Pet Insurance - Making It Work For You!

Pet insurance is a bit like the proverbial computer – great when it works well, a disaster when it doesn’t! For the sake of this article let’s imagine that your pet insurance has fallen into the latter category. Your pet is ill and you need to claim for vets bills. But when you come to make the claim it is disputed by your insurer. What do you do? Well you have two main courses of action and the first of these is:

The Unfair Terms in Consumer Contracts Regulations 1999.

In essence this contract does exactly what it says on the tin – if an insurance contract has unfair terms within it then this body has the power to make those terms unenforceable.

What though is an unfair term?

This is where it gets a little tricky - because unfair terms are basically something that is judged to be contrary to the requirements of ‘good faith’.

Good Faith and the Consumer:

When a consumer takes out an insurance policy they must, in order to exhibit good faith, disclose ALL information to the insurer. To omit information that later on becomes apparent will mean that the consumer forfeits the right to insurance in that instance. Or more simply put – you don’t get paid! As well as this the insurer expects you to take good care of your animal – no insurer is going to want to pay out for vets fees on the grounds that, for the sake of argument let’s say, you starved your animal into ill health... and nor should they. Less drastically perhaps they may also argue against paying for a vet’s bill that could have been avoided if you had consulted a vet earlier – thus avoiding a deterioration in the animals health. Whilst some may think this latter point unfair it is not. In fact it works directly in the animals favour as it ensures the owner is on their toes when it comes to pet health. As well as this we should also consider the fact that it is not all one sided.

The Insurer must also demonstrate good faith:

For an Insurer to do this they must include terms and conditions in their policy that are not detrimental to the consumer. It should be evenly weighted and not favour the consumer or more importantly, themselves. So a policy that states, for instance, that the consumer can only stake a claim for an accident to their pet as long as it doesn’t happen on a Sunday would be deemed as not being in good faith. Charging a high penalty for having missed payment of a premium would also be against the requirements of good faith. The second course of action for complaints against an insurer is to some extent more easily wielded and makes use of The Financial Ombudsman Service. The Financial Ombudsman as the name states deals with complaints about financial products. Pet insurance, happily, comes under this umbrella.

Key points of this service:

• Any decision made by the financial ombudsman is binding on the finance company – it can also be registered as a court judgment.
• In the case of a decision being made against the consumer, it is only binding if he chooses to make it so. If the consumer still doesn’t agree the outcome they can still bring a court claim against the insurer.
• The ombudsman is not bound by strict law – more rather a common sense mandate – he will make decisions on what he feels to be fair and reasonable.
• This does not mean he discounts the law but that he also looks at ‘good practice.

Typically an ombudsman might for instance decide that an owner had no recourse to knowledge of a pet’s pre-existing condition therefore they would still be able to claim for vet’s bills. With all this in mind then, what do we do when it comes to pet insurance? The answer is clearer than one might think. And it is this:

• When insuring a pet read the small print – however tedious it may appear at the time it saves, what are often avoidable and even more time consuming arguments later on.
• Know your rights and stick to them.
• Don’t try to pull the wool over your insurer’s eyes – insurance companies share information – if you have had a previous problem with a pet they will make it their business to know about it – in the case of public liability they may even check with police to see if your pet has a ‘record’.

FINALLY REMEMBER ALL IN ALL PET INSURANCE MAKES SENSE – IF - YOU MAKE IT WORK FOR YOU!