Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:01/19/2023

  Type:Sales and Advertising Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I purchased pet insurance for a new puppy to the family January 2nd, 2022. On the Spot Pet insurance website it listed that my coverage date started January 2nd. On the night of January 14th, I had to go to the emergency hospital for a broken leg. I ended up spending more than half of a grand, with an assuring thought that I had made a wise decision to spend my money on this company. Until my claim was denied and the $670 had not gone to my annual deductible nor had any reimbursement. I was notified by a rep that this was considered a pre-existing condition because there is a 2 week processing period?? How was I supposed to know my dog were to get a broken leg within the first 2 weeks of buying pet insurance. I feel robbed and cheated as there was no acknowledgment of this policy. I want my annual deductible taken care of as well as the rest of the money reimbursed. My puppy has a long life to live and if I want to be spending money monthly for this insurance company, I want to know I am making the right decision on doing business with a MORAL and JUST company.

  

  Business Response

  Date: 02/03/2023

  We are in receipt of your January 22, 2023, inquiry relative to the above regarding her Accident Policy (PET-P-20000-0920) for her dog. Per the Better Business Bureau direction, we have removed any reference that will personally identify our customer. The pet ********************** policy is a personal lines property and casualty product filed under inland marine. 
  
  The customer expressed concern for coverage of pre-existing conditions.  
  
  The customer utilized our online enrollment center on January 1, 2023 to enroll her dog on a pet insurance policy with coverage for accidents and illnesses (PET-P-20000-0920) with an effective date of January 2, 2023.  The Accident and Illness Policy does not cover conditions that occur on or before the effective date of the policy or during an applicable waiting period.  Additionally, the customer elected the available paperless option to receive correspondence electronically.  Upon approval of the customers online application, a subsequent email was sent welcoming the customer to the ************* where she can access and review her policy documentation as well as informing her that her dogs complete coverage begins January 16, 2023.
  
  The customer submitted a claim for veterinary expenses related to the treatment of her dogs fractured leg on January 14, 2023.  Pursuant to the terms of the policy, the veterinary expenses were excluded as treatment for a pre-existing condition which first occurred within the 14-day waiting period.  Please see below for applicable excerpts from the Accident and Illness Policy as it relates to pre-existing conditions.  
  
  DEFINITIONS  
  
  Condition - Illness, disease, injury or change to your pet's health that *** or *** not show symptoms or have been diagnosed (including but not limited to diagnosed or undiagnosed pre-existing, hereditary or congenital conditions, ligament and knee conditions).
  
  Occur or Occurrence  When signs or symptoms related to a condition first were observed by any individual or recorded in your pet's medical record, or would have been detectable by a routine physical veterinary exam.
  
  Pre-Existing Condition Illness, disease, injury, or change to your pet's health that first occurs or shows symptoms before coverage is effective or during a waiting period. This includes conditions that are related to, secondary, or resultant from a pre-existing condition.
  
  WAITING PERIODS
  
  There is a 14 day waiting period for: diagnosis, treatment or surgery related to accidents, illnesses and ligament and knee conditions. The waiting period begins on the first effective date of the applicable coverage. Any condition that occurs during an applicable waiting period is a pre-existing condition.
  
  WHAT IS NOT COVERED  
  
  Exclusions  
  
  We will not pay for costs associated with or resulting from the following:  
  
  r. Pre-existing conditions that occurred on or before the first effective date of the applicable coverage or during a waiting period.
  
  Based upon the available information we have on file, our review indicates the claim was processed in accordance with the terms, conditions and exclusions of the Accident and Illness Policy.  Further, the customer was made aware of the terms and conditions, including but not limited to the pre-existing exclusion, waiting periods, limits, co-insurance, and deductibles prior to enrolling. 
  We hope that the information provided in response to your inquiry is satisfactory. Thank you for the opportunity to respond to this matter.

• Initial Complaint

  Date:12/12/2022

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I was notified that my claim has recently been completed - Claim Number: *******. I see that the "Rectal insufflation DISCOUNTED Ozone therapy 6 sessions" was not reimbursed, as this was ultimately found to be an "experimental therapy" by the customer service agents I have since spoken with, although I was never notified of this when I had submitted my estimate for this treatment in advance. I explained to both customer service representatives that I had submitted an estimate (Claim #*******) ahead of time for the "Rectal insufflation DISCOUNTED Ozone therapy 6 sessions" (same treatment), to ensure that this would be approved prior to paying for this procedure and having it administered, as I don't have the funds to pay for this myself. I see that, via the Explanation of Benefits (***) for the estimate submitted (Claim #*******), Rectal insufflation DISCOUNTED Ozone therapy 6 sessions was FULLY APPROVED. There are no exclusions listed for Rectal insufflation DISCOUNTED Ozone therapy 6 sessions, nor is it listed as an experimental therapy anywhere on the *** within that estimate (Claim #*******). If this was determined to be an experimental therapy, then this should never have been approved on the prior estimate - (Claim #*******). This is a fault/error of ******** Insurance, not an error on my behalf. I am requesting full reimbursement for the Rectal insufflation DISCOUNTED Ozone therapy 6 sessions treatment at 90% reimbursement for the amount of $258.00 on the basis that this treatment was approved in advance via Claim #*******, and it is solely through the fault of ******** Insurance that I was not notified that this was an experimental treatment. Please find attached the *** for Claim #******* showing that all "Professional Services" were fully approved in advance, (to include Rectal insufflation DISCOUNTED Ozone therapy 6 sessions). I fully determine this to be fraud of ******** Insurance.

  

  Business Response

  Date: 12/28/2022

  We are in receipt of your December 12, 2022, inquiry relative to the above regarding his Accident Policy (PET-P-20000-FL-0920) for his dog.  Per the Better Business Bureau direction, we have removed any reference that will personally identify our customer.  The pet ********************** policy is a personal lines property and casualty product filed under inland marine.    
  
  The complainant expresses concern regarding coverage for her dogs experimental therapy initially denied as experimental treatment not covered under the policy. Upon receipt of the BBB complaint we reviewed the customers account and determined an error occurred.  In light of the circumstances and in an effort to resolve the situation, we are reaching out to the customer directly to further discuss the matter.   We apologize for any inconvenience.
  
  We hope that the information provided in response to your inquiry is satisfactory.  Thank you for the opportunity to respond to this matter.

  Customer Answer

  Date: 01/05/2023

   
  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.
  A supervisor from Spot (*****) contacted me and agreed to reimburse me for the Ozone Therapy treatments that have already been paid for. I am waiting for this email to come through, as promised. I was informed I would receive an email with a form that I had to sign within 10 business days. I am still waiting for this email. 
  Sincerely,
  
  *********************************

• Initial Complaint

  Date:12/08/2022

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  This company, ******** Insurance, sent me an email saying my account was past due. When attempting to contact the company to pay my bill, there is a constantly busy phone, (3 days trying), and no response to my emails. All attempts to contact them have failed. I feel that my past payments were a scam and I hope to get refunded since they don't offer any customer service or any service at all.

  

  Business Response

  Date: 12/21/2022

  We are in receipt of your December 8, 2022, inquiry relative to the above-mentioned policy holder regarding his Accident Policy (PET-P-20000-0920)) for his cat.  Per the Better Business Bureau direction, we have removed any reference that will personally identify our customer.  The pet ********************** policy is a personal lines property and casualty product filed under inland marine.   
  
  The complainant expresses concern regarding billing and the inability to reach our **************** Department.
  
  Upon receipt of the BBB complaint we reviewed the customers account including all interactions and confirmed that email communications regarding his policy were acknowledged and responded to promptly and professionally.  Further, we searched for any calls from his phone number on file, which matches the phone number in the customers BBB complaint and did not locate any phone call attempts to reach us.  Additionally, we did not have any reports of any issues with telephone lines.
  
  In his inquiry the customer requests a refund of premiums paid.  In light of the circumstances and in an effort to resolve the situation, we are reaching out to the customer directly to further discuss the matter.  
  
  We hope that the information provided in response to your inquiry is satisfactory.  Thank you for the opportunity to respond to this matter.

• Initial Complaint

  Date:12/06/2022

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I signed up for pet insurance several months ago. I have purebred dogs, and take care of them. I put in a claim for an illness nd am getting the runaround from SPOT. They are not paying my claim, thus causing me a hardship as I count on this money to replenish my pet account in case of future emergencies.

  

  Business Response

  Date: 12/20/2022

  We are in receipt of your December 6, 2022, inquiry relative to the above-mentioned policy holder regarding her Accident Policy (PET-P-20030-0920-**-(3)) for her dog.  Per the Better Business Bureau direction, we have removed any reference that will personally identify our customer.  The pet ********************** policy is a personal lines property and casualty product filed under inland marine.   
  The complainant refers to the processing of her recently submitted claim.
  The customer enrolled her dog on the Accident Policy  (PET-P-20030-0920-WA-(3)) with an effective date of February 12, 2022.  
  On November 29, 2022, we received a claim submission. To properly assess the claim, we required the dogs medical history for the past year. Upon identifying the veterinary facility the pet had been to, we sent multiple requests for the required information per the customers signed authorization on the submitted claim form. Please also refer to the following excerpt from the customers insurance policy regarding authorization to request medical records: 
  Other Claim Procedures 
  When You submit a claim, You authorize Us and Our Administrator to access all medical information that We need to assess Your Pet's health. For example, we may ask you for the name and contact information of any Veterinarian that has ever seen or treated Your Pet. 
  You must also provide proof of identity for Your Pet when We request. 
  If You choose, Your Veterinarian can submit a claim on Your behalf. If You so indicate on Your claim form, We can pay the Veterinarian directly. 
  Payment of one claim does not guarantee that We will pay additional claims. 
  Subsequent emails were sent to the customer advising of the required medical records needed to properly assess the claims. Upon receipt of the required information, the claim was processed in accordance with the terms and conditions of the Accident and Illness policy (PET-P-20030-0920-WA-(3)) and eligible reimbursement was issued to the customer via ACH deposit to the account on file.  The overall claim process took 15 days. 
  Per the customers request, coverage for her dog was cancelled effective December 6, 2022.
  
  We hope that the information provided in response to your inquiry is satisfactory.  Thank you for the opportunity to respond to this matter.

• Initial Complaint

  Date:11/19/2022

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I recently took my dog to the vet and submitted a claim to ******** insurance. There was a discrepancy with the outcome of the claim so I called the corporate number. I called 3 times and each time the customer service representatives told me they couldn't speak to me because my name did not match the account. My name, my phone number, my email, and my address all match the information on the account. I asked to speak to a manager and they refused to put one on. I refuse to call anymore but I need the issue resolved with my claim.

  

  Business Response

  Date: 12/13/2022

  We are in receipt of your December 4, 2022, inquiry relative to the above-mentioned policy holder regarding her Accident Policy (PET-P-20000-FL-0919) for her dog.  Per the Better Business Bureau direction, we have removed any reference that will personally identify our customer.  The pet ********************** policy is a personal lines property and casualty product filed under inland marine.   
  The complainant refers to a discrepancy with the outcome of a claim and unsuccessful communication with our **************** Department.
  The customer enrolled her dog on the Accident Policy (PET-P-20000-FL-0919) with an effective date of May 24, 2022. 
  On November 16, 2022, our **************** Department received a call wherein we were unable to confirm the individual we were speaking to was the listed policyholder on the account.  The caller was unwilling to provide her name and ended the call on her own accord.
  
  On November 30, 2022, we received a follow up call concerning a recent claim denial.  Upon successfully verifying she was the listed policyholder on the account, our **************** Supervisor provided a detailed explanation of a recent claim denial.  The customer submitted a claim received in our office on October 22, 2022 for services rendered on October 17, 2022 for treatment of a gastrointestinal/stomach condition.  The claim was determined ineligible for coverage due to an illness on an Accident Only policy.  Per obtained medical records, there is no indication that the blood in the dogs stool was caused by an accident, therefore it is considered an illness.  A subsequent email was provided to the customer informing her of our appeal process should she wish to provide additional information for review.
  
  We hope that the information provided in response to your inquiry is satisfactory.  Thank you for the opportunity to respond to this matter.