O drug eruption... or immune mediated disease or resistant infection." 10/24/14: "Spoke w/o with owner a/b about skin biopsy & allergy test results - would like for us to order serum & would like a copy of the allergens." 11/12/14: "O owner noticed just today - AD right ear is red; bumpy. Was perfectly normal 2 days ago. R right ear - Ear swab yeast +++... RH & LF right hind and left front - erythemic b/t between digits of paws... ok for o owner to give ketoconazole. Ok to give... Benadryl." Mometamax dispensed. As these signs were documented prior to enrollment and noted to recur post policy, there can be no coverage for this claim. We recognize that it is not intuitive for a pet owner to make an association between otitis (ears), skin lesions/rash, and pododermatitis (paws) however a veterinary professional is aware of the link as allergies/atopy is a common problem among cats and dogs. Both condition r Trupanion understands the frustration and emotion that is involved in receiving a denied claim and it is definitely not our intention for this to be Dr. ************'s experience. In order to continue offering insurance at a reasonable rate without unnecessary and unfair inflation, we can only pay claims that meet the standards set forth by our policy. We will allow the appeal process to determine the condition's secondary outcome and in the event of a re-denial, we have a third and final appeal option of an "Independent Third Party Review". Dr. ************ could pursue this if necessary. We hope that *******'s condition is manageable and wish both he and Dr. ************ the best health in the future. ************* T:XXX-XXX-XXXX EXT **** E: *************@trupanion.com

12/9/2014 Problems with Product/Service | Read Complaint Details
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Complaint: I put a claim in for my dogs leg to get fixed, which is suppose to be covered by them, and they denied the claim saying that it is a pre existing problem, and when I signed up with them she had 100 percent healthy legs no problems at all. She did have a problem after I signed up with them from a accident with the opposite leg, but nothing at all wrong with the leg that I sent the claim inf or now. I pay $127 a month for the insurance and this should be covered.

Desired Settlement: I just want the surgery for the leg to be done, and for them to cover her which they are suppose to do , and that is why I pay $127 a month for.

Business Response: Initial Business Response /* (1000, 5, 2014/11/21) */ BBB Case #XXXXXXXX Policy #TUXXXXXXXXXX ******** ****/**** Slaughter Pet: ***** Enrollment Date: 07/17/2014 Upon receiving Ms. ****'s complaint to the Better Business Bureau, a review of her policy was done to determine if a resolution could be reached to gain clarity of the nature of the complaint. In Ms. ****'s complaint, she expresses that the injury to her pet's ******* leg was not pre-existing to the policy inception date and that the original injury was to the pets "opposite" leg. Ms. **** submitted a claim for her female mixed breed canine, *****, for the date of service of 10/31/14. Claim #XXXXXXX was a "Pre-Approval" for the condition of "Torn ACL (surgery)" which was denied by Trupanion based on the policy exclusions: 7.b.1 Illnesses for which any evidence and/or symptoms of their potential manifestation already exist at, or prior to the policy enrollment date 7.b.2 The cost of treatment for bilateral conditions on one side of the body, if that condition was a pre-existing condition on the other side of the body (such as luxating patella or anterior cruciate ligament (ACL) weakness). In ******** medical records from ************************, it reads: "03/01/2014 (Prior to policy inception): R (right) hind leg - NWB (Non-weight bearing) lameness w/ (with) mod (moderate) edema @ (at) stifle. Was dx'd (diagnosed) @ (at) Southern Keru w/ (with) ligament rupture. Given pain meds (medication) and told it would heal. CCL (cranial cruciate ligament) rupture sx (surgery)..." Since ***** had an injury to her right cranial cruciate ligament prior to policy inception with Trupanion and because of the "bilateral conditions" exclusion (7.b.2), we were unable to extend coverage to the claim for ******** most current ACL injury. We understand how heartbreaking it can be to receive an ineligible claim when your pet is ill or injured and our hearts go out to Ms. **** and ***** during this time, however, in order to be fair and just to all policy holders, we must adjudicate claims based on the criteria that is outlined in our policy. We wish ***** a swift recovery. Sincerely, ****** ****** Customer Resolution Lead XXX-XXX-XXXX EXT **** *************@trupanion.com

11/25/2014 Advertising/Sales Issues | Read Complaint Details
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Complaint: I called the company to cancel the coverage for my two former pets, which were taken from me and no longer in my possession. I was told that they would not cancel the policy, and continue charging me, even though I don't even know where these pets are located, until I spoke with an "********" at (XXX) XXX-XXXX X ***** I have tried repeatedly to call this person without success. I have told this company that I no longer own these pets, and that I want to cancel coverage. I see no reason why I have to try to play phone tag and speak with any one particular person in order to cancel the coverage when I have already informed the company that I don't own the pets any more. I find this practice of theirs completely unreasonable.

Desired Settlement: They need to stop the coverage as requested and quit harassing me with unreasonable requests in order for this cessation of coverage to go through.

Business Response: Initial Business Response /* (1000, 5, 2014/11/05) */ Case # XXXXXXXX Policy #TUXXXXXXXXXX ***** ****** Pets: ******* and ******* Enrollment Date: 04/12/2010 Upon receiving Mr. ******'s complaint to the Better Business Bureau, a review of his policy was done to determine if a resolution could be reached to gain clarity of the nature of the complaint. Mr. ****** called to request cancellation of his policy on October 19th, 2014. He spoke to one of our Care representatives who passed along the cancellation request to our Customer Specialist team who handle cancellation requests. On October 22nd, a Customer Specialist called Mr. ****** to finalize cancellation and a message was left. At this time, the cancellation request was not finalized as we require a written request to complete the process. Upon receipt of Mr. ******'s BBB complaint on 10/29, his account was cancelled as the written complaint was enough to finalize the request. Confirmation of cancellation was then emailed to the address we have on file. At this time, his policy with Trupanion has been cancelled. We are truly sorry if Mr. ****** found this process difficult in anyway. We strive to provide excellent customer service and communication and wish Mr. ****** the best in the future. At this time, we consider this case closed. Sincerely, ****** ****** Customer Resolution Lead XXX-XXX-XXXX EXT **** *************@trupanion.com

11/18/2014 Billing/Collection Issues | Read Complaint Details
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Complaint: I have been making attempts to cancel my pet insurance policy since October 14, 2014 with no success. I've spoken to individuals on the telephone, via chat, and via email and the policy is still not cancelled. My last attempt to cancel it was today, October 16, 2014. I do not wish to be billed again for this service.

Desired Settlement: Cancelled policy, no future billing.

Business Response: Initial Business Response /* (1000, 6, 2014/10/30) */ Policy#TUXXXXXXXXXX Owner: ****** **** & ****** **** Policy Enrollment Date: 6/25/2011 Pet: **** Reason for BBB complaint: Policy Cancellation Request/No further billing Upon receiving Mr. ****'s complaint to the Better Business Bureau, a review of the policy was done to determine if a resolution could be reached and to gain clarity of the nature of this complaint. Mr. **** had called in on 10/15/2014 to request his policy be cancelled for dog ***** Mr. **** was connected with a specialist who explained the cancellation process in detail. As written notice to cancel is required for Mr. ****'s state, he was instructed that he would receive an email to reply to with his intention of policy cancellation. On 10/16/2014 Mr. ****'s reply email was received by Trupanion and the policy was canceled for ***** Confirmation of policy cancellation and discontinuation of billing was then emailed to Mr. ****. We are truly sorry if Mr. **** found this process difficult in anyway. Should Mr. **** have any further questions or concerns I am happy to assist in any way I can. At this time Trupanion considers this case closed.

10/21/2014 Advertising/Sales Issues | Read Complaint Details
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Complaint: I purchased Pet Insurance through the named company. I received a packet in the mail detailing my policy. Shortly after my purchase my pet got sick called the vet and had to go see a specialist in Honolulu, thinking that my pet had cancer. I found out my pet did not have cancer but bladder stones and have to be put on medicine and special food. I submitted a claim, spoke to a representative thinking my claims were going to be paid only to find out that there was a waiting period that was not disclosed. Not in the packet and not by the representative I had spoken with, my total bills have been so far around $2000.00, did expect to be reimbursed for the entire amount but for 90% which was the high option plan I have been paying for.

Desired Settlement: I expect to be reimbursed for what my plan states...90% of my out of pocket costs.

Business Response: Initial Business Response /* (1000, 5, 2014/08/22) */ BBB Complaint #XXXXXXXX Owner: ******* ***** Policy #TUXXXXXXXXXX Pet's name: ****** ***** Policy Enrollment Date: 5/20/2014 Injury Eligible Date:5/25/2014 Illness Eligible Date:6/19/2014 Claim #XXXXXX & #XXXXXX Claimed Condition: Moderate cystitis, urinary bladder, mild to moderate sediment/tiny calculi Claim Conclusion: Ineligible due to waiting periods Upon receiving the complaint to the Better Business Bureau, a review has been done to determine if a resolution to Ms. *****'s concerns could be met. In the BBB complaint, Ms. ***** is seeking coverage for the above listed claims. Sadly Trupanion was not able to approve these claims as the date of loss was prior to the Illness eligibility date. The date of service for Claim #XXXXXX was 5/27/2014 & #XXXXXX was 6/19/2014. Trupanion is unable to extend coverage to illnesses or accidents that have exhibited signs or symptoms prior to policy inception or during the waiting periods. Please find the exact policy wording shown below. WAITING PERIODS: (1) Illnesses that occur or recur within the first 30 days from the Policy enrollment date (or from a policy enhancement date); or (2) Injuries from an accident that occurs within the first 5 days from The policy enrollment date (or from a policy enhancement date). PRE-EXISTING EXCLUSIONS: (A)Illness resulting from any condition for which evidence and/or symptoms of their potential manifestations already exists at, or during the 18 months prior to, the policy enrollment date. Illnesses that occur during the 30 day waiting period and accidents that occur during the 5 day waiting period will be considered pre-existing conditions. Our goal at Trupanion is to offer the best coverage industry wide. We work very hard to make sure that the policy wording is transparent and easy to understand. We remain dedicated to the very best care for pets and customer service for our policy holders. I left a message by phone for Ms. ***** that I am happy to be a point of contact for her and to answers any question she may have. At this time Trupanion considers this case as closed. ******** ******** Research and Resolution t: XXX-XXX-XXXX; ext. **** e:*****************@trupanion.com Initial Consumer Rebuttal /* (3000, 7, 2014/08/29) */ (The consumer indicated he/she DID NOT accept the response from the business.) I did get a message from Trupanion but no one ever told me that there was a waiting period. That last sentence from ******** ******** speaks for itself. Trupanion considers this case closed. They take money from consumers and do not provide insurance in time of need. It is consider false advertising. I want my money refunded to me for all monthly insurance payments to them if they are not going to keep up their end of the deal. I do want this complaint to be posted. They do not inform their clients that there is a waiting period. And yes ******** did contact me but only after I started asking question about payment and when I would receive refund. Final Business Response /* (4000, 9, 2014/09/18) */ BBB Complaint ********* (Rebuttal) Owner: ******* ***** Policy #TUXXXXXXXXXX Pet's name: ****** ***** Policy Enrollment Date: 5/20/2014t Injury Eligible Date: 5/25/2014 Illness Eligible Date: 6/19/2014 Claim #XXXXXX & #XXXXXX Claimed Condition: Moderate cystitis, urinary bladder, mild to moderate sediment/tiny calculi Claim Conclusion: Ineligible due to waiting periods Upon receiving the complaint rebuttal to the Better Business Bureau, a review has been done to determine if a resolution to the concerns could be met. While we can understand how frustrating it can be to have a denied claim, it is important to note that Ms. ***** did enroll her dog ****** through the Trupanion web site. Trupanion has worked very hard to ensure all the pertinent information is visible and easy to understand at every step of the online enrollment process. Once the enrollment was completed online, Mr. ***** was emailed a copy of the policy, ******'s Declaration Page and welcome information. All of the waiting periods are also stated in this paperwork. I attempted to reach out to Ms. ***** on 9/17/2014 by phone. Sadly Ms. ***** explained to me that my call was at a bad time and she could not talk. With this call, I had hoped to come to some sort of resolution even though Trupanion cannot give back premiums on an active policy. Perhaps with direct communication I could be of more assistance to Mr. *****. Therefore I remain available to take Ms. *****'s call at any point should she wish to discuss ******'s policy further. While we know that it may not seem like it now, the coverage that ****** has for future illnesses and accidents is vast. Trupanion would hate for any pet parent to be put in a situation where coverage that could have been eligible is needed but not applicable. We whole heartily encourage Ms. ***** to consider keeping the policy for future, unknown accidents and illnesses At this time Trupanion considers this case as closed. ******** ******** Research and Resolution t: XXX-XXX-XXXX; ext. **** e:*****************@trupanion.com Final Consumer Response /* (4200, 11, 2014/10/01) */ (The consumer indicated he/she DID NOT accept the response from the business.) Yes, ******** ******** did call me, during my lunch hour seconds before I was to clock back into work-I did explained to her that I was unable to speak at this time. *** ******** was very rude, she did not apologize or try to start dialog with me. She simple asked would you like to could you policy through Trupanion, I stated once again that I needed to go right now- I had to go back to work. I do not believe that terminating my pets policy is resolution, Honesty and doing the right thing by the company and its policy-would be resolution. I am not satisfied with this response, I believe that Trupanion needs to except fault and resolve this issue. Thank You, ******* *****

10/15/2014 Problems with Product/Service | Read Complaint Details
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Complaint: Our pet had preapproved surgery which was to involve a $300 deductible - Trupanion paid $300 less than we are owed claiming there should be two $300 deductibles for the same surgical operation that removed two growths from our pet at the same visit.

Desired Settlement: $300

Business Response: Initial Business Response /* (1000, 5, 2014/08/11) */ BBB Complaint #XXXXXXXX Owner: ****** ****** Policy ****** Pet's name: ***** Policy enrollment date: 10/2/2009 Injury coverage eligible date: 10/7/2009 Illness coverage eligible date: 11/1/2009 Deductible $300.00 per-condition Claim #XXXXXX Condition: Mast Cell Tumor Removal Claim conclusion: Condition eligible Upon receiving the complaint to the Better Business Bureau, a review has been done to determine if a resolution to the concerns could be met. In the BBB complaint, Mr. ****** is unhappy that each Mast Cell Tumor is subject to its own deductible of $300.00. Trupanion had the pleasure of processing a claim #XXXXXX for ****** ***** had surgery on 7/16/2014 where he had 2 Mast Cell Neoplasm tumors removed. We were please to advise the ****** family that these two conditions were eligible for coverage. However each of these tumors is viewed as its own conditions. Mr. ****** emailed in to Trupanion on 7/25/2014 with questions regarding this claim. I responded that although I can understand how frustrating it can be, Mast Cell Tumors are common and may be found solitary or multiple on a pet's body. In the event there are multiple masses, if there is not a direct lymphatic or vascular connection between them, they are considered independent tumors. Therefore in a case such as this, if there is a deductible as chosen by the policy holder, it would be applied to each Mast Cell Tumor. DEFINITION: (F) The monetary amount that you pay for each condition. Once the deductible amount has been met for a specific condition, the policy will then pay out all future losses subject to all other terms and conditions. Further in my email response I explained to Mr. ****** that Trupanion has a compressive appeals process. Should his veterinary be able to provide new histopathology results that may put these Mast Cell Tumors in another category, the appeals team would be happy to look over the claim once again. I gave Mr. ****** my direct fax number and advised that I would assist him through the appeals process. I have not yet seen an appeal letter as of yet. CLAIM PROCESS: (C) In the event of a disagreement between you and us concerning the coverage of a claim, you may request a review of Trupanion denial pursuant to our voluntary denied claims review process. If Trupanion affirms denial of your claim, you may further request that your claim be reviewed by an independent third-party veterinarian "ITPV" to adjudicate whether the medical reasoning for denial is justified. The ITPV's decision shall be final and binding on Trupanion. Our goal at Trupanion is to offer the best coverage industry wide. We remain dedicated to the very best care for pets and customer service for our policy holders. We wish for a happy and healthy future for ***** and we are truly happy that he is a part of the Trupanion family. I remain a point of contact for Mr. ****** and will happy to assist in anyway. At this time Trupanion assumes this complaint as closed. ***************** Research and Resolution t: XXX-XXX-XXXX; ext. **** e:*****************@trupanion.com Initial Consumer Rebuttal /* (3000, 7, 2014/08/20) */ (The consumer indicated he/she DID NOT accept the response from the business.) Trupanion's assertion that two deductible amounts for one surgery is unacceptable. There was one surgical procedure removing two masses. One deductible only should apply. This is just an excuse for Trupanion to avoid paying a justly filed claim. They have a history of looking for ways to avoid paying claims as was demonstrated when they previously denied a claim on our dog's hip operation saying that it was a preexisting condition because she had the other hip operated on. I request fairness - I agreed to pay one $300 deductible - NOT two for one surgical session. Pay the claim and have some respect for honoring a long paying customer. Final Business Response /* (4000, 9, 2014/09/02) */ Owner: ****** ****** (Rebuttal) Policy ****** Pet's name: ***** Policy enrollment date: 10/2/2009 Injury coverage eligible date: 10/7/2009 Illness coverage eligible date: 11/1/2009 Deductible $300.00 per-condition Claim #XXXXXX Condition: Mast Cell Tumor Removal Claim conclusion: Condition eligible Trupanion is truly happy to assist our policy holders with any questions that they might have. We also understand the frustration and emotion that is involved when caring for a sick pet and making the best decision for them. However as outlined in the first response, Trupanion has a policy in place that allows an owner to choose a deductible that best suits their financial needs. It is definitely not our intention to upset Mr. ****** but we do have to uphold the policy and be fair to all policy holders. In order to continue offering insurance at a reasonable rate without unnecessary and unfair inflation, we can only pay claims that meet the standard set for the by our policy. As noted in our first response, if Mr. ****** wants to appeal the se specific masses, I am happy to be a point of contact and assist with that appeals process. We hope that ***** is happy and healthy and we are so glad that he is a part of the Trupanion family. At this time Trupanion does consider this case as closed. However we are always here to assist in any way we can. Sincerley, *********** ******** Research and Resolution T:XXX-XXX-XXXX ext. **** E:*****************@trupanion.com Final Consumer Response /* (4200, 11, 2014/09/13) */ (The consumer indicated he/she DID NOT accept the response from the business.) Trupanion is once again manipulating the facts to avoid paying a legitimate claim. They are insisting on charging two $300 deductibles on the same surgical session to remove two growths suspecting on being mast cell cancerous tumors. Trupanion has a history of manipulating the truth to avoid paying rightful claims. I have and continue to pay my monthly premiums but when the one time in the many years we have paid these premiums, we make a claim, Trupanion tries to cheat me by charging two deductible amounts during the same surgical session for removal of two growths. That is unacceptable and Trupanion should be ashamed to try to save $300 when they have been paid thousands of dollars over many years. Do the right thing Trupanion and stop cheating your customers!

9/23/2014 Problems with Product/Service | Read Complaint Details
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Complaint: Trupanion accepted ********* as a non neutered pet when she was 7, but they are refusing to cover the emergency spay due to pyometra citing that it is because she was not neutered before she was one. Well, that's the third story. the first was that she was a "working dog." the second was that she was a breeding dog. Then, when the vet sent a letter saying she had never been bred and it was a life threatening illness, they claim they told me "in a conversation" that I needed a breeding clause even though I had no plans to breed her. A conversation they can provide no copy of.

Desired Settlement: payment for the vet bill in the amount of $2800 for the surgery needed to save the dog

Business Response: Initial Business Response /* (1000, 5, 2014/09/05) */ Date: September 5th, 2014 BBB Case #: XXXXXXXX Ms. ******* ******* Policy #: TUXXXXXXXXXX Pet: "*********" Enrollment date: 01/17/2014 We have reviewed the claims filed by Ms. ******* and affirm the denial for the condition of "Pyometra". Ms. *******'s Afghan hound, "*********", was intact and not spayed at the time of the claimed condition. The condition of Pyometra occurs in unspayed females. Ms. ******* enrolled ********* on January 7th, 2014, endured a five day waiting period before accident coverage began and a thirty day waiting period before illness coverage began. Ms. ******* called into Trupanion on January 7th and was advised by a staff member to consider adding the "Breeding Endorsement (Rider)" onto her standard core coverage. The "Breeding Endorsement (Rider)" allows for extended coverage as our policy includes limitations for intact pets (See section 6.d). At the time, Ms. ******* declined. The condition claimed for on claim #XXXXXX was "Adrenal Gland Tumor + Pyometra - surgery". Trupanion was able to offer coverage to the condition of "Adrenal Gland Tumor/mass". The condition of "Pyometra" was denied under the Section 6.d of the policy: Section 6.d "You must arrange for your pet to be neutered or spayed prior to its first birthday. If you do not comply, no coverage shall apply for illnesses related to prostate problems, hormonal skin conditions, perianal hernias, testicular tumors, perianal tumors, mammary tumors, uterine and ovarian conditions, birthing, or injury due to fighting, collision with a motor vehicle, or aggressive behavior. This stipulation does not apply to pets where the timing of being spayed or neutered was in conjunction with their veterinarian's medical recommendations, or to pets spayed or neutered within 60 days of being adopted." Our goal at Trupanion is to offer the very best coverage industry wide and compassionate customer care. We remain dedicated to offering the most comprehensive policy and all claims to be reviewed in a fair and just manner for all those enrolled with us. ****** ****** Research and Resolution T:XXX-XXX-XXXX *** **** E: *************@trupanion.com

9/12/2014 Problems with Product/Service | Read Complaint Details
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Complaint: This company withdrew funds from my checking account 10 days prior to the date that was agreed upon causing an overdraft fee on my account as I am on disability and I explained the funds were not available yet! I spoke to a supervisor who assured me this error would be corrected and a full refund would be given to me and returned to my mastercard on file with in 3 days and I recieved an email stating such as well! On day two I called and left a message! Noone called me back! On day three I called my bank and the funds were not returned I called this company again another voice message was, left! I then called back to customer service and was told by the same supervisor a check was issued! In the meantime my bank has charged me an overdraft fee because the bank covered the early withdrawal of the funds! Now with the check being issued and I will not recieve any funds until the end of the month I will be assessed another overdraft fee so this original $93 dollar bill will, now cost me an additional $70! I was told by the supervisor that the company will cover all fees after I submit proof of the overdraft fees! Now keep in mind I am disabled and have to figure out a way to get a copy of my account summary emailed or faxed to them!! Terrible just simply inexcusable on their part! Are these people trained at all..

Desired Settlement: I want my $93 refunded to my bank account and all the overdraft fees covered! They need better training as professionals and a clear policy needs to be put in place! As far as a negative, rating with my bank I am not sure how this can be fixed! In today's society credit bureau check into accounts to make sure they are in good standing and now this company error has made a negative remark on my banking account! I wonder if they did this thinking because I am disabled that I can be easily taken advantage of!!

Business Response: Initial Business Response /* (1000, 5, 2014/09/08) */ Policy #TUXXXXXXXXXX Owners Name: ****** ****** Pet's name: ********* Policy enrollment date: 7/16/2014 Injury coverage eligible date: 7/16/2014 Illness coverage eligible date: 7/16/2014 Deductible $500.00 per-condition Complaint: Refund and overdraft fee Upon receiving the complaint to the Better Business Bureau, a review has been done to determine if a resolution to the concerns in this complaint could be met. In this BBB complaint, Mr. ****** is unhappy that his payment was not pulled on the date he felt was agreed upon with Trupanion. Due to this payment pull, Mr. ****** claimed that he incurred an NSF fee. Mr. ****** has requested to have a full refund of his premium and his NSF fee re-funded to him. Trupanion is truly sorry that this event has taken place and that Mr. ****** was inconvenienced. As if September 5th, 2014 a check for the full re-fund and the NSF fee has been issued to Mr. ******. At this time the policy for ********* is cancelled but we would love to see her covered by Trupanion again in the near future. Our goal at Trupanion is to offer the best coverage industry wide. We remain dedicated to the very best care for pets and customer service for our policy holders. We wish for a happy and healthy future for *********. I will remain a point of contact for Mr. ****** and will happy to assist in anyway. At this time Trupanion assumes this complaint as closed. ******** ******** Research and Resolution t: XXX-XXX-XXXX; ext.***** e:*****************@trupanion.com Initial Consumer Rebuttal /* (2000, 7, 2014/09/11) */ (The consumer indicated he/she ACCEPTED the response from the business.)

8/28/2014 Problems with Product/Service | Read Complaint Details
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Complaint: Last October I took out a policy with Trupanion for my dog ********* At 1st his Vet thought he had been poisoned..That was ruled out. Then She diagnosed him with late "Onset epilepsy". I called Trupanion in Jan and asked if "Diagnostic services" would be covered. The lady said "Sure, I don't see why not."..So, I took him to ******* ********** *********** who suggested he have an MRI.. ( $2200.00) which showed he had a "Brain tumor".His Dr said he should have the surgery ASAP..Thinking I had Pet Ins of course I had him do it. ($6000.00 plus)..Then radiation at *** ********** ******** ******* ( $4000.00 plus). Just last month he had to be readmitted to *** for a few days. I took him 1st to "Access ER" ( $330.00) I didn't submit the last bill to Trupanion as they say everything is "Pre-existing"..I am spending a small fortune in his meds every month..I am a widow living on a fixed income and live all alone except for my doggy. I had to take out a "Special credit card" to pay for all of this. They don't care. They even had me get proof of the prior Pet Ins he did have that I had canceled..I asked "Why?" And the lady said "So we know who pays 1st"..As soon as they received the email saying his old ins policy had been canceled I got an email from them saying "No, we are not paying..it is "Pre-existing"

Desired Settlement: I would like for them to pay as his policy states..or at least help out..I do not want to lose my dog because I cannot afford his meds or cannot afford to take him to his Dr.

Business Response: Initial Business Response /* (1000, 5, 2014/07/25) */ BBB Case #XXXXXXXX Policy holder: ******* ****** Policy #TUXXXXXXXXXX Pet: ******** Enrollment Date: 10/25/13 Upon receipt of Ms. ******'s complaint with the Better Business Bureau, the policy was reviewed to determine if a resolution to Ms. ******'s concerns could be established. In the complaint, Ms. ****** expresses her opinion that her pet's condition of "Seizure, Brain Tumor" was not related to the pre-policy seizure condition. Ms. ****** did not agree with the original review of the claim and sought an appeal. Trupanion's appeal processed reviewed all available information plus additional information provided by Ms. ******'s veterinarian. However the appeal ruling upheld the denial as per Trupanion's policy exclusion 7.b.1: b. Conditions Not Covered (1) Illnesses for which any evidence and/or symptoms of their potential manifestation exist at, or prior to, the policy enrollment date; In ********'s medical records from ****** **** ****** ******** on October 2013 it reads: 10/17/13 "... stopped by w/ ********, they were in the car when his body suddenly stiffened and his eyes rolled back, this lasted about a minute and when she came in she said he was acting normally then. She made an appt to see Dr. **** tomorrow.." 10/18/13 "Yesterday, body stiffened, eyes rolled back, lasted about a minute. Diagnosis: Seizures" " 1. Discussed safe seizuring and when to medicate 2. keep a seizure log 3. Plan pending blood work 4. If seizures become more frequent, see **** *******. 10/21/13 "If ******** seizes 2 more times in the next 3 weeks, we need to send him to see **** ********. The cause for acute onset of seizures in a 9 year old dog will require a neurologist." Noted post enrollment, but within illness waiting periods: ********'s signs and symptoms continued during the initial accident and illness waiting periods (5 and 30 days, respectively) as recorded in the medical records from ****** **** ****** ********* 11/12/13 "Another seizure/pooped in house and seems to have lost vision. ******** had another seizure last night. Initially ******** was walking in circles and he defecated. Owner heard ******** collapse then saw him kicking and paddling. After ******** was able to get back up on his feet he seemed blind. Similar abnormal neurologic activity early this morning and again early this afternoon. Sometimes ******** has tonic/clonic activity when he collapses, sometimes he is extensor rigid and trembling. Diagnosis: Seizures. Discussed meds vs neuro consult vs meds and neuro consult. Gave owner contact information for Dr. ******* at SVS. Rx Phenobarbital" As these signs and symptoms were noted prior to enrollment in the policy and during the initial waiting periods, it makes this condition, and anything related to the condition ineligible as in accordance with Trupanion's policy. As Trupanion is secondary insurance, we do require either proof of cancellation of previous insurance policies or we ask that you submit your claims through the primary company first, and then re-submit with the primary company's explanation of benefits for review. Trupanion feels like they have offered every available avenue to allow for a fair and just review of the ********'s claimed condition. Unfortunately, Trupanion was unable to find enough evidence to disconnect the current claimed condition with the pre-policy signs and symptoms. Trupanion understands how heartbreaking it can be for our policy holders when their pets are sick or injured and our hearts go out to Ms. ******. Our goal at Trupanion is to offer the very best coverage industry wide and compassionate ******** service. We remain dedicated to offering the most comprehensive policy and all claims to be reviewed in a fair and just manner for all policy holders. At this time, Trupanion considers this case closed. Sincerely, ************* Research and Resolution lead XXX-XXX-XXXX EXT **** *************@trupanion.com Initial Consumer Rebuttal /* (3000, 7, 2014/07/28) */ (The consumer indicated he/she DID NOT accept the response from the business.) In ********'s records it states "Late onset epilpsey" as his condition. I have those records. He has since been hospitalized once more..if this happens again, I cannot afford to have my 4-legged child anymore. How sad is that??!! Final Business Response /* (4000, 9, 2014/08/07) */ BBB Case #XXXXXXXX Policy holder: ******* ****** Policy #: TUXXXXXXXXXX Pet: ******** Enrollment Date: 10/25/13 Trupanion has thoroughly reviewed all medical records, appeal letters, and questions and concerns from Ms. ****** in regards to *********** policy. We believe that we have treated this case in a fair and just process as the previous responses outlined the steps we took to address the concern. Trupanion understands the frustration and emotion that is involved in receiving a denied claim, and it is definitely not our intention for this to be Ms. ******'s experience. In order to continue offering insurance at a reasonable rate without unnecessary and unfair inflation, we can only pay claims that meet the standards set forth by our policy. We hope that *********** condition is manageable and wish both her and Ms. ****** the best health in the future. At this time Trupanion does consider this case closed. Sincerely, ****** ****** T: XXX-XXX-XXXX EXT **** E: *************@trupanion.com

8/5/2014 Problems with Product/Service | Read Complaint Details
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Complaint: May 26, 2014 BBB of Alaska, Oregon and Western Washington 1000 Station Drive, Ste 222 DuPont, Washington XXXXX To Whom it May Concern: Please accept this as my formal complaint against Trupanion Insurance for not acting in good faith in terms of honoring claims submitted for my dog, ********* related to a condition he began having with inflamed paws after I signed up for insurance with the company and began paying premiums in the amount in excess of $80.00 per month. After adopting ******** from his former owners who moved out of the country, I signed him up for Trupanion Pet Insurance. Sometime later, ******** began having significant discomfort and obvious inflammation on all four of his paws. He licked them constantly, and didn't want to go for walks or play. I took ******** to see Dr. **** **** at **** **** ****** ******* which happens to be the same clinic his former owners had taken him to since he was a puppy. As a result, **** **** was familiar with ******** and had his complete medical history. Upon examining him, Dr. **** determined that ********* problem was due to either spontaneous contact or a wound and that he needed to begin taking the drug Cyclosporin immediately in order to treat it. While it is a fairly expensive drug, I purchased it right away and then filed a claim with Trupanion for reimbursement. I was surprised when the company denied the claim, stating that ******** had previously suffered from chronic ear infections, which according to Trupanion, qualified as a pre-existing condition and that the previous ear infections were somehow related to his current problems with his paws. I called Dr. ***** who said while she could understand how Trupanion could tie the two conditions together in some cases, it was her professional opinion in examining him that the two were not at all related in ********* case. She was confident enough in that she wrote to Trupanion to support my claim for reimbursement for the Cyclosporin. (A copy of Dr. ****** letter is available upon request.) I then appealed to Trupanion, stating that Dr. ***** who is a very well-respected vet in this region, did not believe there was a correlation between ********* paw problem and previous ear infections. Trupanion had one of its in-house vets talk to Dr. ***** at which time she assured him of the same. Trupanion continued to accept ********* insurance premium for several months while they considered my appeal. After another denial, they sent the case to their "independent veterinarian" for a final review. That report came back stating their vet determined there was a correlation between the current problem with ********* paws and his previous chronic ear infections and, therefore, my claim was denied. I immediately cancelled my insurance policy. I do not understand how Trupanion could come to such a conclusion when it isn't a cut and dry situation, and the veterinarian examining the animal emphatically states there is no preexisting condition with such confidence that she is willing to put it in writing. I spoke with a Trupanion representative to let them know how troubled and disappointed I was with what I saw as an arbitrary determination that was disputed by a professional veterinarian who had the dog and his full set of records in front of her. I have not filed this complaint until now as I waited until I had irrefutable proof that Trupanion's decision was wrong. After several months on Cyclosporin, ****** has not had one recurrence of any problems with his paws. He has, however, had a very serious ear infection that required immediate medical attention while he was on the drug, proving the two conditions are not related. If they were, either he would not have had another ear infection or the problems with his paws would not have been addressed. As an insurance company, I believe Trupanion did not act in good faith in that they completely ignored the diagnoses of the doctor who had a long history with the animal and who could physically see the difference between the two problems. As a result, I am requesting that you conduct an investigation of this matter and any other complaints you may have received against the company. Many people pay their pet's insurance premiums expecting that problems like this would be covered if they arise. Clearly, I would never have expected ear infections to be covered as his file clearly showed he had many throughout his life. The inflammation of his paws is another matter. I am also filing a complaint with the ********** ***** ********* ************ and would appreciate if you would let me know what your investigation reveals I would be happy to discuss this matter in more detail or answer any questions you might have if you call me at***/XXX-XXXX. I also believe Dr. **** would be willing to talk to you as well. She can be reached at ***/XXX-XXXX. Thank you in advance for your help and consideration, and I look forward to hearing from you. Sincerely, **** ** *****

Desired Settlement: I wish to be be fully reimbursed for all of the insurance premiums I paid to Trupanion for ******** as I believe the company did not act in good faith or honor their obligation to pay for his care in this case.

Business Response: Initial Business Response /* (1000, 6, 2014/05/30) */ BBB Case #XXXXXXXX Policy #TUXXXXXXXXXX Owner: **** ***** Pet: "******" Enrollment date: 05/14/2013 Upon receiving this complaint from the Better Business Bureau, a review of the policy was to determine if a resolution to the policy holder's concerns could be reached and to gain clarity of the nature of the complaint. In the complaint, Ms. ***** expresses her opinion that her pet's condition of ************** was not related to the pre-policy ******** condition. Ms. ***** did not agree with the original review of the claim and sought an appeal. Trupanion's appeal processed reviewed all available information plus additional information provided by Ms. *****'s veterinarian. However the appeal ruling upheld the denial as per Trupanion's policy exclusion 7.b.1: 7.b.1: b. Conditions Not Covered (1). Illnesses for which any evidence and/or symptoms of their manifestation already exist at, or prior to, the policy enrollment date; ******'s medical records reflect extensive history ******-like symptoms as described in the appeal ruling: Secondary Review Comments: Appeal: **************: Remains denied. Pre-policy pet displays recurrent ******/ ******** ****** symptoms. **** are chronic recurrent with refills and treatment of **** noted for y**** and most recently as April 2013- just prior to enrollment. Claimed condition presents just outside all waiting periods and app**** initially as an isolated focal **************, but progresses to affect all ******************, ****** becomes a component in subsequent visit and condition is then assessed as "continued *****" and pet is placed on ******a. This condition is consistent with a continuum/progression of the pre-policy *******/******** ****** symptoms and is treated as such. After the appeal, our staff veterinarian, Dr. ************** reached out to Dr. **** at *********************** at the request of Ms. *****. Dr. ********'s review of the conversation with Dr. **** was that both doctors agreed that this dog's pre-existing problems are associated with current claim. Ms. ***** reached out to management at Trupanion and further discussed options. She opted to pursue the Independent Third Party Veterinarian ("ITPV") review to adjudicate whether the medical reasoning for the denial is justified. The "ITPV" decision is final and binding on Trupanion. The veterinarian, who is a board-certified specialist in veterinary dermatology, reviewed all available medical records as well as Dr. ****' s original appeal letter. The ITPV outcome upheld the original denial and stated in conclusion, "As such, all claims for ******, **************, secondary ********** h***************, secondary ************************ and any/all secondary ********* associated with ******* (****** dermatitis and food *******) should be considered pre-existing". Trupanion feels like they have offered every available avenue to allow for a fair and just review of the ******'s claimed condition. Unfortunately, Trupanion was unable to find enough evidence to disconnect the current claimed condition with the pre-policy signs and symptoms. Trupanion understands how heartbreaking it can be for our policy holders when their pets are sick or injured and our hearts go out to Ms. *****. Our goal at Trupanion is to offer the very best coverage industry wide and compassionate ******** service. We remain dedicated to offering the most comprehensive policy and all claims to be reviewed in a fair and just manner for all policy holders. At this time, Trupanion considers this case closed. ************* Research and Resolution T:XXX-XXX-XXXX Ext: **** E: *************@trupanion.com Initial Consumer Rebuttal /* (3000, 8, 2014/06/09) */ (The consumer indicated he/she DID NOT accept the response from the business.) Trupanion continues to claim that my dog's long history of ear infections indicate a preexisting condition in relation to the problems he experienced years later with his paws. As stated previously, the veternarian who examined him vehemently disagreed as she saw the paws as a contact reaction as opposed to a systemic allergic reaction. Trupanion continues to repeadtedly state the paw issue was pre-existing despite the fact we subsequently proved beyond any reasonable doubt that it was not, when the ongoing treatment of Cyclosporin has completely eradicated any and all issues with his paws, while his chronic ear infections continue. Again, if the two illnesses were related, the Cyclosporin would address both. My dog's vet records are available for review if needed. It concerns me that even with irrefutable, factual proof, Trupanion is unwilling to reverse its original decision and admit the denial was made in error. It is simply wrong and I consider it not only to be a bad business practice, it is nothing less than a breach of contract. Final Consumer Response /* (4200, 12, 2014/06/20) */ (The consumer indicated he/she DID NOT accept the response from the business.) (The consumer indicated he/she DID NOT accept the response from the business.) Trupanion continues to claim that my dog's long history of ear infections indicate a preexisting condition in relation to the problems he experienced years later with his paws. As stated previously, the veternarian who examined him vehemently disagreed as she saw the paws as a contact reaction as opposed to a systemic allergic reaction. Trupanion continues to repeadtedly state the paw issue was pre-existing despite the fact we subsequently proved beyond any reasonable doubt that it was not, when the ongoing treatment of Cyclosporin has completely eradicated any and all issues with his paws, while his chronic ear infections continue. Again, if the two illnesses were related, the Cyclosporin would address both. My dog's vet records are available for review if needed. It concerns me that even with irrefutable, factual proof, Trupanion is unwilling to reverse its original decision and admit the denial was made in error. It is simply wrong and I consider it not only to be a bad business practice, it is nothing less than a breach of contract Final Business Response /* (4000, 15, 2014/07/02) */ Policy #TUXXXXXXXXXX Owner: **** ***** Pet: ********** Enrollment date: 05/14/2013 Trupanion has thoroughly reviewed all medical records, appeal letters, and questions and concerns from Ms. ***** in regards to ********* policy. We believe that we have treated this case in a fair and just process as the previous responses outlined the steps we took to address the concern. The Independent Third Party Review appeal is final and binding on the claim outcome as per our policy document, section 4.c. We wish Ms. ***** and ****** the best in the future. At this time Trupanion does consider this case closed. Sincerely, ****** ****** T: XXX-XXX-XXXX EXT **** E: *************@trupanion.com

8/4/2014 Problems with Product/Service | Read Complaint Details
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Complaint: June XX XXXX at 7:47pm I enrolled my pet ***** ***** because Trupanion was offering a free trial at my place of employment for all employees. Shortly after enrollment my dog had severe bloody diarrhea and was relieved that I had signed up for this insurance. I took her to the vet which is my secondary place of employment and performed radiographs and blood work. The Doctor on staff determined that ***** would have to stay over night. Something I would have never done if I had not had insurance. All said and done I submitted a claim to Trupanion. Which was quickly denied. Their first reasoning for the denial was that ***** had eaten a chicken 7 days prior, which later Trupanion was told by the Doctor that, that was unrelated to his diagnosis and was just taking a good history of the patient. A secondary denial was that the time stamp to the Idexx(lab) machines where previous to enrolllment. I had one of the practice managers and Doctor on the case confirm there was an error on the machines(the machines where 2 hours and some change off) and informed Trupanion of this. Unsure of what time I had gotten ***** to the vet I had told the representative I would get paper documentation because I knew it was sometime after enrollment that I had brought her. I sent in paper documentation that I checked into the hospital at 8:20PM, that is clearly MORE than one hour after enrollment. However because I was unsure of the times and the woman on the phone was using the times I had said AFTER I had clearly said I am not sure exactly let me get documentation. My claim was declined. This is an outrage to me. All proper protocols were preformed. This was not a preexisting condition prior to enrollment. Trupanion has all of these documents.

Desired Settlement: The policy that I signed up for is a $250 and a 90% pay out. The bill is $1,046.40. I am responsible for a $250 deductible and the remanding 10%. That is what I am seeking from Trupanion.

Business Response: Initial Business Response /* (1000, 5, 2014/07/09) */ BBB Complaint #XXXXXXXX Owner: **** ********* Policy #TUXXXXXXXXXX Pet's name: ***** ***** Policy Enrollment Date: 6/13/2014 Claim #XXXXXX /Invoice Amount $1,046.40 Claimed Condition: Hematochezia Claim Conclusion: Ineligible Upon receiving the complaint to the Better Business Bureau, a review has been done to determine if a resolution to the concerns could be met. In the BBB complaint, Ms. ********* has concerns regarding the denial of claim #XXXXXX for her pet ***********. The claimed condition of Hematochezia was found to be ineligible. Based on the time stamps noted by Idexx Chemistry labs, the diagnostic testing was started for ***********'s condition at 6:55 p.m. EST. However the 30-day trail Declaration page indicates that enrollment began at 7:37 p.m. EST. Because of these time stamps, the claim was deemed ineligible in accordance with the policy. Unfortunately Trupanion is unable to extend coverage to illnesses or accidents that have exhibited signs or symptoms prior to policy inception. PRE-EXISTING EXCLUSIONS: (A) Illness resulting from any condition for which evidence and/or symptoms of their potential manifestations already exists at, or during the 18 months prior to, the policy enrollment date. Illnesses that occur during the 30 day waiting period and accidents that occur during the 5 day waiting period will be considered pre-existing conditions. Upon learning of the denied claim, Ms. ********* and her vet *** ******** request an appeal for claim #XXXXXX. To support her appeal, Ms. ********* sent in evidence she felt proved that the Idexx time stamps were incorrect. *** ******** also stated that *********** was already enrolled when she began to treat him that night. As Trupanion has a comprehensive appeal process, all the new info provided to Trupanion was reviewed by the Appeals team. Sadly upon second review the claim for *********** remained denied. CLAIM PROCESS: (C) In the event of a disagreement between you and us concerning the coverage of a claim, you may request a review of Trupanion denial pursuant to our voluntary denied claims review process. If Trupanion affirms denial of your claim, you may further request that your claim be reviewed by an independent third-party veterinarian "ITPV" to adjudicate whether the medical reasoning for denial is justified. The ITPV's decision shall be final and binding on Trupanion. Our goal at Trupanion is to offer the best coverage industry wide. We remain dedicated to the very best care for pets and customer service for our policy holders. I have been in contact with Ms. ********* by phone on a few occasions. Ms. ********* remains dissatisfied with the appeal denial. I have advised Ms. ********* that Trupanion is still looking into this case for her. At this time there is no agreed upon resolution between parties. As new info becomes available, I will update this BBB case. Ms. ********* is aware that I am acting as her point of contact and that I will reach out to her with questions or any new information that I have. At this time *********** is still on his 30-day trial however it will expire on 7/13/2014. We hope Ms. ********* will continue ***********s insurance and convert to a full policy. We would love to continue to be a part of ***********'s life and hope that he stays with Trupanion for many more years. ******** ******** Research and Resolution t: XXX-XXX-XXXX; ext. **** e:*****************@trupanion.com Initial Consumer Rebuttal /* (3000, 7, 2014/07/11) */ (The consumer indicated he/she DID NOT accept the response from the business.) As explained by myself, the doctor on the case and Practice manager the time stamps on the lab machines were incorrect. The check in sheet shows that I arrived at 8:20pm X-rays also were time stamped for 8:20pm I performed blood work after the fact. This information also was given to Trupanion. I feel even with my supporting documentation Trupanion just will not abide by their own policies. This was NOT a preexisting condition. Trupanion will not give me coverage because of human error that I had no control over, a simple mistake was made by not having the correct time stamp. Final Business Response /* (4000, 9, 2014/07/21) */ Case rebuttal:XXXXXXXX Complaint or Desired Resolution: Denied claim Policy I.D. #TUXXXXXXXXXX Owner: **** ********* with dog ***** ***** Enrollment Date: 6/13/2014 Eligibility date: 6/13/2014 Claimed Condition: Hematochezia Claim#: XXXXXX/Invoice Amount $1,046.40 Claim Conclusion: Ineligible Outcome: Claim denial stands *First signs or symptoms presented at exam on 6/13/2014 prior to enrollment. As per the trial, any new conditions that occurs after the trial enrollment is eligible for coverage. We are so sorry to hear that Ms. ********* remains unhappy with the claim denial. Our goal at Trupanion is to offer the very best coverage industry wide. Pets are our passion *** we completely understand how frustrating it can be when your pet is sick or injured. So Trupanion would not want to put Ms. ********* in the position of not being reimbursed for a claim unless we could reach a solid conclusion that we stand behind. In an effort to be completely fair, Trupanion veterinarian *** ***** ******** looked into this case extensively. *** ******** was in close communication with *** ******* from *************************** who did confirmed that *********** was seen somewhere between 7-8 p.m. for the condition of Hemotochezia. The final ruling on this claim is that Trupanion can find no evidence that the time stamps for the diagnostic tests ran for *********** are incorrect. *** ******* has confirmed that the first labs started at 6:55 p.m. and the last at 7:19 p.m. So Trupanion is confident that the free 30-day trial in questions was activated after *********** was already admitted to the hospital. Even though we are unable to pay this claim we would like to extent our gratitude for allowing us to assist Ms. ********* with her medical needs for ***********. Currently ***********'s policy is cancelled however I remain a point of contact for Ms. ********* and welcome any questions she may have. Lastly we wish *********** health and happiness. ******** ******** Research and Resolution T:XXX-XXX-XXXX xt. **** e:*****************@trupanion.com

7/14/2014 Problems with Product/Service | Read Complaint Details
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Complaint: I have been trying to cancel my policy with Trupanion for the last 3 months. I have called 3 times and they always say that someone will get back to me and they never do. This is an automatic withdrawal every month and I feel that I should be reimbursed for the last 3 months that I have been unable to contact them to stop these withdrawals.

Desired Settlement: DesiredSettlementID: Refund Refund for the past 3 month's for which I did not want service.

Business Response: Initial Business Response /* (1000, 5, 2014/07/11) */ BBB Case #XXXXXXXX Policy holder: *** ******* Policy #TUXXXXXXXXXX Pet: ***** and **** Upon receipt of *** *******'s complaint with the Better Business Bureau, the policy was reviewed to determine if a resolution to Ms. *******'s concerns could be established. Upon reviewing Ms. *******'s account, it has been confirmed cancelled on June 30, 2014 when email confirmation was received. Trupanion must receive written (or emailed) request in order to cancel a policy as required by state insurance law. Trupanion found that Ms. ******* attempted to cancel her account by phone on April 2nd, 2014. The representative sent Ms. ******* an email to respond to so that Trupanion may finalize the cancellation. After fifteen days, the cancellation request was voided and the account remained active as Trupanion had not received response. As Trupanion has already refunded for the remaining days in June (amounting in $63.95 for 23 prorated days), we are willing to compromise and refund the policy holder the premium cost for the month of May 2014 if that will assist the policy holder and address her frustration. At this time, Trupanion considers this case closed. Sincerely, ****** ****** Research and Resolution Manager XXX-XXX-XXXX EXT **** *************@trupanion.com Initial Consumer Rebuttal /* (2000, 7, 2014/07/14) */ (The consumer indicated he/she ACCEPTED the response from the business.) Yes, I will accept this compromise and take the refund for the month of May.

7/14/2014 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: I have a pet that just had to have surgery that cost over $5000 and they will not pay any of the claim. They are denying my claim because they say it was a "pre-existing condition" YET my Veterinarian wrote a letter to them specifically stating that it was not a pre-existing condition and that they have no right to deny my claim based on this. I was told that their veterinarian, who has never seen my dog, thinks it was a pre-existing condition so they are not going to pay it! Additionally, I was sent a letter stating that my claim was denied because the accident occurred before the policy was in place. However, the agent with the company incorrectly imputed the date and therefore it was not before the policy was in effect. However, when this was brought to their attention, they quickly came up with another excuse as to why they would not pay the claim. This is an unfair business tactic used to avoid making a payment on a valid claim.

Desired Settlement: Payment of the claim that was filed with the company.

Business Response: Initial Business Response /* (1000, 7, 2014/06/06) */ Upon receiving this complaint from the Better Business Bureau, a review of the policy was done to determine if a resolution to the policy holders concerns could be reached and to gain clarity of the nature of the complaint. In the complaint Ms. ******** stated that her vet did not agree with the denied claim for Hind Limb Parasis/Disc Disease. While processing the claim Trupanion found that in the medical records clinical signs or symptoms that were pre-policy were present. As per the Trupanion policy section (5.C.1.) the condition was denied on the basis of being a pre-exiting condition. PRE-EXISTING EXCLUSIONS: (A) Illness resulting from any condition for which evidence and/or symptoms of their potential manifestations already exists at, or during the 18 months prior to, the policy enrollment date. Illnesses that occur during the 30 day waiting period and accidents that occur during the 5 day waiting period will be considered pre-existing conditions. Trupanion offers a comprehensive appeal process where Ms. ******** and her vet requested an appeal of the denied claim. This condition has been reviewed by an independent third party specialist for final determination of eligibility. Unfortunately the ruling came back as also denied. There can be no coverage extended. Ms. ******** and her veterinary were notified on 6/4/2014 by phone and in writing. CLAIM PROCESS: (C) In the event of a disagreement between you and us concerning the coverage of a claim, you may request a review of Trupanion denial pursuant to our voluntary denied claims review process. If Trupanion affirms denial of your claim, you may further request that your claim be reviewed by an independent third-party veterinarian "ITPV" to adjudicate whether the medical reasoning for denial is justified. The ITPV's decision shall be final and binding on Trupanion. The team here at Trupanion absolutely understands how heartbreaking it can be for our policy holders when their pets are sick, injured or pass away. We too are pet owners and lovers and share these same struggles. Although Trupanion will not be able to cover this claimed condition, there is still so much value as we can never plan what will happen to our pet's health. I remain a contact point for Ms. ******** should she have any further questions. At this time Trupanion considers this case closed. Sincerely, ******** ******** Customer Experience Lead P: XXX-XXX-XXXX:Opt # ********** Initial Consumer Rebuttal /* (3000, 10, 2014/06/13) */ (The consumer indicated he/she DID NOT accept the response from the business.) The response is just the same thing they told me on the phone. Their vet, who has never seen my pet, has decided that there was something wrong with my pet and therefore the company would not cover my claim because they say it is a pre-existing condition. My vet, who has been seeing my pet for over 4 years, said that it was not a pre-existing condition. How can a company on the opposite side of the country know what has happened to my pet? I think this company is just like every other insurance company out there who does everything they can not to pay your legitimate claims. I would not recommend this company to anyone. They are a RIPOFF! Final Business Response /* (4000, 12, 2014/07/01) */ Case rebuttal: # XXXXXXXX Complaint or Desired Resolution: Denied claim Policy I.D. #TUXXXXXXXXXX Owner: ****** ******** & dog ***** Enrollment date: 4/18/2014 Eligibility date: 4/18/2014 First signs or symptoms presented at exam on 4/18/2014. As per the trial, any new conditions that occurs after the trial enrollment is eligible for coverage. Outcome: Claim denial upheld by ITPV We are so sorry to hear that Ms. ******** remains unhappy with the results of the Independent Third Party Review. Our goal at Trupanion is to offer the very best coverage industry wide. Pets are our passion and we completely understand how frustrating it can be when a pet is sick or injured. Although Ms. ******** disagrees with the ruling, Trupanion remains confident that Dr. ********* ** ******* who is board certified animal Neurology, has fairly reviewed and made an unbiased ruling in accordance with the policy terms and conditions. Even though ******** policy is cancelled at this point, I remain as a point of contact for Ms.******** and welcome any questions she may have. Lastly we wish ***** health and happiness. Sincerely, ******** ******** Research and Resolution *****************@trupanion.com XXX-XXX-XXXX ext ****

7/3/2014 Problems with Product/Service | Read Complaint Details
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Complaint: ***** from customer service handled my shock over a less than half payment on a claim with a very passive-aggressive demeanor. This was my first and only claim in the year I have been a customer. Not only did the clain take a very long time to complete with numerous confusing emails, many requests for information, and an untrained entry level customer service rep but the manager ***** that I spoke with after I was sent an email with all kinds of exclusions in it, treated my concerns with a highly passive aggressive and aggravating conversation. She seemed unaffected and haughty about the company and offered no feeling of customer service regarding my issues. I asked who the CEO was and she told me it was Mr ********. When I told her that the claim only paid me back what I had spent on premiums over the one year I had been a customer, she just kept saying, I apologize you feel that way. I then asked how I could cancel and she seemed happy to tell me how. I will let everyone on the internet and in the dog community know that this company is not worth the money spent. They seem to just be about finding everyway they can exclude themselevs from paying this amount and that amount, until you are left with 40% actual payout. Overall the claim took far too long, the reps are inexperienced, the payouts minimal, and the supervisor ***** pushed me out the door. ****** was a pleasure to deal with but ***** acted like she was doing me a favor and was abrupt. when I asked her to have her manager call me so that I could complain, she said what number should she call? I told her to use the # on file. ***** then said what number is that. I said you have the number and know that I am who I say I am so why are you asking me? She said it is a violation of privacy to tell me what my own phone number is??! She was difficult and I never want to deal with them again, while still sending money to them for that kind of poor service and coverage. Product_Or_Service: pet insurance Account_Number: TUXXXXXXXXX

Desired Settlement: DesiredSettlementID: Replacement I would like to speak to the executive level of management to let them know what I had to deal with and how I felt cheated by the process, payout, exclusions, and customer service. the xrays, mandatory cleaning to derail infection from the infected tooth, and examination fee were part of one accidental condition and should not be viewed as exclusions. I followed the doctors orders for my beloved pet's health.

Business Response: Initial Business Response /* (1000, 5, 2014/06/19) */ BBB Case #XXXXXXXX Policy#TUXXXXXXXXXX Owner: ******* ******** & dog Delgado Policy Enrollment Date: 7/31/2013 Claim #XXXXXX/Payout ******* Date of Loss ******** Claim Condition: Trauma & Tooth Death, Traumatic Periodontal Disease Upon receiving Ms. ********'s complaint to the Better Business Bureau, a review of the policy was done to determine if a resolution to Ms. ********'s concerns could be reached and to gain clarity of the nature of the complaint. I would like to begin by addressing Ms. ********'s concerns about the interactions she has had with a team member here at Trupanion on 6/6/2014. Trupanion is dedicated to providing you with the best pet insurance plan possible, so owners can easily and safely protect their pets in the event of unforeseen injury or illness. Each and every one who is employed at Trupanion is a pet lover and works tirelessly to assist pet parents to their best ability. However if we fall short of offering the highest level of customer service, we take it very seriously. I can assure ************* that management has taken her complaint as a training opportunity and will address the issue internally. In the BBB complaint Ms. ******** expressed that she would like to speak with a member of the executive team about her concerns. I am happy to serve as a point of contact for Ms. ******** and phacilitate a phone call with an executive at a time that is convent for her. I have reached out to Ms. ******** on 6/17/2014 and sent her my contact info by email. I look forward to speaking with her soon and setting up this call. I am happy to report that claim #XXXXXX was deemed eligible for coverage and a refund check in the amount of $760.95 was issued to Ms. ********. However as shown below, there are some stipulations to the Policy that directly affected this claim. For instance the Root Canal and endodontics treatment performed were on a tooth that is not a canine or carnassial. This portion of the claim equaled $ 253.00 and was not eligible for coverage. Further there was an exam fee and cleaning not eligible for coverage. These exclusions are stated in the policy and outlined below: 3. ELIGIBLE CLIAMS-WHAT YOU PAY: a. Veterinary Examination Fees. 7. WHAT WE DO NOT COVER: c. PREVENTIVE CARE - Preventive care such as, but not limited to, Vaccinations or titer test, flea control, tick control, heartworm Medication, dental care and prophylaxis (meaning cleansing of tooth Surfaces), deworming, nail trim, or other grooming. d. DENTAL - Coverage for the cost of scaling, cleaning and polishing the Teeth at any time, and for any reason. 8. STIPULATIONS c. DENTAL - We will pay for endodontic treatment due to dental Disease or trauma for canine and carnassial teeth. If endodontic Treatment is performed on any other teeth, we will pay for the Cost of extraction. In conclusion it is our goal at Trupanion to offer the very best coverage industry wide. We remain dedicated the best care available for pets and customer service that is superior to none. Once Ms. ********'s has had the opportunity to speak with an executive at Trupanion; I will update this complaint with the BBB. Sincerely, ******** ******** Customer Experience Lead P: **************** # ********** *** NW ******* Way: Seattle, WA XXXXX http://trupanion.com

6/20/2014 Problems with Product/Service | Read Complaint Details
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Complaint: I submitted out first claim, for my dog *****, for a behavioral consultation. I was told I will not be covered due to a veterinary record that stated our dog was being enrolled into Pet Training classes due to my concern about aggressive behavior. This record was prior to his enrollment into Trupanion. ***** was a rescue puppy, a Cockamo mix, we adopted at 8 weeks of age. This vet examined him right after we adopted him. I told this vet he was a very hyper puppy and was biting everything. I enrolled him in classes as soon as he was old enough to go. Trupanion enrolled ***** on 8/7/12 when he was 10 weeks old. I am sure during my many phone chats with Trupanion I told the girl I spoke to during enrollment he was a very nippy puppy and I was enrolling him in classes. What puppy doesn't bite? ***** has completed many levels of training and is now enrolled in a tricks class. He outgrew (with the help of positive reinforcement training) his rough play. He is now 21 months old and has developed an occasional tic and seems nervous at times. He bit my hand about a month ago so our current vet and trainer recommended seeing a behaviorist and neurologist. He is a wonderful dog so this was quite a surprise. Now because the vet we used until he was about 5 months old used the word aggressive in describing why our 10 week old puppy was enrolling in puppy training,Trupanion who enrolled him at 10 weeks of age is trying to use this not to cover his bill. I called them on 3/25/13 and was told the supervisor would call me back. I called today and told them they never returned my call. I was told the supervisor would call me back shortly. I am still waiting.

Desired Settlement: Coverage for his behavioral veterinary care and they should not be allowed to use enrolling our 10 week old puppy into training classes to correct puppy behaviors as grounds to deny a claim.

Business Response: Initial Business Response /* (1000, 7, 2014/04/18) */ BBB Case #XXXXXXXX Policy #TUXXXXXXXXXX Owner: ***** ******* regarding pet, "***** ******* Upon receiving the complaint to the Better Business Bureau, a review has been done to determine if a resolution to the concerns could be met. In the BBB complaint, Ms. ******* had concerns regarding the denial of a recent claim submitted for her pet, "***** ******** The claim in question was for a behavioral consultation for her pet's aggressive behavior. The claim was deemed ineligible in accordance with our policy document which outlines that we are unable to extend coverage to illnesses or accidents that have exhibited signs or symptoms prior to policy inception. This exclusion can be reviewed under section 7, part b.1: b. CONDITIONS NOT COVERED (1) Illnesses for which any evidence and/or symptoms of their potential manifestation already exist at, or prior to, the policy enrollment date; As the medical records for "***** ******* reflects that on August 7th, 2012 (pet's enrollment date was January 8th, 2013) he is noted to have "aggressive tendencies" and that the policy holder has a six week training class due to a concern about "aggressive behavior", the claim was consider pre-existing and therefore denied. However, on April 9th, 2014, Trupanion reached out to Ms. ******* and advised her that in the event a policy holder disagrees with the outcome of a claim, they are welcome to appeal the outcome. An appeal letter was received by Trupanion on April 9th, 2014 and is currently is process of review. At this time, we do not have the outcome as it is still under review. Our goal at Trupanion is to offer the very best coverage industry wide. We remain dedicated to the very best care for pets and customer service for our policy holders. Ms. ******* reached out to Trupanion regarding the initial denial on March 24th, 2014. A called was then placed back to her by a manager on March 27th, 2014 and a message was left at the residence. Ms. ******* called back into Trupanion on April 4th, 2014, where she was connected with a manger and advised to appeal. Trupanion apologizes for any missed opportunities to discuss her concerns and are pleased that we have been able to make a connection. Trupanion will notify Ms. ******* of the outcome of her appeal as soon as it is complete. At this time, Trupanion considers this case closed. Sincerely, ****** ****** Research and Resolution Manager P:XXX-XXX-XXXX Ext***** *************@trupanion.com Initial Consumer Rebuttal /* (3000, 9, 2014/05/03) */ (The consumer indicated he/she DID NOT accept the response from the business.) We enrolled ***** on 1/8/2013 when he was 7 months old. We told them that he was in puppy classes from 10 weeks of age, They have tape recordings of my conversations with their agent. The agent sold us a policy with an additional Rider A that covers many extra treatments including being seen by Behaviorist. They are saying that at 8 weeks old when we adopted him that he is considered to be aggressive because we enrolled him in puppy training classes. We were being responsible owners giving him proper socialization and training. Rescue said he is a cross between a hunting dog and a herding dog, so understanding the "drive" of these breeds we did not want aggression problems and have kept him in training classes up to present day. We discussed with our veterinarian how the trainer worked with him concerning his puppy issues which he outgrew. The trainer wrote a letter to Trupanion stating that all his issues were typical of a puppy, addressed, and resolved. On Sept.11, 2013 he past his K9 Good Citizenship test. Now we are being told that his ears may not be covered if we submit a claim. This is due to when we adopted him he had very dirty ears. The vet treated the ears to make sure he would not have any issues. He also cut his ear when he was a few months old and they treated whet appeared to be an infection. So, we are paying $53.22 a month for the better policy that they told us would cover all the above and now they say they won't cover him. Final Business Response /* (4000, 22, 2014/06/11) */ Date 06/11/2014 BBB Case #XXXXXXXX Policy #TUXXXXXXXXXX Owner: ***** ******* regarding pet, "***** ******* We are hoping to address all of Mrs. *******'s remaining questions in this response. We are sorry that she does not feel satisfied with our explanation of our coverage and how it applied to "***** *****" claim #XXXXXX. We hope that this explanation will help Mrs. ******* better understand. Upon enrollment with Trupanion, the policy exclusions were explained to Mrs. *******, including the pre-existing exclusion that reports how we are not able to offer coverage to any condition that shows signs or symptoms prior to enrollment or within the initial waiting periods (five days for accidents and thirty days for illness, respectively). After the enrollment call, Mrs. ******* was emailed our policy document (standard for all enrolled pets) that outlines the coverage she can expect from Trupanion. As her pet's aggressive tendencies were not disclosed to Trupanion, there was no way, at the time of enrollment, to go over the coverage for this condition. Trupanion is unable to extend further coverage for his behavioral condition as it showed signs and symptoms prior to policy inception. Mrs. ******* is able to remove the additional rider that offers behavioral coverage at any time - however she should know that this rider has many other benefits that could be useful should "***** *****" ever come down with an eligible illness or accident. I am happy to go over the coverage of this package with Mrs. ******* if she wishes to learn more. On 05/2/14, Mrs. ******* spoke to a representative at Trupanion who was able to start a Paw Print for her. A Paw Print is a "snap shot" of the medical records and will outline what types of conditions will be pre-existing and other signs or symptoms that need further assessment should they ever show up again in the pet's health. This Paw Print was completed on 05/02/14 and a copy was emailed to Mrs. *******. We are happy to review our coverage with Mrs. ******* again if she has outstanding questions. We review all claims based on the individual pet's medical record and our policy document. We are obligated to reviewing claims in a fair and just manner to all those enrolled with Trupanion. Unfortunately, I cannot offer a number of behaviorist claims that have been submitted and paid as each claim is unique to the medical history of the insured pet. Trupanion wishes "***** *****" the best health in the future and are happy to be a part of his health care. At this time, Trupanion considers this case closed. Sincerely, ************* - Trupanion Research and Resolution Lead XXX-XXX-XXXX EXT **** Final Consumer Response /* (4200, 20, 2014/05/30) */ Please do not close this case. I find Trupanion's response to be very unsatisfactory. They sold me a policy along with an additional more costly premium that covered treatments for conditions such as behavioral problems. I have no way to hear the numerous phone conversations that took place between us at the time of taking out the policy, but I am sure if you were able to listen to them it would clearly show that I was lead to believe the policy they were charging me extra for would pay for these charges. Now after my last conversation with them it is clear they may try to get out of other future bills. I cannot get them to tell us what they will exclude based on his health records in the future. Maybe the BBB can get them to commit to what they will exclude, and why. Also, maybe the BBB could find out how many bills to cover a behaviorist have been submitted by other customers, and how many have been declined. Thank you.

6/2/2014 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: Our Claim # XXXXXX v. *** Our dog has a partial cruciate ligament tear on his right leg and Trupanion states that since he had a pulled sore muscle on his left leg, almost a year prior, its related to him slipping in the snow and tearing his ligament in his knee on his right leg. Every dog owner in America has had a dog that at one point gets a sore muscle from running around. A sore muscle is completely different than a partially torn ligament. The torn ligament wasn't from running as it was from slipping on the snow that we had in March. He was 100% healthy all winter until he slipped on the snow. I also want it on the record that we weren't going to the vet each time because he had a sore muscle. We were going to the vet for routine checkups and just happened to mention that he had a sore muscle that went away in 3-4 days. Every dog I've ever owned would have a sore muscle from time to time. The same thing happens to humans. Our vet reviewed the rejection notice and feels that Trupanion misconstrued their notes and doesn't agree with Trupanion's assessment. Trupanion are insurance professionals, they are not in the industry of treating animals, so I have a hard time understanding their judgment. Are they certified to know the difference between a sore muscle on one leg and a ligament tear in the opposite knee? Three different vets who have seen this claim disagree with Trupanion's assessment that should tell you something. If you really look into the details, of all visits, you will see that its clear there was no issue with his knees. Like I said above a partial tear on the knee is completely different then a hip issue or a sore muscle from running. I play hockey and my muscles and hip flexor are sore all the time after a big game. If it was a tear I wouldn't be able to skate. Same thing here, if my dog had torn his cruciate back in 2012 I can promise you both his knees would be replaced. Once a ligament is torn, the dog doesn't put weight on the leg at all. All these cases above he was still putting weight on his left leg and had no trouble with stairs. To be honest after reading these notes you would think he had a hip issue, which is NOT the case. IF you talk to any physical therapist in the pet industry they will tell you hundreds of dogs sprain their hip flexors from running. A hip flexor has nothing to do with slipping on snow and tearing a cruciate in the knee. Also, if there was an ongoing hip problem, which there ISN'T, he would be slow getting up, climbing stairs and he would hop. Our dog does NONE of that.

Desired Settlement: For Trupanion to cover 90% of the estimated total of $4374.05.

Business Response: Initial Business Response /* (1000, 5, 2014/05/15) */ BBB Case ********* (TUXXXXXXXXXX) Upon receiving this complaint from the Better Business Bureau, a review of the policy was done to determine if a resolution to the policy holders concerns could be reached and to gain clarity of the nature of the complaint. In the complaint Mr. ******** stated that he and his vet did not agree with the denied claim for Rear Hind end lameness. While processing the claim Trupanion found the in the medical records clinical signs or symptoms that were pre-policy appear. As per the Trupanion policy section (5.C.1.) the condition was denied on the basis of being a pre-exiting condition. PRE-EXISTING EXCLUSIONS: (A) Illness resulting from any condition for which evidence and/or symptoms of their potential manifestations already exists at, or during the 18 months prior to, the policy enrollment date. Illnesses that occur during the 30 day waiting period and accidents that occur during the 5 day waiting period will be considered pre-existing conditions. Trupanion offers a comprehensive appeal process where Mr. ******** and his vet requested an appeal of the denied claim. With more information provided to us, Trupanion was able to overturn the condition. Mr. ******** and his veterinary were notified on 5/12/2014. CLAIM PROCESS: (C) In the event of a disagreement between you and us concerning the coverage of a claim, you may request a review of Trupanion denial pursuant to our voluntary denied claims review process. If Trupanion affirms denial of your claim, you may further request that your claim be reviewed by an independent third-party veterinarian "ITPV" to adjudicate whether the medical reasoning for denial is justified. The ITPV's decision shall be final and binding on Trupanion. The team here at Trupanion absolutely understands how heartbreaking it can be for our policy holders when their pets are sick, injured or pass away. We too are pet owners and lovers and share these kinds of struggles. So the team here at Trupanion is always excited when an appeal is overturned and a claim is paid out. It was truly a pleasure to work with the ******** family through this process. The team here at Trupanion is excited to continue to assist with ********* heath care in the future. Sincerely, ******** ******** Customer Experience Lead P: XXX-XXX-XXXX:Opt # **********

6/2/2014 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: My puppy was seen by a vet about 3 times when we 1st bought him. He had an ear, eye and respiratory infection that was found in those visits. After me,ds, all infections cleared up. He is a Shar Pei and he is most likely to have many hereditary problems. After my 30 day waiting pd. he was seen by an eye dr. because he wasn't able to see and was bumping into tables etc. The claim I submitted for the eye exam was denied saying if was pre-existing due to him seeing the dr. during my 30 day waiting pd. The vet agreed, that the condition they treated him for was not related to the eye condition. Later he had nose surgery that was also denied stating that it was pre-existing due to the vet seeing him during waiting pd. and saw that his nasel passages were very narrow. This is all hereditary due to the type of dog he is. I called this co. prior to enrolling my puppy to make sure he would be covered and the person over the phone said because he is a Shar Pei, it should be considered hereditary. The vet has stated to them it's not linked and that he was born with conditions but yet we wait for the appeal process and they continue to take monthly payments out of my account when I specifically told them I was upset with this and wanted to cancel my policy if they weren't going to cover my puppy. The policy stresses on hereditary conditions and how this co. pays those claims. This poor puppy was born with extra skin over his eyes that needed to be removed so he could see and he needed his nasal passages *** away so he could breathe. That's a hereditary condition plan and simple. I have been contacting this co. Since March and still have not one paid claim.

Desired Settlement: I either want my claims paid due to hereditary condition. If they won't pay and since I have been at this since the beginning of the policy, would like all my money back that I paid. A payment is due again and still no resolution, I can't afford to pay the vet bills plus their premiums if they won't pay. It was my understanding after reading the policy and talking to a rep. from this co. that my poor puppy would be covered. I really feel this is a scam and they put my claims on hold so they can continue to collect money.

Business Response: Initial Business Response /* (1000, 6, 2014/05/29) */ BBB Complaint #XXXXXXX Owner: ******** *********** & dog ****** Policy #TUXXXXXXXXXX Upon receiving the complaint to the Better Business Bureau, a review has been done to determine if a resolution to the concerns could be met. In the BBB complaint, Ms. *********** had concerns regarding the denial of a recent claim submitted for her pet, *********** The claims in question were for ******** ***** and ********* ********* condition. The claim was deemed ineligible in accordance with our policy document which outlines that we are unable to extend coverage to illnesses or accidents that have exhibited signs or symptoms prior to policy inception. PRE-EXISTING EXCLUSIONS: (A) Illness resulting from any condition for which evidence and/or symptoms of their potential manifestations already exists at, or during the 18 months prior to, the policy enrollment date. Illnesses that occur during the 30 day waiting period and accidents that occur during the 5 day waiting period will be considered pre-existing conditions. Ms. *********** was in constant communication with a supervisor from Trupanion, Malari Fraser. While trying to assist Ms. ***********, Malari advised that Trupanion does have a comprehensive appeals process. Upon receipt of a letter from ******'s Veterinary, the appeal was opened for the denied claims. CLAIM PROCESS: (C) In the event of a disagreement between you and us concerning the coverage of a claim, you may request a review of Trupanion denial pursuant to our voluntary denied claims review process. If Trupanion affirms denial of your claim, you may further request that your claim be reviewed by an independent third-party veterinarian "ITPV" to adjudicate whether the medical reasoning for denial is justified. The ITPV's decision shall be final and binding on Trupanion. Sadly upon second review the claims for ****** remained denied. Ms. *********** was issued a refund of three months and her policy was closed upon her request. Our goal at Trupanion is to offer the very best coverage industry wide. We remain dedicated to the very best care for pets and customer service for our policy holders. At this time, Trupanion considers this case closed. However I will remain a point of contact should Ms. *********** have any further questions or concerns. We wish Ms. *********** and ****** all the best and thank them for allowing us to assist with his medical insurance needs. ******** ******** Research and Resolution t: XXX-XXX-XXXX; ext. **** e:*****************@trupanion.com Initial Consumer Rebuttal /* (3000, 8, 2014/06/02) */ (The consumer indicated he/she DID NOT accept the response from the business.) I had to fight to get the premium's back and followed all the policy procedures but this co. does not care about animals and only the money. My puppy was born with hereditary conditions but occurred infections due to negligent care prior to me owning him. Trupanion, linked the smallest sickness to a surgery and did not cover it. I did a lot of investigating before signing up and also spoke with an employee that said he would be covered for surgeries needed due to hereditary conditions. That was a lie. They tell you it's covered but it's very hard to get claims paid. Buyer beware! I feel putting money away in a account is much safer and if you don't make any claims then you still keep YOUR money. There is no safe pet insurance.

5/21/2014 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: I purchased pet insurance from Trumpanion for my dog in May of 2013. I was thoroughly informed that any preexisting conditions would not be covered. My dog developed additional eye problems unrelated to his documented seasonal allergies of years past. He was first diagnosed by his regular Vet ******** **********) with an ulcer in his left eye on 11/25/13. He continued to have difficulty and was seen by an ophthalmologist on 2/28/14 where he was officially diagnosed for the first time with KCS (dry eye) and an indolent ulcer. A procedure had to be done to address the eye ulcer and he will continue to need eye drops for the remainder of his life. Claims were submitted to Trupanion and immediately denied. They were appealed and Trupanion acknowledged only the KCS and not the ulcer. In the ophthalmologist's report it clearly stated that KCS and ulcers go hand in hand and ulcers can reoccur with this condition. I still disagreed with half coverage for they eye diagnosis and it was then passed on to a third party for review. As of 4/14/14 all coverage was denied for any eye issue. I believe Trupanion is not acknowledging this new diagnosis and treatment needed (eye drops as well as a procedure performed) and denying me reimbursement for all medical attention needed. They continue to claim that it is a pre-existing condition. They have been provided with all medical records which clearly indicate that my dog has NEVER been diagnosed with KCS or an ulcer prior to the policy purchased in May of 2013. They refuse to provide coverage that they are liable for in this case. They were provided with 3 letters from vets along with a report from the ophthalmologist. They continue to disregard the professional opinions of vets and specialist that KCS/ulcer are unrelated to allergies.

Desired Settlement: To provide reimbursement of all medical needs after my $1000 dollar deductible is met. To acknowledge the diagnosis of KCS and indolent ulcer as a new eye issue after purchase of policy unrelated to seasonal allergies.

Business Response: Initial Business Response /* (1000, 5, 2014/04/27) */ BBB Case #XXXXXXXX Upon receiving Ms.****'s Better Business Bureau complaint, a review of the policy was done to determine if a resolution could be reached and to gain clarity of the nature of the complaint. Under policy review, all claims submitted for Ms. ****'s dog ******* have been deemed ineligible due to pre-existing conditions as outlined under section 1. (Pre-Existing Exclusions) PRE-EXISTING EXCLUSIONS: (1)Illness resulting from any condition for which evidence and/or symptoms of their potential manifestations already exists at, or during the 18 months prior to, the policy enrollment date. Illnesses that occur during the 30 day waiting period and accidents that occur during the 5 day waiting period will be considered pre-existing conditions. Trupanion offers a comprehensive appeal process and upon Ms. ****'s request, the claim was sent for a third and final review by Dr. ****** who is a board certified Ophthalmologist. Unfortunately, Dr. ****** also found the eye condition had signs documented prior to enrollment. As this was the final review, the claim conclusion stands as denied and there can be no coverage for this claim. Independent Third Party Review is outlined under section 4. (J. General Conditions) GENERAL CONDITIONS: 4. (J) In the event of any disagreement between you and us with regards to a claim, the matter will be review internally. If the matter is still not resolved, we shall appoint an independent third party veterinarian who consults as a member of our expert veterinary panel. This decision shall be final and binding on all parties. The team here at Trupanion absolutely understands how frustrating it can be to have a denied claim. We too are pet owners and lovers and understand how our policy holders feel when their pets are sick or injured. As such, throughout the appeal process Ms. **** and her vet were kept in close contact throughout the appeals process. Upon receiving this BBB complaint I have left another voice message for Ms. **** explaining that I remain a point of contact and am happy to assist in any way I can. As this claim has gone through the final appeal stage and was found to be not eligible, Trupanion considers this case as closed. Sincerely, ******** ******** Customer Experience Lead P: ************* Opt # ** ******** ******************* Seattle, WA XXXXX http://trupanion.com Initial Consumer Rebuttal /* (3000, 7, 2014/04/28) */ (The consumer indicated he/she DID NOT accept the response from the business.) I am highly disappointed with Trupanion's decision to not provide coverage for my pet. While this insurance was purchased when he was of 7 1/2 years of age and not a puppy, he has never been formally diagnosed with KCS or an ulcer, only allergies. Simply stated, the diagnosis of KCS and the ulcer is NOT a pre-existing condition as there is no documentation stating so. As for Trupanion's claim that there is evidence of this diagnosis in his records, I submitted three veterinarian letters (ones he has seen over the course of 7 1/2 yrs) signed stating the condition/s were unrelated to allergies. There was also the report of the ophthalmologist. I feel like my pet has been discriminated against the fact that this policy was purchased in his later years. Basically, any conditions could be considered pre-existing if you skew the information. I find it very difficult to accept that multiple underwriters and an ophthalmologist (3rd party) who has never laid "eyes" on my pet deem this a pre-existing condition when those who have seen my pet over his years have indicated this is a new condition. I will certainly voice my opinion and experience with Trupanion to other pet owners and through other social forums. In my "eyes," Trupanion should have done the right thing and covered my pet with this particular situation. There is no way that I can live up to their logo on the pamphlet of "Be a Tru Hero" with "Trupanion gives you the power to protect your pet with NO LIMITS." My pet is not covered for this condition should there be future problems and clearly that limits me as his owner. Final Business Response /* (4000, 9, 2014/05/08) */ Our goal at Trupanion is to offer the very best coverage industry wide. We remain dedicated to the very best care for pets and customer service for our policy holders. While Ms. **** continues to remain unhappy with the results of the appeal, Trupanion is confident that the ruling is in accordance with the policy terms and conditions and is fair. As always Trupanion welcomes any opportunity to assist our policy holders. We too are pet parents and have claims ourselves that are not eligible for coverage on occasion. We can understand how frustrating it can be to have a sick pet. I will remain a point of contact for the Ms. **** and welcome any questions she may have. Lastly we wish ******* a speedy recovery! Sincerely, ******** ******** Research and Resolutions P: ************* Opt # ** ******** ***************************, WA XXXXX http://trupanion.com

4/7/2014 Billing/Collection Issues | Read Complaint Details
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Complaint: I signed up for trupanion on 5/2012. I didn't have a claim for my pet ***** until 12/2013. once the vet submitted the claim I was constantly harassed for her previous vet's names. I did not have their names as I divorced my husband and no longer had access to a rolodex. I paid $70 per month for almost 2 full years and when I had a claim for $350 dollars all they did was ask for previous vet information. I could only provide them with the name of 1 vet so they want to close my case stating that I need to provide them with *****s previous health records for 2 yrs before I signed her up for pet insurance. Why didn't they ask for this information when they accepted my application. This company is the biggest scam. Don't buy into it. They won't want to pay a claim when you finally have one. I've paid over $1,400 in premiums but cannot get them to pay on a claim for $350. They say they need her heart worm medication paperwork. She is not being treated for heartworm so what does that have to do with my claim? Do NOT sign up for Trupanions Pet Insurance. It is the biggest ripoff and the employees do not care at all about you or your puppy. Stay away!!

Desired Settlement: At this point I would like all the premiums that I paid refunded as they entered into this contract in bad faith. What health insurance compay signs you up for coverage and once you have a claim expects you to prove you were healthy 2 years before you signed up after you signed up. Do it BEFORE someone signs up for your pet insurance. It's unfair to ask for it after you've alreay

Business Response: Initial Business Response /* (1000, 5, 2014/03/24) */ BBB Case #XXXXXXXX Policy #TUXXXXXXXXXX Owner: ****** ****** with dog Lacey Upon receiving the complaint to the Better Business Bureau, a review has been done to determine if a resolution to the concerns could be met. In the BBB complaint the Ms. ****** states that she is being constantly harassed for her previous vets name and that she does not have access to the records needed to establish her pet's medical history. Ms. ****** expresses in her complaint that she would like to see Trupanion collect a pet's medical history before policy enrollment. Our goal at Trupanion is to offer the very best coverage industry wide. We remain dedicated to the very best care for pets and customer service for our policy holders. The highly skilled claims team works closely with owners when the first claim is submitted. Owners often need help gathering the required information on a pet's history and a pet's complete medical history is required from all vets they have seen. This includes current and previous veterinarians as well as specialty/emergency hospitals. This can take approximately 7-10 days depending on how long it takes for us to receive all necessary information from all hospitals involved. We are truly sorry if this process has proven difficult for Ms. ******* in any way or frustrating. Medical history collection for a pet is outlined in the policy as shown below: GENERAL CONDITIONS: 4. (A) You must provide to us, when requested, all medical history associated with your pet. You authorize us, at the time of enrollment, to contact any and all veterinary clinics or hospitals in your area to obtain all available medical records for your pet that exist prior to your enrollment. You authorize any and all veterinary clinics or hospitals to release to us all medical records for your pet that may exist when requested by us. Failure or refusal to disclose all medical history for your pet when requested may result in the denial of your claim(s) and the voiding of your policy. If your policy is voided, the policy premium paid will be refunded to you. Upon receipt of this BBB case I reached out to Ms. ****** by phone on 3/12/2014 and again on 3/20/2014. Voice messages were left with my contact information. An email was also sent on 3/20/2014. As of today's date I have not made contact with Ms. ******, however I have advised her in my messages that I am searching for the missing medical history. Trupanion would like to attempt once more to find this information before the claim is closed. Trupanion will continue to communicate and seek resolutions to this complaint. Our goal is to offer Ms. ****** as smooth claims process as possible and to assure her full satisfaction. As more information becomes available this BBB case will be updated. As always Trupanion welcomes any opportunity to assist our policy holders. I will remain a point of contact for the Ms. ****** and welcome any questions. Sincerely, ******** ******** Research and Resolutions P: ************* Opt # ** ******** ******************: Seattle, WA XXXXX http://trupanion.com

3/19/2014 Billing/Collection Issues | Read Complaint Details
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Complaint: On I received my credit card statement and it listed a charge for $226.51 by True Companion pet insurance. I cancelled the policy in July of 2013 but they still collected the payments monthly for a total of $1359.06 from my credit card account. I called and talked to ****** ***** and asked why I was still being bill and I was told calling was not enough and I should have sent a letter to cancel the policy. She said they had a recording of the conversation that I agree to do so. She told me I was not authorize to hear it and I would have to take their word for it.I asked to speak to a supervisor and I would be called that day. No call. I sent to e-mails and no answer. I haven't had any replies to my inquires. Product_Or_Service: pet insurance

Desired Settlement: DesiredSettlementID: Refund I would like a full refund of the monies they charge me on my credit card to the amount of $1359.06 plus a reasonable interest payment.I can not believe I would have so much of a problem canceling a policy and not be able to hear a recording of a phone call they are using as a reason not to refund money I was charged after I cancelled the policy I will not ever let..anyone have a have access to my card again..

Business Response: Initial Business Response /* (1000, 5, 2014/02/28) */ BBB Case ********* (TUXXXXXXXXXX) Upon receiving this complaint from the Better Business Bureau, a review of the policy was done to determine if a resolution to the policy holders concerns could be reached and to gain clarity of the nature of the complaint. In the complaint, *** **** states that he had attempted to cancel his policy for his three pets with Trupanion in July of 2013. The cancellation process is outlined in Trupanion's policy, "General Conditions" section (5.b) General Conditions: b. You may cancel your policy by notifying us in writing via mail, fax or email. Unfortunately Trupanion is not able to cancel insurance policies without written consent and until receipt of this BBB report, Trupanion had not received a written request for policy termination. During the phone calls to Trupanion on July 3, 2013 and then again on February 10, 2014, *** **** was advised to submit his cancellation request by email or by letter through the post. He was advised that Trupanion cannot finalize the cancellation request verbally. *** **** also requested to be contacted by a manager during his call on February 10, 2014. It is a goal of Trupanion to always respond to contact requests within 24 hours; however it does appear that his request was not responded to when it was requested through our contact center. This is not a common occurrence and we apologize for not following up with *** ****. Trupanion reached out to *** **** on February 25, 2014 and left a voicemail at the number we have on file. As of February 19, 2014, upon receipt of the written BBB report and in accordance to our policy, Trupanion has cancelled *** ****'s three-pet policy. At this time, Trupanion considers this case closed. Sincerely, ****** ****** Research and Resolution Manager P: XXX-XXX-XXXX EXT **** *************@trupanion.com Final Consumer Response /* (2000, 11, 2014/03/18) */ (The consumer indicated he/she ACCEPTED the response from the business.) Something is better than 0 Final Business Response /* (4000, 9, 2014/03/17) */ BBB Complaint Case #XXXXXXXX ********. **** Policy # TUXXXXXXXXXX Final Rebuttal - 3/16/14 Upon receipt of initial BBB concern, Trupanion has reached out to the client on 02/25/14 and left a voicemail with return contact information. As of 03/16/14, Trupanion has not heard back from the client to resolve the issue. The case has been reviewed by management and as goodwill, would like to refund back 2 months premium payment to policy holder. The refund amount will be the premiums paid for the months of November and December 2013, totaling $453.02. Trupanion does record all phone conversations but we do not share them with the public, nor can we use them in place of a legal, written cancellation notice. Trupanion considers this case closed.

3/17/2014 Problems with Product/Service | Read Complaint Details
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Complaint: I enrolled my Lab in 3/2011$41.76 One yr later I received an email stating my policy was increasing to $109.30 thats a 162% rate hike!!! I called and complained they said costs of vet care have increased and they havent raised their rates in 4 yrs thus the substantial rate hike. Well, The Bureau of Labor Statistics only showed an inflation of California vet care costs to be 2.4% increase from 2011-2012 so why the 162% rate increase? Trupanion could not justify their rates and they just sent me another email stating my policy rates are going up another 20%!! Unbelievable!!! It's the bait and switch. When I signed up trupanion said the age and # of claims doesnt effect your rate but it most certainly does!!!!! I'd like trupanion to disclose where they get their information regarding vet costs for labradors.

Desired Settlement: I would like trupanion to disclose where they get their information on rising costs in vet care, because the CA dept of insurance only shows less than a 4% increase in vet costs. Since trupanion has already raised my rates over 100% I would expect my rates to maintain the same for the life of my dog.

Business Response: Initial Business Response /* (1000, 5, 2014/03/01) */ BBB Case #XXXXXXXX *** ***** & ***** ********* Upon receiving the complaint to the Better Business Bureau, a review has been done to determine if a resolution to the concerns could be met. In the BBB complaint the *********'s claim that they had a 162% rate increases. They would also like Trupanion to disclose where the actuarial data used to create rates is collected from. Prior to the receipt of this BBB complaint, the management team at Trupanion had already been made aware of the *********'s concerns and had initiated contact. To date Trupanion's C.E.O Mr. ****** ******** has had two phone conversations with Mrs. ********* and further communication is scheduled in the immediate future.Trupanion will continue to communicate and seek resolutions to this complaint. As more information becomes available this BBB case will be updated. Our goal at Trupanion is to offer the very best coverage industry wide.We remain dedicated to the very best care for pets and customer service for our policy holders.Trupanion works diligently to keep premiums as up-to-date as possible so that policyholders only experience slight fluctuations in premiums over the lifetime of their policy rather than any significant changes. Simply put, the value of any insurance policy is the percentage of premiums that are paid back in claims. This amount has increased every year for Trupanion - which highlights the exceptional value of our insurance coverage. Currently we pay out more of our premiums relative to claims cost than any other pet insurance company. It's important to also note that Trupanion is approved in each state or providence it provides coverage in and all governing bodies' rules and regulations are adhered to. Trupanion is approved to pay out more than 70 cents on the dollar while industry wide this percentage is only 50%. As a pet owner you don't know when your pet will get sick. Trupanion is dedicated to offering 90% coverage with no limits regardless of how much has been collected in premiums. As always Trupanion welcomes any opportunity to assist our policy holders. I will remain a point of contact for the Schofields and welcome any questions. Sincerely, ******** ******** Research and Resolutions P: **************** # ********** *** ** ******* *** : Seattle, WA 98107 http://trupanion.com

2/14/2014 Billing/Collection Issues | Read Complaint Details
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Complaint: WHEN I FIRST SIGNED UP FOR INSURANCE WITH THIS COMPANY, I SIGNED UP MY CAT FOR $19/MONTH. NOT I JUST GOT AN EMAIL FOR THE 3 YEAR IN A ROW THAT MY PREMIUM WILL BE RAISED AGAIN. IT IS NOW AT $36/MONTH!!!!!!! THEY STATE THEY ONLY RAISE THE PREMIUMS DUE TO INFLATION. THIS IS JUST NOT TRUE. THEY HAVE BEEN GIVING ME YEARLY RAISES. THEY KEEP GOING UP ON THEIR PRICES EVERY YEAR, TO THE POINT WHERE I CANNOT ALMOST NO LONGER AFFORD THIS. I COMPLAINED LAST YEAR, AND WAS TOLD IT WOULD STOP SOON BECAUSE "INFLATION" WILL CATCH UP.I NOW NOW HAVE TO CANCEL ONE OF MY CATS BECAUSE I CANT AFFORD $80/MONTH WHEN 3 YEARS AGO IT WAS $39. THIS IS NOT RIGHT, AND HOW IS THIS LEGAL. THEY SHOULD NOT BE GETTING AWAY WITH THIS EVERY SINGLE YEAR. I HAVE A SICK CAT AND CANNOT CANCEL HIM, HE NEEDS MEDS BUT THIS IS BECOMING OVER THE TOP! IF IT KEEPS GOING UP LIKE THE COMPANY IS CHARGING IT'S CUSTOMERS, THE ORGINAL $20/MONTH I ORIGINALLY AGREED TO WILL GO UP TO $120/MONTH IN THREE YEARS!!!! THIS IS NOT RIGHT!!!!!!!!!!

Desired Settlement: I WANT THEM TO STOP LYING TO CUSTOMERS. WHY DON'T THEY JUST SAY WHEN THE CUSTOMER SIGNS UP THAT THEY WILL RECEIVE YEARLY INCREASES; MY PREMIUM DOUBLED IN 3 YEARS. THIS SHOULD BE ILLEGAL. THEY ARE LYING ABOUT INFLATION, FLAT OUT LYING. I HAVE A SICK CAT NOW AND CANNNOT GET INSURANCE THROUGH ANOTHER COMPANY AND I AM STUCK WITH THEM. IT'S GONE UP SO MUCH THEY ARE FORCING ME TO CANCEL INSURANCE ON MY SECOND CAT NOW...

Business Response: Initial Business Response /* (1000, 5, 2014/01/16) */ BBB Case #XXXXXXXX Policy #TUXXXXXXXXXX *** ******** ***** with ************* Upon receiving the complaint to the Better Business Bureau, a review of the complaint has been done to determine if a resolution to the concerns could be met. In the BBB complaint *** ***** states that her premium has been raised 3 years in a row. That Trupanion should tell policy holders at enrollment that their rates will increase yearly. However the exact info about rates is clearly stated in the policy: As per the policy 1). INSURING AGREEMENT * CHANGES TO YOUR PREMIUM: Your premium will not change due to your pet aging or your pet's individual claims experience. However, your monthly premium may change (up or down) during the life of the policy as a result of changes in the overall cost of veterinary care for your enrollment factors. Such changes will never occur more than once per year and will not exceed 20%. If your premium changes, we will notify you in writing, by regular mail or by email (to the last addresses made known to us), at least 30 days before your changes is to take effect. Here at Trupanion we understand that rate changes are never fun. However we do not raise our rates arbitrarily. Because we cover 90% of the actual bill with no limits, we must adjust our rates to keep in line with the amount of animal health care being delivered. Premiums are based on the cost of the average pet of your situation (breed, age at enrollment, deductible chosen and geographical location). If your premium increases, that is a sign of more health care being delivered and more claims being paid out for the average pet of your situation. All rates are guaranteed for 12 months unless the policyholder makes elective changes to their policy, i.e. adds a rider or working pet status, or changes the deductible. In order to make sure all of this data is processed effectively, Trupanion has a dedicated staff of Actuaries who work diligently to calibrate rates to ensure they are not excessive, inadequate, or unfairly discriminatory for all policyholders. It had been brought to my attention on January 8th 2014 that *** ***** was upset with the rate increase information sent to her. I reached out and left a voice message on that date and also sent an email in an attempt to make contact. Another voice message was left again on January 15th 2014 as well. To this date there has not been a return call. I remain available to assist *** ***** in any way I can. My contact is shown below and I look forward to any further questions *** ***** might have. At this time Trupanion considers this case closed. Sincerely, ******** ******** Research and Resolutions P: **************** # ********** *** ** ******* *** : Seattle, WA 98107 http://trupanion.com   Final Consumer Response /* (3000, 7, 2014/01/17) */ (The consumer indicated he/she DID NOT accept the response from the business.) I understand that it increases due to inflation... That is all I ever hear; but whatever data you have I cannot see. And since it is approved I'm sure Trupanion works through some sort of loop holes to be able to get away with such high increases each year. However, when you state that it will occasionally increase due to vet medicine inflation; most people (like me) are not assuming it will go up 100% in 3 years. Also, Trupanion is trying to make the deductible go higher for the customers who have a low deductible. And there is just no point in paying a company $20 a month and then still paying $1000 for a vet bill before I can even use my insurance. That makes no sense, and most people do not have $1000 vet bill all that often, so that just wouldn't work out for me. If this is the situation that I was going to be left with when I signed up (An ultimatum almost: Less raise if you switch to a higher deductible; much higher raise for staying with a low deductible), then I never would have signed up both my cats and I would have put the $40 and the deductible money away in a separate account. If that is how Trupanion wants it to work, then there seems to be less of a point to pet insurance if you need such a high deductible for your rates not to increase over 20% each year. I know I am not the only customer unhappy about this. There is no solution that would make me happy unless the percentage stops increasing by so much each year just because I have a lower deductible. I expect I will be paying $70 around this time next year for both cats and that is not an acceptable increase from a consumers point of view. Again, based on the amount of people that are unhappy with this, it seems to be a problem with the company. Adjust your quotes that you give to new customers then!!!! Final Business Response /* (4000, 9, 2014/01/31) */ BBB Case ********* (Rebuttal) Policy #TUXXXXXXXXXX *** ******** ***** with ************* Upon receiving the rebuttal complaint to the Better Business Bureau, a review of the complaint has been done to determine if a resolution to the concerns could be met. In the BBB rebuttal complaint *** ***** states Trupanion works through loop holes to be able to get away with high increases each year. While we understand that a rate change can be frustrating, it is important to know that the Insurance Commission Boards approve all our rates changes. While our actuarial data is proprietary, you can rest assured that Trupanion works full compliance with all governing bodies. Our goal at Trupanion is to keep premiums as up-to-date as possible so that policyholders only experience slight fluctuations in premiums over the lifetime of their policy rather than any significant changes. Simply put, the value of any insurance policy is the percentage of premiums that are paid back in claims. This amount has increased every year for Trupanion - which highlights the exceptional value of our insurance coverage. Currently we pay out more of our premiums relative to claims cost than any other pet insurance company. The current average in the pet insurance industry is 52-55% ! We have had 7 rate increases over the last 10 years, and not one penny of those rate changes has been used to pay administration costs or overhead. In fact, all administrative costs and overhead have decreased as a percentage of your premium year over year, we're becoming more efficient and this helps us offer the lowest cost of premium based on our generous benefits of 90% with no limit Trupanion is dedicated to holding our target profit margins flat. This means that our earnings go into our product, not into our pockets! Lastly and most importantly, Trupanion is approved in each state and providence to pay out more than 70 cents on the dollar. For the average pet, if you put 70 cents on the dollar in a cookie jar, at the end of your pet's life, your cookie jar would be empty. Insurance offers financial security that a savings account can't match. As a pet owner you don't know when your pet will get sick. You may not have a full cookie jar to work with. We're here for 90% with no limit regardless of how much has been collected in premiums. I remain available to assist *** ***** in any way I can. My contact is shown below and I look forward to any further questions *** ***** might have. At this time Trupanion considers this case closed. Sincerely, ******** ******** Research and Resolutions P: **************** # ********** *** ** ******* *** : Seattle, WA 98107 http://trupanion.com  

1/16/2014 Advertising/Sales Issues | Read Complaint Details
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Complaint: In trying to set up a Pet insurance plain from Trupanion, I received an unsolicited email from them clearly stating "If you're still interested in enrolling Koko you can save $15 off the enrollment." That is an offer to save $15.00 and there is no exclusions stated. They denied the $15.00 savings. My problem is not really about the small amount of $15.00, but if the company is going to quibble over a stated $15.00 promotion that they sent to us, unsolicited, - I am VERY VERY skeptical if we were to have a major Vet bill come along that we would then have a MAJOR PROBLEM with the company handling its responsibility in settling it. It seems their use of the email to offer a savings is simply FALSE and misleading. After contacting them about the matter they admitted that they knew about it and yet they continue to send out the false promotions regardless - I received a second email today with the same offer. They boasted in there reply to me that - "We have been accredited with the BBB since 2008 currently with an A+ rating..." It would be very disheartening to find out that the BBB gives an A+ rating to a company that knowingly uses misleading promotional tactics.

Desired Settlement: Trupanion needs to stop the use of false and misleading promotion. Trupanion needs to have their rating with the BBB reduce to a more appropriate rating.

Business Response: Initial Business Response /* (1000, 7, 2013/12/20) */ BBB Case #XXXXXXXX Policy # TUXXXXXXXXXX ***** ******** & Koko Upon receiving the complaint to the Better Business Bureau, a review of the policy was done to determine if a resolution to the concerns could be reached and to gain clarity of the nature of the complaint. Upon review it appears that the complaint stems from an overlap of two promotions that were made available to the ************ Through our marketing tracking we can see that the person using the email address shown on the BBB complaint had found their way to Trupanion's web site and was offered a $15.00 off enrollment on 11/23/2013. This would allow an owner to save a bit of money and begin to enjoy insurance coverage for their pet. This is a standard enrollment process and it does require a waiting period of 30 days for illness and 5 days for illness. Further it appears that the *********** received a free 30-day trial for Koko upon a puppy exam with their vet on 11/23/2013. It is important to note that not all clinics offer these trials. Should a clinic run out or not participate, the trial may not be available to a new pet owner. Should an owner receive this trial they are to enroll with 24 hours of the exam and the above mentioned waiting periods are waived. ***** ******** did in fact enroll Koko in this trial to Trupanion's delight. With this trial there is no billing for the 1st 30-days and depending on what deductible the *********** would have chosen on a standard enrollment, they saved anywhere from $58.00 to $25.25. Trupanion feels this is a much better promotion and for those few owners who receive it, it can make an emergency room visit in those 30-days, a lifesaving event! While we can understand the *********** frustration, Trupanion stands behind both promotions. We have also made a commitment to be smart with our money while helping our policy holders keep their pets healthy and happy. This does require limitations to be put on the number of promotions that can be given to one pet at once. At this time KoKo is still on her 30-day free trial. As there has not yet been a claim submitted, we can assume she is a happy healthy puppy! We are so glad for that. However we would love the Thompson's to give us a call and convert her to a full policy. Trupanion would like to be a part of her life for a long time. A voice message was left for the *********** on 11/20/2013. As I mentioned in the voice message, I am happy to assist in any way I can. I would like to be a point of contact for the Thompson's and my contact info is below and left on the voice message. At this time Trupanion considers this case as closed. Sincerely, ******** ******** Customer Experience Lead P: XXX-XXX-XXXX:************** 907 NW Ballard Way: Seattle, WA XXXXX http://trupanion.com Final Consumer Response /* (4200, 13, 2014/01/13) */ (The consumer indicated he/she DID NOT accept the response from the business.) ******** ******** did contact me on the two occasions she mentioned. On 12/12/13 I was available to speak with her, she was very kind and professional to speak with. ******** acknowledged what the problem is, but had no resolution for the problem. Trupanion is STILL sending out unsolicited promotions and is STILL not honoring them if the customer is previously using the 30 day trial, as we did. She acknowledged that this is a problem for Trupanion and has no resolution for the problem. I feel strongly if a company is capable in setting up an unsolicited deceptive promotional program - they are also capable of correcting the program if they were required to. It is apparent that they do not care to make this correction. As a senior citizen I feel companies that pry upon the public, especially seniors on a fixed/limited income and use their loving pets to do so, should not be allowed to operate and promote their company the way that Trupanion finds it necessary to do. It is sad that "...Trupanion considers this case as closed." as it has not even tried to correct their acknowledged deceptive practices. This complaint is NOT about us getting anything from Trupanion, it is about Trupanion stepping up and operating in a way that is not deceptive. I do not consider this case closed until they have stopped the promotion(s) they use in this manner. I still find it very disheartening that the BBB gives an A+ rating to a company that knowingly uses misleading promotional tactics. Final Business Response /* (4000, 11, 2014/01/10) */ BBB Case #XXXXXXXX Policy #TUXXXXXXXXXX ***** ******** & Koko Upon receiving the complaint to the Better Business Bureau, a review of the complaint has been done to determine if a resolution to the concerns could be met. Trupanion understands that **** ******* & ***** ******** feel that by offering two different kinds of promotions and not honoring them both serves as deceptive practices. The team here at Trupanion takes every comment and concern given to us by policy holders seriously. We are always striving to help our customers in the best most efficient way possible. So we have taken another look into this case. While we stand behind the promotions offered and that on occasion a pet might be offered more than one for various reasons, we wish there had been better customer service offered at the time of the call. With a bit more research and reaching out to a manager, perhaps both promotions could have been honored. We have seized this as learning opportunity and hope to better address such issues in the future. On 1/10/2014 I spoke with *** **** ******* by phone and explained that I had reached out to him to try and assist back on 12/12/2013. I explained that we are happy to assist in anyway and thanked him for bringing his concerns to our attention. At this time Koko has an insurance policy with another company and Trupanion considers this case as closed. ******** ******** Research and Resolutions P: XXX-XXX-XXXX:Opt: ******** *** ** ******* **** Seattle, WA 98107 http://trupanion.com

11/12/2013 Problems with Product/Service | Read Complaint Details
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Complaint: The policy that I purchased had a hidden clause stating that Trupanion redefines the term preexisting condition to encompass issues that may happen in the future but currently show no signs of having a problem. I believe it to be unfair for an company to hide such an important part of a policy in pages and pages of terms and conditions. I was told on the phone by ****** ***** the Trupanion representative thats been dealing with me that if I had signed up over the phone opposed to utilizing their web site that the sales person would have told me about this clause in their policy.

Desired Settlement: I would like for Trupanion to honor my claim that I filed with them for my dogs surgery. My claim ID is XXXXX X, and the total amount due to me is 2,641.68.

Business Response: Initial Business Response /* (1000, 5, 2013/10/29) */ BBB Complaint Case #XXXXXXXX *** ****** Policy # TUXXXXXXXXXX Upon receiving *** ******'s complaint with the Better Business Bureau, a review of the policy was done to determine if a resolution to ***'s concerns could be resolved and to gain clarity of the nature of the complaint. Under policy review, one claim, claim #XXXXXX, dated 06/20/13, for his pet named Frank was determined to be ineligible. The claimed condition for an "Left Cranial Cruciate Ligament Rupture" had been denied as ineligible due to the Bilateral Exclusion under Trupanion's policy. The Bilateral Exclusion is outlined under section 7.b.2: B. Conditions Not Covered (2). The cost of bilateral conditions presenting on one side of the body, if that condition was a pre-existing condition on the other side of the body (such as luxating patella or anterior cruciate ligament(ACL)weakness); Trupanion reviewed the denial a second time to ensure it followed protocol of claims processing. Trupanion reached out to *** ****** by telephone on 10/29/13 and made contact with him. The denial reasoning was explained in detail as well as Trupanion's policy coverage. *** ****** accepted a goodwill premium refund for three months and decided to end his relationship with Trupanion. At this time, Trupanion considers this case closed.

10/21/2013 Guarantee/Warranty Issues | Read Complaint Details
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Complaint: Trupanion changed its policy on coverage continuously. I was told there was a waiting period, however in MD there is no waiting period for pet insurance. I had to always appeal every claim, and had to always get letters from vets etc I paid my paid my payment on time every month. And it seemed like the only time you got reimbursed was when you paid for zero deductible. I was never told that my 650 deductible was for every new injury or illness. I had to figure out the physical therapy was a separate add on. When I did add it on, it still covered nothing. Trupanion is a scam and I would like some of my monthly payments back. It was a joke and the customer service is. The worse.

Desired Settlement: Partial reimbursement or some coverage for my least the physical therapy. Since there is no waiting time in Md.

Business Response: Initial Business Response /* (1000, 5, 2013/10/16) */ BBB Case ******** (TCXXXXXXXXXX) Upon receiving this complaint from the Better Business Bureau, a review of the policy was done to determine if a resolution to the policy holders concerns could be reached and to gain clarity of the nature of the complaint. In the complaint ******* ****** stated that Trupanion's policy is always changing. It is true that the team at Trupanion is always looking for ways to improve and add even more coverage for our policy holders. On Zoe's anniversary date her policy did roll into our new policy with more coverage and options. A nothing is ever taken away in a policy, only enhanced and written notice of at least 30 days in advance is given. Also in the complaint there comments on waiting period, however Zoe had met her waiting periods back when she originally enrolled back in August of 2011. When looking over Zoe's claim history I see a total of 22 claims that were processed. 5 of these claims were deemed ineligible due to pre-existing conditions. 1 claim was in fact appealed and overturned. Under Trupanion policy, the pre-existing condition exclusion is outlined under section (5.C.1 PRE-EXISTING EXCLUSIONS: (A) Illness resulting from any condition for which evidence and/or symptoms of their potential manifestations already exists at, or during the 18 months prior to, the policy enrollment date. Illnesses that occur during the 30 day waiting period and accidents that occur during the 5 day waiting period will be considered pre-existing conditions. I see that for Zoe's policy there is a $650.00 deductible per condition. Trupanion is currently the only pet insurance provider in the United States and Canada that offers the pet owner to select any deductible from 0 dollars to 1,000 dollars. A higher deductible reflects a lower monthly premium, and vice versa. By paying slightly higher monthly premiums, pet owners are responsible for a much smaller overall portion of their vet bills. Although a higher deductible makes for a lower monthly payment it can take longer for a claim payout on new conditions. This choice is left to each pet owner to determine and it can be changed at any point. Upon enrollment or at any point an owner makes a change, a Declaration Page is sent to the email address on file. On this Declaration Page it is outlined that the chosen deductible is per condition. As well as outlined in the policy under section 9. F. DEFINITIONS: (F) Deductible-The monetary amount that you pay for each condition. Once the deductible amount has been met for specific conditions, the policy will then pay out all future losses subject to all other terms and conditions. The team here at Trupanion absolutely understands how frustrating it can be for our policy holders when their pets are sick or injured as we too are pet owners and lovers. We are truly sanded to hear a policy holder feels they were not treated well during their communication with Trupanion. I can assure you that we all want to make sure Zoe's health needs are met to the best of our abilities. I see the most recent contact was attempted 10/7/2013 to ******* ****** but the call was disconnected by *******. I have also left a message as of today 10/16/2013 by way of voice message. I would love to see Zoe keep her policy active and I await a return call where I can be of more assistance. At this time, Trupanion considers this to be case closed. Sincerely, ******** ******** Customer Experience Lead P: **************** # ********** *** ** ******* *** : Seattle, WA 98107 http://trupanion.com Final Consumer Response /* (4200, 11, 2013/10/21) */ (The consumer indicated he/she DID NOT accept the response from the business.) Trupanion continues to tell me about the claims that have been processed. Which some of them were the same claim, but it had to resubmit a few times. They never told me my deductible was per injury. And I was told of a waiting period. This is a company that I would never use again or refer anyone too Final Business Response /* (4000, 9, 2013/10/18) */ BBB Case ******** (TCXXXXXXXXXX) Rebuttal Upon receiving this complaint from the Better Business Bureau, a review of the policy was done to determine if a resolution to the policy holders concerns could be reached and to gain clarity of the nature of the complaint. As stated in the previous letter we have reached out to ******* ****** on 10/7/2013 & 10/16/2013 by phone with no success. I await a return call where I can be of more assistance. Trupanion truly values our policy holders and their pets. Often a one on one conversation can bring resolution. This case has been reviewed by management and we are all in agreement that the policy information was made available to the owner and that the denied claims' ruling was fair and according to policy. At this time, Trupanion considers this to be a closed case. Sincerely, ******** ******** Customer Experience Lead P: **************** # ********** *** ** ******* *** : Seattle, WA 98107 http://trupanion.com


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