Claim Denied
My cat unfortunately passed away in 2025 due to what appeared to be a tumor on her spleen or liver, as indicated by the X-ray. However, the insurance claim was rejected because her bloodwork from 2016 showed an elevated protein level. Is there any way I can challenge this decision?
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I’m really sorry to hear about your cat. It’s heartbreaking to lose a pet, especially under such difficult circumstances. Regarding the insurance claim, you may have a few options to consider:
Review the Policy: Carefully read your insurance policy to understand the terms, especially regarding pre-existing conditions. Sometimes, companies have specific clauses that define when a condition is considered pre-existing.
Collect Evidence: Gather all relevant medical records, including the x-rays and bloodwork results. Look for any documentation that indicates your cat’s health status over the years, as well as any statements from your veterinarian regarding the likelihood of a tumor being related to past health issues.
Contact Customer Service: Reach out to your insurance provider for clarification on their decision. Ask for a detailed explanation of how the elevated protein value influenced their decision and if additional documentation could change their assessment.
Appeal the Decision: Most insurance companies have a formal appeals process. Follow their guidelines to submit a detailed appeal, including all your supporting evidence and any new information from your vet.
Seek Veterinary Insights: If possible, ask your veterinarian to provide a letter explaining the situation and their perspective on the probable cause of your cat’s passing. They may be able to clarify that the elevated protein was not indicative of a pre-existing condition related to your cat’s final illness.
Consider Legal Assistance: If you feel the denial is unjust and your appeal is unsuccessful, consult with a legal professional experienced in insurance disputes. They can advise you on further steps and your rights.
Stay persistent and good luck!