Pet insurance fraud

Re: Pet insurance fraud

Helen Tottey — Mon, 11 Jun 2012 14:28:28 GMT

It is in this months VN Times, so hopefully you should get to see it, if not, let me knwo and can email you the original

Re: Pet insurance fraud

madelinepikevn@aol.com — Mon, 11 Jun 2012 10:32:31 GMT

Hi Not sure if this article has been published, or whether I have missed it in a journal..... Does anyone have any details of where I can find it or an electronic version?

Many Thanks

Re: Pet insurance fraud

Arlo Guthrie — Wed, 09 May 2012 17:53:50 GMT

Helen, strictly speaking, all content on vetnurse.co.uk becomes copyright vetnurse.co.uk and you are not allowed to reprint it elsewhere.

The reason we have the copyright is to protect authors of posts. You should ALWAYS check with a poster whether or not they are happy for their story to be quoted elsewhere. If they are happy, so am I (i.e. you don''t need to get permission from me if you have the permission of the author).

All the best

Arlo

Re: Pet insurance fraud

Helen Tottey — Wed, 09 May 2012 11:22:20 GMT

This the contet it has been written in, it is no way saying who you are

Previous histories

The minimum 14 day exclusion period on pet insurance policies is there to protect against someone realising their pet is unwell, takes out a policy so that they can claim for any treatment needed. But insurers are experiencing an increase in claims that are made for injuries on the day of a policy been taken out.

Obviously not every person that turns up with a new dog/cat that has no previous history that is unwell/injured and insured is trying to make a fraudulent claim, however, careful questioning should be used to try to establish if there is previous history somewhere that would affect any insurance claim as this example shows

a client registered a cat that apparently has never had anything wrong with it and has never seen a vet before in its life, but when vaccinations were discussed it already has a vaccination record bearing the cats name and address which is fully up to date with the previous practice name on it. The client is attending our practice because the cat is lame and x rays clearly shows an implant! We showed the client the x ray and asked them if they knew about the fracture repair (bearing in mind they said they had the cat since a kitten) and we also asked them if they still wanted to make an insurance claim - strangely enough they changed their mind

Re: Pet insurance fraud

Sal the 1st — Wed, 09 May 2012 11:11:37 GMT

I have been in touch with VBD and would like the scenario to be removed.

Re: Pet insurance fraud

Helen Tottey — Wed, 09 May 2012 10:45:57 GMT

I can assure you that your name has not been used, just the scenario which backs up one of the many things that what was spoken about in the meeting

Re: Pet insurance fraud

Sal the 1st — Tue, 08 May 2012 19:28:30 GMT

I am not that happy about being quoted and hope my name hasnt been quoted?

Re: Pet insurance fraud

Helen Tottey — Tue, 08 May 2012 13:28:30 GMT

Thanks all for your comments, it is certainly an interesting topic. I have used a couple of quotes from Sal the st about cat Xray & NickyVN about GDV that fitted in with what i wrote. I am not exactly sure if the article is going in VN or Vet Times but it will be one of them.

I may ask for you help again as this was only part of the meeting, there was another question that i think will get some interesting replies too!

thanks again - Helen

Re: Pet insurance fraud

ginny — Fri, 27 Apr 2012 17:38:58 GMT

I've never worked anywhere where procedures were priced differently for insured and uninsured animals.

Clients are just told the procedure price - the vet doing the op is the best person to give the quote. The client can then decide if they can afford the procedure or not - if they have insurance or can pay by some other means. If they have limited funds then the vet will discuss their options with them. Insured or uninsured can ask for referral.

I can't help thinking that the big problem with pet insurance is that some big companies who insure cars, houses etc, thought they might be onto a nice little earner if they did pet insurance as well. Seems to me that they didn't research their market well enough. Although there are some insured pets who never get claimed for there are a lot more that do, possibly more than say house or car claims.

I have a dog with almost monthly claims as she is diabetic and yet one of my cats has never had a claim (touch wood!!) and he is now 12yrs old!

Re: Pet insurance fraud

Lor12 — Wed, 25 Apr 2012 15:22:41 GMT

I agree with the previous posts in that an insured pet will have the full work of investigation etc, which on one hand might be taking the mick a little but on the other like previous posters mentioned its nice to know we are doing all we can and certainly can be more thorough for that animal.

It is unfortunately happening that things get added to bills for insured pets that say wouldnt be for an unisured. A surgical procedure say would be priced up down to the suture material if claiming whereas not so if not.

From a personal view I have insurance for my pets and always have regardless of me being a nurse because I like the piece of mind that should anything major happen that may cost thousands then the cover is there and I dont know how many others would feel the same but I expect the very best for my little guys and personally I would choose referral everytime whether for orthopaedic surgery or cardiologist and thats not saying I have no trust in first opinion vets its just my personal feelings.

Also just to mention that previously I took one of my older uninsured pets to a referral practice also and I paid the bill so I dont just choose it because of the insurance its just an added help.

I hope your article goes well, its a very interesting subject

Re: Pet insurance fraud

Helen Tottey — Tue, 24 Apr 2012 20:58:38 GMT

[quote user="Sal the 1st"]

I am struggling to see where this thread is heading, but hopefully all will be revealed in an issue of the Vet Times at some stage.

[/quote]

In answer to this question i am just trying to gather thoughts about how insurance within veterinary practice is perceived by owners and veterinary staff. I have no intention of "bad mouthing" the vet profession with this i just think the different views are interesting. According to the ABI meeting i was at, most proven fraud comes from clients and not our profession. I hope this clarifies my position in this

Re: Pet insurance fraud

Emma Purnell — Tue, 24 Apr 2012 20:47:11 GMT

I don't know if this is the case all the time but PetPlan DO give vouchers to practices - however not for signing people up to their full policy. We give the free 4 week cover notes which stop after 4 weeks and advise clients to use this 4 weeks to shop around and be 100% sure what they are getting. We get the vouchers from PetPlan simply for doing these cover notes.

Not sure if it is really relevant but just so people know

Re: Pet insurance fraud

Sal the 1st — Tue, 24 Apr 2012 19:08:43 GMT

[quote user="Helen tottey"]

playing a bit of devils advocate here but who's decision is it to refer - the vets or the clients?

I agree that a lot of people come in saying "do whatever, i have insurance" so are clients putting vets under pressure for everything to be done and a diagnosis reached in 2 hours?!

Is fear of a delayed/mis diagnosis by first opinion vet driving them to clear themselves from any potential complaint by offering referral? Afterall most insured clients are the ones who are most worried.

[/quote]

The vet can guide the client - they can offer their best advice and suggest what they consider to be the best course of action but at the end of the day its up to the client to make decisions based on the information, advice and options provided to them. I do believe that sometimes vets are put under a great deal of pressure to come up with answers in the quickest time possible yes.

I disagree that 'most insured clients are the ones that are most worried' I dont feel that if a client hasnt had the foresight to take out an insurance policy or has fallen on hard times and cannot now afford the insurance it doesnt mean that they worry about their animals any the less but it does mean they have less to spend on them and that when presented with different options may decide on course of action that is within their means. There are a few clients where I work now that have worked out that because of rising premiums, exemptions and big excesses it is more cost effective for them to drop their insurance all together and just buy their monthly meds

I am struggling to see where this thread is heading, but hopefully all will be revealed in an issue of the Vet Times at some stage.

Re: Pet insurance fraud

Kristina Clarke RVN — Tue, 24 Apr 2012 17:27:26 GMT

Vets are ethically bound to offer all options available to that client, and I think its reasonable to offer all the options to the client whether insured or not. On that basis I feel that it is the clients decision whether or not to refer with appropriate advice from the vet. I also think it is down to the integrity of the vet to be honest with the limitations of their own ability and know what other vets in the practice are also capable of. I have known situations where the owner of a practice has had the capabilities and beyond of carrying out some surgical procedures, but such cases were actually referred by assistant vets, not always new grads. Not only did this dent the profits of the practice, but it meant that the client had to travel for referral and deal with another practice unnecessarily. I think that wherever possible care should be given in house as far as possible before referral, but the option, and potential, should always be laid on the table from the offset.

Re: Pet insurance fraud

Helen Tottey — Tue, 24 Apr 2012 16:17:46 GMT

[quote user="Sal the 1st"]

Specialist referral or evaluation can be suggested to anybody insured or not and I dont think it is unreasonable if the person making the referral has already done all they can to suggest another course. I suppose a lot depends on the severity or the perceived severity of the complaint by the owner.

[/quote]

playing a bit of devils advocate here but who's decision is it to refer - the vets or the clients?

I agree that a lot of people come in saying "do whatever, i have insurance" so are clients putting vets under pressure for everything to be done and a diagnosis reached in 2 hours?!

Re: Pet insurance fraud

Sal the 1st — Tue, 24 Apr 2012 15:35:14 GMT

This is a question you should be asking the vets? - Specialist referral or evaluation can be suggested to anybody insured or not and I dont think it is unreasonable if the person making the referral has already done all they can to suggest another course. I suppose a lot depends on the severity or the perceived severity of the complaint by the owner.You even get owners requesting referral from the off ie I have known an owner who requested referral for full airway investigation because the dog snored - not that the snore was causing a problem to the dog but the owner said that they were having difficulties sleeping through it. I have also seen some dogs with breathing so noisy they could be heard from the other end of the car park before they even hit the waiting room and their owners think nothing of it and would probably look at the vet sideways if they even dared to suggest it - I dont think its all down to insurance . The snoring beagle was not an insured pet but the gasping bulldogs were insured to the hilt

Re: Pet insurance fraud

Helen Tottey — Tue, 24 Apr 2012 14:07:46 GMT

What about this thought - Are we too quick to jump up the treatment ladder when clients are insured.

Take for example an intermittent lame dog, xrays have shown nothing so it has been suggested she seeks specialist opinion (or at least send the xrays to be reviewed). Would the advice be the same if it wasn't insured?

The dog in question is a very active 4 year old pointer that lives with its sister and goes to the stables twice a day and runs around the fields. While the owner has tried to rest it, she hasn't been able to rest it as much as should and didn't seek vet attention until last week so no anti inflammatories given until then. Obviously clinical judgement comes in but it can;t be too bad as it races up the stairs....

Re: Pet insurance fraud

scubamoo — Tue, 24 Apr 2012 11:33:23 GMT

Hi There.

I have been in practice for over 18 years and have worked in SA, Mixed and referral setting. I have been asked numerous times is there anyway that we could lose records - regarding to when an animal has been seen for a problem so they can then get the pet insured and claim, also have had clients trying to claim for more treatment than the pet had (to cover the excess fee). One client also asked if I could sign a blank form so they could fill in the details later!!

All the clinics I worked at have had a set fee structure so everyone pays the same, regardless of whether they are insured or not.

Re: Pet insurance fraud

Saz jam — Mon, 23 Apr 2012 17:24:16 GMT

I found that many people were confused about whether to get pet insurance and who to go with so I wrote up a hand out to leave at reception, put in puppy packs etc. It is basically information on the different types of policies, accident only, lifetime and advice to read the small print. I also attach a list of the most common procedures and their costs. VIP is also a very good unbiased company where people can get advice on the best policy - kind of confused.com but they specialise in pet insurance.

I also have no hesitation in telling people NOT to use certain insurance companies -whether we're allowed to or not I don't care, i think the least we can do is warn people that make and effort to get their pet insured that there are some terrible pet insurance companies about!!

Re: Pet insurance fraud

Kristina Clarke RVN — Mon, 23 Apr 2012 15:19:53 GMT

I currently work in pet insurance as a veterinary tech advisor, and you are absolutely right on this - in my experience I think the majority of the pressure comes from the client. I have known a particular case where the vet had written a letter in support of the client because they were being physically threatened by the client. The complaint advisor who was dealing with the case rang and spoke to the vet, as the letter raised a few concerns as it did not tally with the clinical history. Upon speaking to the vet they confessed that the client had threatened them and they had written the letter under duress, they knew it wasn't covered under the terms and conditions of the policy but felt that they had no option. Its very sad to see, we felt very sorry for them. On the flip side, I have seen some quite a few claims from referral practices that raises a few eyebrows, especially when they are split into 'symptoms' and not 'conditions', but on the whole compared with the amount of claims processed within the department, we only see a few claims like this.

Helen, feel free to PM me, this is very interesting. Have there been any notes from this meeting at BSAVA made public? Was it this year?

Re: Pet insurance fraud

Helen Tottey — Sun, 22 Apr 2012 18:30:55 GMT

[quote user="Dippy"]

Maybe it's not the insured clients/insurance companies getting "ripped off" but the non insured clients getting a lesser service in some cases, simply due to their own finances?

[/quote]

I genuinley agree with this as we all know how treatment is often not given, short cuts taken or guess work having to be used due to financial constraints. Insurance fraud is probably far more likely to come from the client than the practice and although hopefully still in a minority of cases, i do think our profession needs to have some safeguards in place to prevent it becoming a bigger issue and in turn costing the honest majority.

Re: Pet insurance fraud

ginny — Sat, 21 Apr 2012 18:55:43 GMT

Competely agree with Dippy. If you have a very sick animal presented and you find it is insured its almost a feeling of relief because you know you can give that animal the best treatment you have available or refer to someone who can. Sadly the best is often the most expensive and that is in no way the fault of the vet or client.

It would be great to say the treatment regime is the same for all patients but in real life we are working to the finances of the client. Discussing cost is quite hard with some people. I think they find this hard because they have no human comparison in the UK - we have the NHS - and so have little or no idea how much certain tests and procedures actually cost.

Re: Pet insurance fraud

Sal the 1st — Sat, 21 Apr 2012 16:21:42 GMT

[quote user="Dippy"]

Just to throw another perspective into the discussion (not mine, I should add, but that of a vet I worked with a while ago), it could be argued that it's not a case of vets carrying out more procedures and therefore charging more just because a client is insured and therefore they can "get away with it" but that in fact they have their hands tied and cannot do all the procedures they would choose to if given free rein in order to make a diagnosis more quickly or easily in the case of the majority of non insured clients. If it were like the NHS system and they felt that a specific, though maybe expensive test or procedure would confirm something that they would otherwise have to treat symptomatically or diagnose by elimination, they would just be able to do it. Maybe it's not the insured clients/insurance companies getting "ripped off" but the non insured clients getting a lesser service in some cases, simply due to their own finances?

[/quote]

Yes I agree and I know a few vets who would as well

Re: Pet insurance fraud

Dippy — Sat, 21 Apr 2012 12:35:33 GMT

Re: Pet insurance fraud

Sal the 1st — Sat, 21 Apr 2012 10:53:06 GMT

[quote user="Helen tottey"]

I agree that people assume we are on some sort of commission so i tell people we do get something from them being insured - piece of mind we can help them more in the event of serious illness/injury! That normally shuts them up!

[/quote]

So Pet Plan have stopped giving out vouchers for the number of policies generated through a practice? - and I only know about these because a former employer used to share them out with staff in lieu of giving staff a Christmas box and Direct Line have stopped having periodic 'competitions' within one of the corporates offering chocolate as the prize for the practice that had filled in the most introducer forms? ( which could be the case now as I have been out of that corporate for some years) - ok it isnt a lot but insurance companies have (or still do?) offer incentives. Owners buying direct over the phone what are they getting? 12 months for the price of 10 cover or a 'free' cuddly toy. I am not suggesting somebody will buy a policy just on the basis of a free cuddly toy but every company out there is offering some 'incentive' to either the client directly or those that display their advertising or point clients in their direction - so when clients know about the chocolates or shopping vouchers yes they do think that a practice is tied to a particular company

What really surprises me is that the major pet food manufacturers havnt already launched their own insurance products - they are already present in most practices, could offer food as their incentive at little cost and good reductions on pets needing their Rx foods as part of the policy (and if any of them are watching this and take this on board please credit me with the idea!)