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Pet Insurance Claims: terms & conditions
Claiming to Yourself
This is the usual way of claiming on pet insurance. You pay for treatment and provide us with a claim form. We fill it in and send it to your insurance company who then reimburse you.
You pay the policy excess and any items not covered by your insurer and the vet claims the treatment costs direct from your insurer.
Please consider the following;
· There are over 60 insurance companies, all with different types of policies. An excess will be payable as per the amount stated on your current policy documents.
· Cover varies between insurers: amounts covered may be per condition or for a specified period of time. Diet food, wormers, flea treatment, dentistry, hydrotherapy, physiotherapy, etc may not be covered.
· Some policies are "12 month" - this means they will exclude a condition 12 months after the clinical signs of illness are first noted. Some policies offer "life cover" but will still attract an excess for each condition each policy year.
· Inception periods: cover may be limited in the first 10 to 14 days of any policy.
· Pre existing medical illnesses must be declared when you insure your pet. Exclusions may be placed for conditions which were evident before your insurance policy began.
· Some insurers may take up to 4 months to pay: others may not offer a claim direct facility.
· The Data Protection Act - as the claim is essentially on your behalf, insurance companies don't necessarily tell us if there is a problem and some won't even talk to us regarding the claim.
· Insurers may cancel your policy with immediate effect if payments are missed.
PLEASE BE AWARE THAT WE CANNOT GUARANTEE YOUR CLAIM AS INSURERS MAY DECLINE CLAIMS FOR A NUMBER OF REASONS. OUR ‘CLAIM DIRECT’ FACILITY IS OFFERED AT CALDER VETS’ DISCRETION: WE RESERVE THE RIGHT TO DECLINE THIS FACILITY AND ASK FOR PAYMENT AT THE TIME OF TREATMENT.
Insurance claims create a considerable administrative burden. Calder Vets has a dedicated insurance department: please contact us at the Dewsbury surgery if you wish to discuss your claim.
· Although claiming direct, any problems or shortfalls are still essentially your responsibility. We will endeavour to help sort out any problems, but this is on your behalf. Please notify us immediately if you receive any correspondence from your insurer.
· If you want to claim direct, check your policy details before the procedure. We will need to know: policy number and start date, any exclusions and cover limits. We will need a completed claim form signed by the policyholder, in the correct place. There is no way all our staff can know your policy details: this information must come from you. A further claim form will be needed for all subsequent visits/ treatments; please ask at reception. If you can’t supply us with a claim form within 3 days of treatment we reserve the right to ask you to pay in full.
· At Calder Vets we are one of only a handful of practices in the UK who are authorised directly by the Financial Services Authority. This means we can advise you on all aspects of pet insurance including filling in your claim form.
· Your insurer may not settle your claim in full: items may not be covered e.g. food and wormers or further excess. Please contact your insurer if you wish to clarify the amount paid. Deducted amounts must be settled to Calder Vets within 7 days. Some invoices may not be fully completed when you collect your pet, as the treating vet may still be in surgery. A finalised invoice will be available the following working day. If your claim is declined, outstanding treatment costs must be settled within 7 days.
· If your claim has not been settled by your insurer within 6 weeks of treatment, we reserve the right to ask you to settle the account and we will instruct your insurer to pay you.
USE OF OUR CLAIM DIRECT SERVICE IMPLIES ACCEPTANCE OF THE ABOVE TERMS AND CONDITIONS.
Calder Vets is directly authorised by the FSA. This means that selected members of staff with suitable training are allowed to advise you on the most suitable insurance for your pet and are also able to administer insurance claims on your behalf.
If you have any complaints about any advice given or about the handling of your insurance claim, please write to Stephen Dixon, Calder Vets, Savile Road, Dewsbury WF12 9LN. Amended 16/08/2011.