Complaints

This profile includes complaints for Embrace Pet Insurance's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  Embrace Pet Insurance

  PO Box 22188 Beachwood, OH 44122-0188

  
• 

  Embrace Pet Insurance

  4530 Richmond Rd Cleveland, OH 44128-5757

  

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:12/14/2022

  Type:Billing 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.

  All of 2022. I purchased in good faith a policy for my oet Norfolk Terrier *****. I recently sent in all vet bills from 2022 and they denied all but 1 which a small smount went towards my 300 deductible. It took them 2 weeks to review Puppy's prior vet visits and they found every excuse they could to NOT COVER ANYTHING on any claim. I calked them about this and a lady explained to me things about this insurance that I wasn't even aware of when I pirchased the policy. They willingly take your money and then tske forever to process snd deny claims. This is a bait and switch approach written in the fine print. BUYER BEWARE. Stay away from this lying company .

  

  Business Response

  Date: 12/15/2022

  Hello BBB,

  
  I would be happy to
  address this case.

  
  On
  1/13/22 ***** ***** purchased a policy for her nine-year-old Norfolk terrier,
  *****. At inception of the policy, *** **** received an email outlining the
  policy waiting periods, which also included the policy's terms and conditions.
  ******* policy included a two-day accident waiting period, a 14-day illness
  waiting period, and a six-month orthopedic waiting period. *** **** elected to
  complete the optional orthopedic waiver, which shortened the orthopedic waiting
  period from six months to the 14-day illness waiting period ending on 1/27/22.

  
  Prior
  to processing any claim under the illness policy, we must first obtain, then
  review the complete medical records from one year prior to the policy through
  the waiting periods to determine any pre-existing conditions, this procedure is
  referred to as a medical history review. A medical history review was offered
  via email to *** **** on 1/27/22, within this email it is addressed the policy
  does not provide coverage for pre-existing conditions and if one is not
  requested at that time, we will begin the review at the time of the first
  claims submission.
  
  *****'s
  first claim was received 11/21/22, the medical history review process typically
  takes 30 business days once all the required medical records are received.
  During the medical history review process, any abnormalities noted within the
  medical records prior to the policy or within the waiting periods are a
  pre-existing condition according to the terms and conditions included below.
  
  According
  to the medical records from **** ****** ********* on 7/13/21, prior to the
  policy, ***** was noted to have diarrhea, creating this exclusion. This
  abnormality was noted again within the policy waiting period on 1/15/22 within
  the medical records for Town and Country Veterinarians and Pet Resort.
  
  Town
  and Country Veterinarians and Pet Resort indicated on 1/14/22, within the
  policy waiting period, ***** experienced vomiting, creating this additional
  pre-existing, not covered condition. 
  ******* visit on 1/14/22 also included the notations of the heart murmur
  and dental disease.
  
  **** ****** ******** began noting treatments for dermatologic conditions, in the
  form of Cytopoint injections, on 9/23/21, then on 11/18/21, which were prior to
  the policy, ***** then had an additional injection within the waiting period on
  1/14/22.
  
  A
  medical history review outlining these policy exclusions was sent to *** ****
  on 12/13/22, the claims were then processed accordingly and completed by
  12/14/22.
  
  Claim
  *********** was eligible for coverage as it was for an adverse vaccine
  reaction, which is not a pre-existing condition. Unfortunately, the remainder
  of the claims were for pre-existing conditions not eligible for coverage by the
  policy or for preventative care, which is only eligible for reimbursement under
  the optional Wellness Rewards plan.
  
  Please let me know if
  you have any questions.
  Kind Regards,
  ******* ****** ***
  Lead, Claims Adjuster
  
  From your Embrace Terms & Conditions:
  PART I – DEFINITIONS
  11. Clinical Signs means changes in a Pet’s normal healthy
  state, bodily function or behavior observed by you, a Veterinarian, or other observer.
  32. Pre-existing Condition(s) means:
  a. A Chronic Condition observed by you or your Veterinary
  Provider prior to the end of the Waiting Period for your Pet(s) and any related conditions; or
  b. An Illness or Injury that first
  occurred or showed Clinical Signs prior to
  the end of the Waiting Period for your Pet and any related conditions.
  c. Undiagnosed conditions with the same Clinical Signs as those in a. or b. above are also considered pre-existing.
  
  34. Temporary Condition means an abnormal Clinical Sign or diagnosis, which is likely to resolve. A Temporary Condition may
  become a Chronic Condition.
  
  36. Undiagnosed means the underlying or causative condition has
  not yet been identified.
  
  39. Waiting Period means the time
  period where the policy’s Coverage is restricted. For this policy, the time period is two (2) days for Accidents and fourteen (14) days for Illnesses, except for Orthopedic conditions for dogs where the Waiting Period is six (6) months.
  The Waiting Period starts from
  the Pet Original Start Date. Conditions that occur during the Waiting
  Period will be excluded from your policy’s Coverage as Pre-existing
  Conditions. The Waiting Period also applies again when there are Coverage increases but is waived for policy renewals and optional Coverage renewals.
  
  PART IV – EXCLUSIONS
  
  1. Pre-existing Conditions;
  2. Preventative Care including,
  but not limited to, wellness exams or tests, preventative Treatment,
  tests or diagnostic procedures, vaccinations, flea and other parasite
  prevention, spaying or castration (including preventative sterilization
  surgery, such as for Treatment for cryptorchidism, chimerism, or
  chromosomal abnormalities), grooming and de-matting, and dewclaw removal;

  
  

  Customer Answer

  Date: 12/15/2022

  Better Business Bureau:
  
  
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  
  
  
  [To assist us in bringing this matter to a close, we would like to know your view on the matter.]
  
  
  
  Regards,
  
  
  
  ****** ****
  
  
  
  
  
  
  
  
  
   

• Initial Complaint

  Date:12/13/2022

  Type:Billing 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 Embrace Pet Insurance in March of 2022. After meeting my deductible, despite a note from the Veterinarian is denying the claim on a false premise. *** ******* clearly disagrees as the supporting email is attached. This company has a reputation for denying legitimate claims until they are contested.

  

  Business Response

  Date: 12/15/2022

  Hello BBB,
  I would be happy to discuss this case with you.
  Mr. ***** ********* purchased a policy with Embrace Pet
  Insurance (EPI) on 4/6/22 for his 3 year old kerry blue terrier, ******. After
  purchasing this policy, *** ********* received an email, which explains the
  waiting periods associated with the policy, the requirements for a physical
  exam as well as a copy of the terms and conditions. When a policy is purchased,
  there is a 48-hour accident waiting period, a 14-day illness waiting period,
  and a 6 month orthopedic waiting period. Once a pet is past its 14-day illness
  waiting period, we request the records for the pet from any clinic the pet was
  a patient at within 12 months before the policy start date, until the end of
  the illness waiting period. For ******, the end of the illness waiting period
  and first day of coverage was 4/20/22.
  Once the illness waiting period has been completed, an email
  is sent to the pet parent explaining that a medical history review can be requested
  to determine any pre-existing exclusions their pet might have. If a medical
  history review is not requested, the medical history review will be completed
  after EPI receives the pet’s first illness claim. A medical history review was
  not requested for ****** so the review was completed at the time of his first
  illness claim.
  While reviewing medical history from ****** ***** ********** ********, ****** was noted to be vomiting bile on 3/17/22, which was prior to
  the policy purchase. The veterinarian had noted that the vomiting could have
  been due to the pet having an empty stomach, but no diagnosis was given for the
  vomiting. Per EPI’s terms and conditions, any condition or illness noted in the
  12 months prior to the policy purchase through the waiting periods is
  pre-existing to the policy. Since ****** was noted to be vomiting prior to the
  purchase of the policy, vomiting is a pre-existing exclusion until ****** goes
  12 months without signs, symptoms, or treatment for vomiting.
  In the medical history that we received from Animal Place
  Veterinary Hospital, ****** was noted to be experiencing loose stools on
  3/20/22. At this time ****** was sent home with a prescription diet formulated
  for gastrointestinal issues and a probiotic. No cause was determined for the
  loose stool. Since this abnormality was noted prior to the purchase of the
  policy, diarrhea is a pre-existing exclusion on ******’s policy. This exclusion
  can be expired if ****** goes 12 months without signs, symptoms, or treatment
  for diarrhea.
  On 11/9/22, EPI received a claim for ****** with a date of
  service of 11/7/22 for vomiting and diarrhea. At that time, the cause of
  ******’s vomiting and diarrhea was not able to be determined. Since undiagnosed
  vomiting and diarrhea were noted prior to the purchase of the policy, vomiting
  and diarrhea are pre-existing to the policy. Because of this, EPI was not able
  to provide coverage for the claim. If ****** can go 12 months from the most
  recent occurrence of vomiting and diarrhea, these exclusions can expire and
  coverage for vomiting and diarrhea could be provided.
  Please let me know if you have any additional questions.
  Kind regards,
  ***** *******l, RVT
  Lead Claims Adjuster
  Embrace Pet Insurance
  

  

  Business Response

  Date: 12/19/2022

  Hello BBB,
  

  I would be happy to respond to Mr. *********** rebuttal. *** ********* purchased a policy for ******, a 3 year old Kerry blue terrier on
  4/6/22. This policy came with a 2 day accident waiting period, 14 day illness
  waiting period, and a 6 month orthopedic waiting period.
  To determine any potential pre-existing exclusions, all pets
  with a policy through Embrace Pet Insurance (EPI) receive a medical history
  review. During this review, we review any medical history from clinics the pet
  was seen at in the 12 months prior to the policy purchase through the waiting periods.
  

  We received medical history from ****** ***** ********** *******l
  for review for ******. During this review it was noted that ****** had a wound
  and was noted to be vomiting bile on 3/17/22. The veterinarian recommended at this
  time that ****** be fed a bland diet of bland chicken and rice with no
  seasoning for 5 days. On 3/20/22, ****** was noted to be experiencing loose
  stools in the medical history we received. At this time the veterinarian
  prescribed prescription gastrointestinal food and a probiotic to help with the
  loose stools.

  
  Per EPI’s terms and conditions, a pre-existing exclusion is
  defined as an illness or injury that first occurred or showed clinical signs
  prior to the end of the waiting period. A clinical sign is defined in the terms
  and conditions as a change in a pet’s normal healthy state, bodily function, or
  behavior observed by the pet parent, veterinarian, or another person. It is
  also stated in EPI’s terms and conditions that if a pet has been treated for undiagnosed
  vomiting and/or diarrhea prior to the end of the waiting period, the pet must
  be free of conditions with the same clinical signs for twelve (12) consecutive
  months before any conditions with the same clinical signs may be covered again.
  

  Since ****** was noted to be vomiting bile and having loose
  stool prior to the purchase of the policy, coverage for vomiting and diarrhea
  is not available until ****** goes 12 months without signs, symptoms, or
  treatment for vomiting or diarrhea.
  

  Since ****** was not able to go 12 months without signs,
  symptoms, or treatment for vomiting or diarrhea, coverage for his claim from
  11/7/22 for vomiting and diarrhea is not available.

  
  Please let me know if you need any further information.
  
  Kind regards,
  ***** ********* RVT
  Lead Claim Adjuster
  Embrace Pet Insurance

  Customer Answer

  Date: 12/19/2022

  Better Business Bureau:
  
  
  
  I have reviewed the response made by the business in reference to complaint ID 18569208, and have determined that this does not resolve my complaint. 

  ****** was seen in March of 2022 for a an infected paw which required 2 surgeries.  He was not brought in for diarrhea or vomiting.  The Vet clearly states that he may have had loose stools or some phlegm which is common when a dog may have an infection.  I repeat, the primary reason was for surgery to repair his paw.

   

  In October, ****** picked up a virus or some type of gastro intestinal problem which causes bloody stools and some vomiting.  He was treated with antibiotics and an anti nausea medication. 

   

  The Vet will also be glad to send a follow up that ****** was not treated for Chronic Diarrhea.  He is willing to help me resolve this and can be contacted.  

   

  This is simple.  An injured dog or sick dog may have diarrhea as a result of a number of conditions.   ****** was brought in for an injured paw in March.  ****** was brought in October for diarrhea with blood.  The root cause is not Chronic diarrhea. 

   

  Embrace can pay the claim, or I will file a claim with the District Court of Maryland.  They are within walking distance from my house, and provide free filing assistance.  

   

  Ask them to let me know if I need to go to the next step.

   

  Thanks,

   

  For your reference, details of the offer I reviewed appear below.
  
  
  
  
  
  
  
  Regards,
  
  
  
  ***** *********
  
  
  
  
  
  
  
  
  
   

• Initial Complaint

  Date:11/23/2022

  Type:Billing 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.

  The nature of this dispute is in regards to a blatant misunderstanding or disregard for what a pre-existing condition is vs. what an ailment is.
  
  To be blunt on the situation we had a puppy that had ********** at a very young age, a very common disease that can be picked up from a number of places but most commonly dirt, dirty water, or another dog's feces that also has it. Now the disease itself is from a microscopic parasite ******* ********** that is in these sources. Not something that lives in the dog forever to be clear.
  
  We had a number of claims, a total of 4, that included medication to CURE the issue that was declined because this company considers ********** to be a pre-existing condition if your dog at any point before the point of insurance starting to now and forever in the future not be covered.
  
  The biggest reason behind this complaint is that this is not made abundantly clear to the purchaser of the insurance. The original visit was in February, the claims in question are from 5/23, 5/25, 6/1 and 7/01. This clearly shows the disease was cured with no issues and reoccurred 3 months later. All of these are for one episode, including medications, feces analysis, additional medication, and final feces analysis not for 4 different cases.
  
  So for people reading this and wondering if they should get pet insurance, consider what you are getting it for, and realize that any ailment that might come up again, from before you had pet insurance, will not be covered by this pet insurance company.

  

  Business Response

  Date: 11/30/2022

  Hello
  BBB,

  I would
  be happy to further discuss this case with you. ******* ******’s policy with Embrace
  Pet Insurance (EPI) for **** started on 1/29/22. The accident waiting period
  ended on 1/31/22 and the illness and orthopedic waiting periods ended on
  2/12/22. Once the policy was purchased with EPI, an email titled “Klarisa, Your
  Embrace Pet Insurance Policy is Activated”  was sent to ******* and contains all the
  necessary policy documents including the terms and conditions of the policy for
  the policyholder to review.
  
  Our policy requires a medical history review
  for all pets before we can process an accident or illness claim, so we can
  determine any pre-existing conditions since those are excluded from coverage. When
  reviewing medical history, we review records from 12 months prior to the policy
  start date to the end of the illness waiting period or in ****** case, due to
  being less than 12 months old at the time of policy purchase, we review from
  the start of the medical history record.
  
  *** ****** was offered a preemptive
  medical history review on 2/12/22, when the illness waiting period ended in an
  email titled “Preexisting Conditions Explained.” This email also provides an
  explanation of pre-existing conditions and states no pet insurance company
  covers pre-existing conditions. A review was not requested or completed at this
  time. If the preemptive medical history review is not requested, EPI begins the
  medical history review process when the first illness claim is received, which
  for **** was 8/29/22.
  
  Upon reviewing the medical history for
  Arya, it was found she was first diagnosed with ******* on 12/30/21, which was
  prior to the purchase of the policy with EPI. Since this illness occurred prior
  to the purchase of the policy, it created a pre-existing condition. EPI terms
  and conditions definition of illness and pre-existing condition:
   16.
  Illness means sickness, disease, or any change in a Pet’s normal, healthy
  state, which is not caused by Injury to the Pet
   27. Pre-existing Condition(s) means:
  a.
  A Chronic Condition observed by you or your Veterinary Provider prior
  to the end of the Waiting Period for your Pet(s) and any related
  conditions; or
  b.
  An Illness or Injury that first occurred or showed Clinical
  Signs prior to the end of the Waiting Period for your Pet and
  any related conditions.
  c. Undiagnosed conditions with the same Clinical Signs as those in a. or b. above are also considered pre-existing.
  
  Since giardia
  is considered a temporary pre-existing condition, meaning it is likely to
  resolve, **** must go 12 months without a related sign, symptom, or treatment for
  the pre-existing condition to be eligible for review for expiration. Since **** did not go 12 months, the claims for ******* from dates of service 5/23/22,
  5/25/22, 6/1/22, and 7/1/22 were not eligible for coverage. Currently, the
  pre-existing condition of ******* has an expiration date of 7/1/23, which is 12
  months from the last occurrence.
  
  If you have
  any additional questions, please do not hesitate to ask.
  
  Sincerely,
  
  **** ******* RVT
  Senior Lead
  Claims Adjuster

  Customer Answer

  Date: 12/01/2022

  Better Business Bureau:
  
  
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  
  
  I can't believe that the period in which you will start covering for this is 12 months. I don't agree with this business practice at all and feel that 12 months for something that is curable is an insane time period for something like this to not occur again before being covered again. I understand that this is your policy, but I also feel like it shows the true nature of the business. 
  
  
  
  Regards,
  
  
  ****** ********
  
  
  
  
  
  
  
  
  
   

• Initial Complaint

  Date:11/16/2022

  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 purchased a pet insurance policy in January 2021. My pet's first claim was an emergency room visit for a twisted knee in July 2022. Every time I speak with Embrace they are still processing the claim. It should NOT take 4 months to process a claim. I have canceled the policy and I am seeking a FULL $1271.18 refund.

  

  Business Response

  Date: 11/22/2022

  Dear BBB,
  

  I would be
  happy to discuss the case with you. This pet’s policy started on 1/13/21 and
  the waiting periods ended on 1/15/21 (accidents), 1/27/21 (illnesses), and
  7/13/21 (orthopedic conditions). Our policy requires a medical review for all
  pet’s before we can process an orthopedic accident or illness claim, so we can
  determine any pre-existing conditions since those are excluded from coverage. A
  medical review is also performed upon request from the pet parent once the
  illness waiting period has ended. The policy also requires at least one exam in
  the 12 months prior to the policy start or within the first 14 days after the
  policy start.

  Mr. Wright
  submitted a claim on 8/3/22 for an orthopedic condition, hindlimb lameness. As
  no medical review was previously requested, Embrace began gathering medical
  records to perform the review. The only clinics Embrace had on file at the time
  was Hurst Clinic and Animal Emergency Hospital of Mansfield, so requests for
  records were sent. Mr. Wright received an email from Embrace on 9/3/22 letting
  him know medical records were in line to be reviewed and that the review could
  take up to 30 business days to complete. Mr. Wright emailed Embrace on 9/29/22
  expressing his frustration with the review time. Records on file were reviewed
  on 10/3/22 and it was found we did not have an exam in the required timeframe
  of the policy.

  An adjuster
  reached out to Mr. Wright to obtain veterinary information for where **** was
  seen prior to the start of the policy. Another adjuster forwarded the original
  email on 10/7/22 as we still had not received a response. On 10/7/22, Mr.
  Wright provided additional veterinary clinics and requests were sent out to those
  clinics for medical records. On 11/1/22, the records received from Texas
  Coalition for Animals were reviewed and we found they did not contain any
  detailed physical examination findings and Embrace reached out for additional
  records. We had also not yet received records from ********* ****** ********* and a second request was sent.

  On 11/16/22, *** ****** called Embrace and again expressed frustration in the processing time,
  and he was advised we were still missing necessary medical records to complete
  our review. An Embrace administrator called both Texas Coalition for Animals
  and ********* ****** ******** for medical records and was informed by both
  clinics the records would be emailed over. On 11/17/22, we received records
  from both clinics and again they were found to not contain detailed examination
  findings, which is required by the policy to satisfy the examination
  requirement. ********* ****** ******** emailed Embrace on 11/17/22 stating they
  had not examined **** since 2018. ***** ********* *** ******* was also contacted,
  and a staff member confirmed **** never had a full physical exam with a
  veterinarian and only received vaccines. As such, **** did not fulfill the
  policies examination requirement and on 11/22/22 the illness waiting period was
  extended.

  From your Embrace terms and conditions document:

  PART II – CONDITIONS
  
  1. Your pet must have been examined by a Veterinarian in
  the twelve (12) months prior to the Pet Original Start Date as shown on the
  Schedule Page(s) or within 14 days after the Pet Original Start Date.
  Failure to do so may result in your policy being voided. If your policy is
  voided, your premium will be refunded. No coverage is available until a
  qualifying Veterinarian has examined your Pet, and Pre-existing
  Conditions, if any, may be determined upon the date of the qualifying
  Veterinarians exam.
  
  7. By purchasing a policy you give us permission to gather all medical
  history for your Pet(s) from all your veterinary providers as we deem
  necessary. The medical information must contain detailed Veterinarian exam
  findings and must be made available to us for review to satisfy the examination
  requirement in Part II 1.
  
  Due to the
  extension, the first exam on file from 7/30/22 was used to fulfill the
  requirement and any conditions noted during this exam are pre-existing and not
  covered. As such, the claim for **** was not eligible for coverage as the
  condition is now pre-existing. The claim for **** has been processed and a
  refund for the unused illness premium has been processed.

  If you have
  any additional questions, please do not hesitate to ask!

  Warm
  Regards,

  ****** ********,
  R.V.T
  Senior Claims Adjuster

  Customer Answer

  Date: 11/23/2022

  Better Business Bureau:
  
  
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.  I am seeking a FULL refund.

  
  
  Regards,
  
  
  
  **** ******
  
  
  
  
  
  
  
  
  
   

• Initial Complaint

  Date:11/12/2022

  Type:Billing 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.

  A claim was submitted when our cat passed away for the final costs of the emergency hospital visit since September. During this time, the insurance company has done nothing but put the claim on hold and keep on asking for medical records.

  

  Business Response

  Date: 11/21/2022

  Hello BBB.

  
  I would be happy to address this case with you.

  
  On 11/5/20, ***** ********* purchased a policy with Embrace
  Pet Insurance for her cat ******. After purchasing this policy, Ms. ********* received an email, which explains the waiting periods associated with the
  policy, the requirements for a physical exam as well as a copy of the terms and
  conditions. When a policy is purchased, there is a 48-hour accident waiting
  period and 14-day illness and orthopedic waiting periods. Once a pet is past
  its 14-day illness waiting period, we request the records for the pet from any
  clinic the pet was a patient within 12 months before the policy start date,
  until the end of the illness waiting period. For ******, the end of the illness
  waiting period and first day of coverage was 11/19/20.

  
  Every pet has a review of its medical history completed to
  determine its pre-existing conditions. The medical history review can be
  completed at the end of the illness waiting period per request of the pet
  parent or when the first illness claim is submitted to Embrace Pet Insurance. A
  medical history review was never requested for ******.

  
  The first illness claims we received for ****** were dated
  8/31/22 and 9/1/22 and we received the claim documents on 9/13/22. This triggered
  a medical history review to be completed for ******. As Ms. Rodriguez did not
  respond to the email regarding where ****** was seen prior to the policy start,
  we requested medical history from the veterinary clinics we had a wellness
  claim from (******** *** *******l) as well as the veterinary clinics the pending
  claims were from (********* and Veterinary Emergency Group).  

  
  We received ******** medical records from ******** *** *******l
  on 9/1/22 and reviewed these records on 10/12/22. The medical records from Veterinary
  Emergency Group showed that there were no examinations prior to the policy. As
  we cannot process any illness claims until a full medical history review is
  complete, the pending claims were placed on hold. At this time, we still
  waiting on medical records from *********, these records were not received
  until 11/4/22. The full medical history review was completed on 11/21/22 and
  ******** claims were opened and processed immediately after.

  
  If you have any additional questions, please do not hesitate
  to ask.
  

  ***** *********r, RVT
  Senior Claims Adjuster

• Initial Complaint

  Date:11/06/2022

  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 recently moved to Embrace Per insurance . My animals were previously with Pet Plan and have never not had coverage . I am also an Insurance Professional and am well aware of policy provisions and an extremely reasonable person. . I had four claims and verified information was sent to the Embrace not once but twice for 3 outstanding claims . These animals only have one primary vet . They delayed payment for clearly an accident (laceration ) . That was after I had already done a vet visit to show no pre existing . Vet confirmed info sent . 3 other claims , both they are saying they can’t get Information . Yet my vet actually emailed on one direct to the claim rep sue to the system being faulty . They are committing fraud in my opinion due to the systemic delay of paying claims . I am now going to go and send information myself certified Mail . Take the time to do their job because they are evading their contractual obligation . I also intend to report this to the DOI in Ca . I pay over $200 for 3 dogs , plus I have two cats so close to $300 , I hope that there is a class action out there because I can tell you their behavior isn’t just understaffing . They are delaying payment , lying about receiving information that vet says they have received , and are in breach of contact .

  

  Business Response

  Date: 11/08/2022

  Hello BBB,
  
  I would be happy to address this case with you.
  
  *********** and ****** ***** purchased an insurance policy
  on 6/18/22 for their dogs, ****** ****** and ******* as well as their cats ******* and *******  Each of the insured pets have a two-day accident
  waiting period, ending 6/20/22, a 14-day illness waiting period ended 7/2/22,
  and the three dogs have a six-month orthopedic waiting period ending 12/18/22.
  Prior to processing any claims under the illness policy, we must complete a
  medical history review, which reviews all medical records from one year prior
  to the policy through the waiting periods.
  
  We received one claim for a laceration that occurred on
  9/8/22 for *****. The claim was received on 9/8/22 and processed on 10/10/22.
  As this was *****' first claim, a medical history review was required prior to
  processing. That has since been completed and the ******* received an email
  listing the results of the medical history review on 10/10/22.
  
  Regarding *******s pending claims, ** ***** was
  inadvertently listed as a veterinary hospital that Oliver had visited. We
  confirmed he has only been seen at VCA Acacia Animal Hospital and Pet Resort in
  the 12 months prior to the start of the policy and we have all of the medical
  records from that facility. *******s medical history review is now complete,
  and his claims have been processed.
  
  For ********* pending claim, we have her medical records
  from *** ****** ****** ******** and *** ******* *** ********* ****** ********
  and Referral Center, and Veterinary Specialty Hospital. These records have all
  been reviewed; however, it was noted that Trinity was referred to ** ***** for
  a consultation regarding her leg. We received the needed confirmation from UC
  Davis indicating they do not have any additional information for Trinity;
  therefore, her medical history review is now complete, and her claim has been
  processed.
  
  Each of the pending claims have now been processed and the
  medical history reviews are complete for each of the five insured pets.
  
  Please let me know if you have any questions.
  
  **** ********
  ******* ****** RVT
  Lead, Claims Adjuster

  Customer Answer

  Date: 11/23/2022

  RECEIVED VIA EMAIL BY BBB STAFF MEMBER:

  Hello,
   
  I could not figure out on line how to log in and tell you this has been resolved . 
  
  You can close and disregard the complaint.
  
  Thank you !
  
  ******

• Initial Complaint

  Date:11/03/2022

  Type:Billing 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.

  On 10/27/22 I took our dog ******** is for health issues he was having. The bill came to approximately $500 of which $206.80 was scheduled to be reimbursed to me by check. On 11-1-22 I called 1-800-927-4357 for a status update. I spoke with Skye who told me a check was mailed and that worst case scenario it would arrive by 11/9/22. I gave Skye my bank account info. and she said that "going forward with my next claim reimbursement I would receive my money by direct deposit. After that I saw that the post office was delivering my check on 11/3/22. On 11/3/22 before I got home to get the check out of my mailbox I saw another email from the Embrace Financial Operations (no name given) that said they decided to void my check and provide a direct deposit which may take up to 3 days. Mind you, **** was very clear in her comment to me that I was getting the check by mail and at no time did she ask permission to have the check voided. I now have the check in my hand and cannot cash it. I was told that it is no good. I was extremely frustrated that they basically bounced my check w/o any agreement by me to do so. I asked to speak to a supervisor and later spoke with ******** ******** who said the best she could do was move my payment date 15 days as a one time courtesy. I believe that if they wanted to make a direct deposit in addition to sending me a check but if I sent them a check and then asked them to tear it up as they did with me, it would have been considered a bounced check. I asked if they would credit my payment this month and they said they could not do that. Due to the fact that I was put in a financial bind by not being able to cash my check when I received it and for all the time it took me away from my job which I did not get paid for, they should honor the check or at least replace it and still let me keep the direct deposit as it was not agreed upon that I wanted them to void the check. They should not void checks w/o the customers consent.

  

  Business Response

  Date: 11/18/2022

  I acknowledge that our service team did make an error in not
  advising Ms. ***** that the check issued would be cancelled during the phone
  call on 10/27.  A billing rep did follow up and let her know that the
  check was cancelled before the check arrived.  This process was followed
  because the Postal Service is inconsistent, and we wanted to get her payment to
  her as soon as possible.  The date the check was scheduled to arrive was
  11/9 (it arrived earlier than expected). The ACH payment was received prior to
  11/9. Ultimately,  if the process had gone as planned,  the
  experience would have been better,  but the postal service beat us to the
  punch. Our supervisor delayed the next month’s payment to ensure Ms. ***** would have time to collect the claims payment before we collected the next
  months premium.  I am sorry for the inconvenience and am glad we could
  move the payment to ensure any financial issues arose.

• Initial Complaint

  Date:10/31/2022

  Type:Billing 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.

  Between the dates of 7/21-7/23, my puppy had multiple vet visits and bills totaling to $3,876.37 due to severe illnesses of gastroenteritis and pancreatitis because of ingestion of a foreign body. Without any worry of how much I spent because I thought I had a pet insurance that will help pay for these costs because of the policy I had towards accident and illness for a new puppy. After over a month of waiting to have my money reimbursement, I receive a message from Embrace stating that none of the bills will be covered by them because on my initial vet visit on 6/13, 13 days after bringing my puppy home, I stated to the vet that my puppy had 1 episode of vomiting of undigested food. Because the date of that visit was in Embrace’s 14 day waiting period, vomiting was then considered a pre-existing condition. To my disappointment and knowledge, vomiting is a very vague symptom that can occur due to anything including stress, anxiety, and/ or any other mild to serious illnesses. An appeal process was begun with the help of my puppy’s primary veterinary in which a statement letter was written by the doctor stating and comparing the circumstances between the two separate events. After a long 14 business days, Embrace paid $522.89 for the first claim from the ********* visit on 7/21. That urgent visit totaled $865.86, however my puppy was still very ill the following 2 days which required more fluid resuscitation and an overnight hospitalization as well as very expensive tests such as repeat blood work tests, x-rays, and ultrasounds, which were done between 7/22 and 7/23. I have fought with the help of the primary veterinarian and Embrace has asked for another appeal letter without guarantee of having those costs covered. I am dissatisfied with their business and monthly payments because vomiting is such a vague symptom which can occur due to anything and now my puppy has that on their record for an entire year. Embrace representative have agreed with me but won’t pay.

  

  Business Response

  Date: 11/01/2022

  Hello BBB,
  
  I would be happy to further discuss this case
  with you. I have reviewed the claims *** ***** submitted along with the
  exclusions placed on her policy. *** ***** purchased her policy 5/17/22, with
  it going into effect on 5/18/22. Unfortunately, one of the conditions of the
  policy is that the pet must be in the home. Since *** ***** did not acquire
  Dexter until 6/1/22, her waiting periods did not start until that day. Her
  policy has a 2-day accident waiting period, 14 day illness waiting period and a
  6 month orthopedic waiting period.

  
  Unfortunately, Dexter was noted to have undiagnosed vomiting
  on 6/13/22, which was within the policy’s illness waiting period. Per the Terms
  and Conditions of the policy, undiagnosed clinical signs are also excluded from
  coverage if noted prior to the policy start or within the waiting period. The
  Terms and Conditions also use undiagnosed vomiting as an example, since this is
  a common exclusion. As Dexter was noted to have this vomiting, the policy
  excludes all other episodes of vomiting and underlying conditions causing
  vomiting, until he is free of treatments, signs and symptoms for 12 months.

  
  From the Terms and Conditions

  
  PART I – DEFINITIONS
  
  10. Clinical Signs
  means changes in a Pet’s normal healthy state, bodily function or behavior
  observed by you, a Veterinarian, or other observer.
  
  27. Pre-existing Condition(s) means:
  a. A Chronic
  Condition observed by you or your Veterinary Provider prior to the end of the
  Waiting Period for your Pet(s) and any related conditions; or
  b. An Illness or
  Injury that first occurred or showed Clinical Signs prior to the end of the
  Waiting Period for your Pet and any related conditions.
  c. Undiagnosed
  conditions with the same Clinical Signs as those in a. or b. above are also
  considered pre-existing.

  
  31.
  Undiagnosed means the underlying or causative condition has not yet been
  identified.

  
  34. Waiting Period means the time period
  where the policy’s Coverage is restricted. For this policy, the time period is
  two (2) days for Injuries and fourteen (14) days for Illnesses, except for
  Orthopedic conditions for dogs where the Waiting Period is six (6) months.
  The Waiting Period starts from the Pet
  Original Start Date. Conditions that occur during the Waiting Period will be
  excluded from your policy’s Coverage as Pre-existing Conditions. The Waiting
  Period also applies again when there are Coverage increases but is waived for
  policy renewals and Optional Coverage renewals.

  
  PART
  II – CONDITIONS

  
  6.
  Your Pet(s) must reside with you and be under your regular care and supervision
  at the physical address zip code listed on the Declaration Page. 

  
  PART IV – EXCLUSIONS
  
  1. Pre-existing Conditions
  Specific situations include but are not
  limited to:
  
  ii. If your Pet has
  been treated for Undiagnosed vomiting and/or diarrhea prior to the end of your
  Pet’s Waiting Period, your Pet must be free of conditions with the same
  Clinical Signs for twelve (12) consecutive months before any conditions with
  the same Clinical Signs may be covered again.
  
  Ms.
  Lopez submitted several claims with dates of service from 7/21/22-7/23/22 for
  pancreatitis, gastroenteritis and gastritis. In the medical history we received
  for these dates, Dexter was seen for vomiting and no underlying cause was
  found, although pancreatitis was suspected. Since vomiting and any underlying
  conditions causing vomiting, including but not limited to pancreatitis,
  gastritis, and gastroenteritis, are excluded from coverage, we were unable to
  provide coverage for the claims.
  
  We
  received an appeal letter from *** ******* veterinarian. In this letter, it
  stated in her opinion, the two vomiting episodes were unrelated, and the claims
  should be covered. She continued stating the vomiting in June was likely due to
  puppy stress. Finally, it was also noted on 7/21/22, there was pieces of toy in
  ******** vomit. Due to this notation about the toy, we overturned coverage for
  the initial visit on this date. However, the medical history makes no
  indication that the continued gastrointestinal problems were indeed related to
  this ingestion as *** ***** stated in the complaint. It is also noted the
  pancreatitis, first listed by her regular veterinarian, was not showing on more
  advanced diagnostics and noted to be possible, not diagnosed. Since the toy
  ingestion does not appear to be the cause of the continued vomiting, we are
  unable to provide coverage for the rest of the claims.
  
  Regarding
  the claim covered on the appeal, the reason her reimbursement was not the full
  amount is because she has a yearly deductible and a copay, which is her
  responsibility. There were also two items on this claim unavailable for
  coverage by the policy. The deductible on her policy, which had not been met
  prior, is $200. Her copay was $58.10. In addition, there were two items
  dispensed, which are excluded from coverage by the Terms and Conditions. These
  items were prescription food (Purina EN) and a non-FDA approved supplement (Pro
  Pectalin) and totaled $82.76. The policy’s Terms and Conditions specifically
  exclude coverage for medications and supplements not FDA approved, as well as
  prescription food.
  
  I’m
  sorry we are unable to further change the decision on her claims; however,
  according to the Terms and Conditions of her policy, the claims are not
  eligible for coverage.
  
  If you have any additional questions, please do not hesitate
  to ask.

  
  Regards,

  
  ******* ****** RVT

  
  Senior Claims Adjuster

  Customer Answer

  Date: 11/01/2022

  Better Business Bureau:
  
  
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  
  
  
  [To assist us in bringing this matter to a close, we would like to know your view on the matter.]
  
  
  
  Regards,
  
  
  
  ******* *****
  
  
  
  
  
  I strongly believe that Embrace Pet Insurance has created these policies to make it difficult for them to pay for a pet’s vet bills. I am unhappy with their response because they do not have a licensed veterinary to actually overlook these claims. I am a nurse and I work in the healthcare field and can say that vomiting is a symptom that can result from stress, anxiety, motion sickness to something more severe such as pancreatitis, not a pre-existing condition. A pre-existing condition is a diagnosis made by a veterinary that is CHRONIC not an ACUTE EVENT. In my puppy’s case, he was perfectly healthy before him becoming very sick, that was an ACUTE event. A condition that is CHRONIC requires constant treatments and medications. Trust me when I say Embrace has this all figured out so they don’t have to reimburse their clients. It’s very sad. However my primary veterinary is happy to no longer recommend Embrace Pet Insurance to patients because of this situation. She is a knowledgeable licensed veterinary and understands the pathophysiology of illnesses. She knows my puppy and the day I took him when he was sick, she knew this was not him and could have died from how sick he became. Embrace is a scam, unreliable insurance for your pet. DO NOT PURCHASE THEIR POLICY. They will find any loophole in their ridiculous terms and conditions that’s ARE NOT overlooked by a licensed medical professional so they won’t have to pay. I am deeply saddened with how corrupt they are. They have lost a client and will continue to do so when people realize that this is manipulation and gaslighting just so they can keep their bank will millions. 
  
  
  
   

• Initial Complaint

  Date:10/23/2022

  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.

  On 6/14/22 our dog *** had an initial wellness exam with ********* ****** ****** to obtain an insurance policy with Embrace. After submitting this paperwork through the mobile app, we were notified his policy began 6/16/22, accident coverage began 6/16/22, illness and orthopedic coverage began 6/28/22. From then on Embrace has deducted $86.34 from my credit card every month for ***'s coverage. On or after 7/20/22 *** ingested my husband's wedding band and needed an emergency stomach surgery, x-ray, and monitoring at another vet's office after the procedure. Once these claims were submitted via the app, the company states to process them within 15 business days in their confirmation e-mail. After the allotted time we reached out to Embrace regarding the unprocessed claims and were told that they required more information regarding ***'s initial wellness exam back in June. Up until us contacting the company we had no contact from Embrace stating that there were any issues with ***'s wellness exam or coverage, nor of any attempts to contact the vet for the wellness exam information. This has been an ongoing back and forth with us as the go between with the vet and Embrace since July with one known attempt of Embrace actually calling the vet's office. The surgery cost $2,644.43 his monitoring cost $183.55. Our resolution is that Embrace reimburse these claims and terminate our policy.

  

  Business Response

  Date: 10/29/2022

  Hello BBB,

  I would be happy to address this case with you.

  On 6/13/22, ***** ****** purchased a policy with Embrace Pet
  Insurance for her dog ***well that went into effect on 6/14/22. After
  purchasing this policy, Talia received an email, which explains the waiting
  periods associated with the policy as well as a copy of the terms and
  conditions. When a policy is purchased, there is a 48-hour accident waiting
  period, a 14-day illness waiting period, and a 6-month orthopedic waiting
  period. Once a pet is past its 14-day illness waiting period, we request the
  records for the pet from any clinic the pet was a patient within 12 months
  prior to the policy start date, until the end of the illness waiting period.
  For ***well, the end of the illness waiting period was 6/28/22.

  Every pet has a review of its medical history completed to
  determine its pre-existing conditions. The medical history review can be
  completed at the end of the illness waiting period per request of the pet
  parent or when the first illness claim is submitted to Embrace Pet Insurance.
  Wellness claims do not require a medical history review and as such would not
  initiate such a process. A medical history review was not requested for
  ***well, and it was not until the first illness claim was received on 7/19/22
  that this process was initiated.

  Medical records from ********* ****** ****** (NAC) were
  requested on 6/28/22, 7/3/22, and 8/9/22. Records from NAC were received on
  8/10/22, however, these records did not include the doctor’s detailed
  examination notes as required by the policy and one of our adjusters sent a
  questionnaire to the veterinarian at NAC on 8/12/22 to retrieve the detailed
  component. This questionnaire was resent on 9/14/22 and 10/5/22 as well as a
  follow-up call to NAC that took place on 10/7/22. A response to this questionnaire was
  received on 10/24/22 and ***well’s medical history review as well as all
  pending claims were expedited.

  I am happy to report all these claims were covered and if
  you have any additional questions, please do not hesitate to ask.

  Regards,

  ***** T, RVT
  Senior Lead Claims Adjuster

• Initial Complaint

  Date:10/21/2022

  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.

  Embrace billed me twice. I called the company and they stated they have sent the money back to my bank account. Never received it. I have the company multiple times with no resolve. I want my 111.00 back! I

  

  Business Response

  Date: 10/24/2022

  Thank you for sending us your concerns. 

  *** *******'s payment that was due on 9/6/22 was declined, and her policy went into failed billing. 
  On 10/6/22, *** *******'s scheduled monthly payment went through successfully after she updated her payment type. 
  On 10/14/22, the declined payment from 9/6/22 cleared on the updated payment method. 
  *** ******* cancelled on 10/21/22. 

  A phone rep mistakenly told *** ******* that we took two payments and one would be refunded, when that was not the case.  The two payments were both owed for September and October, to get the policy caught up to date. 
  When *** ******* cancelled her policy, she received a prorated refund of $49.48 for the insurance, and $16.85 for the Wellness plan. 

  No additional refunds are due at this time. 

  Thank you! 

  ***** *******
  Contact Center Manager