WHEN Pamela Hay’s dog Buddy was taken seriously ill in August, there was no question of whether she would fork out the £997 needed for treatment to save him.
The pooch had to undergo a lot of tests to figure out what was wrong and was eventually diagnosed with pancreatitis – a painful inflammation of the pancreas that can lead to death if left untreated.
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Pamela, from South Ayrshire in Scotland, wasn’t worried as she knew her policy with Perfect Pet Insurance would cover her fees.
So seven-year-old Buddy, a Bichon frise and Lhasa-apso cross, was treated at his local vet during the day and transferred to another vet for overnight care.
After spending three days in the clinics, Buddy was discharged and sent home to recuperate on August 2 and has now made a full recovery.
But while Pamela was so relieved to have him home, life got in the way and she didn’t get round to sorting out her claim with Perfect Pet for several weeks.
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When she found time to get all the required paperwork together, she realised she actually needed to make two separate claims, because Buddy had been treated by two different surgeries.
The daytime vet sent the papers back straight away, but the overnight vet said it would need up to 18 working days to get all the forms over to the insurer.
By the time the overnight vet sent its form back, it had been 91 days since Buddy came home.
Pamela’s policy had a 90-day limit for making a claim, so Perfect Pet Insurance refused to pay up.
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Pamela thought this was extremely unfair as even though Buddy had come home on the second of the month, his medical records show that his formal discharge from treatment was actually August 3.
On that basis, it would have been 90 days, meaning her claim was within the timeframe.
But the insurer dug its claws in and Pamela was left almost £1,000 out of pocket.
Thankfully, after our consumer champion stepped in and explained the situation, Perfect Pet rang Pamela and said it had decided to honour her claim.
While the original claim was for £997, there were deductions based on other clauses in the insurance policy so Pamela has got back £463.70.
But she’s still thrilled with the result after fearing she would get nothing.
The case serves as a reminder not to put off life admin as it could end up costing you a pretty penny down the line.
Our Squeeze Team has now won back more than £158,000 for readers.
Can I complain if my insurer won’t pay out my claim?
If your insurance claim is rejected and you don’t think the reason was fair, you can make a complaint directly to your insurer.
Talk to them first and explain why you’re not happy with their decision. It might have been an automatic rejection that more information or paperwork could overturn.
If your insurer still refuses to budge, ask the firm about its formal complaints procedure.
It should show you how to do this and insurers are obliged by the city regulator, the FCA, to respond to formal complaints within eight weeks.
If your insurer doesn’t respond in this timeframe or you’re still not happy with the outcome, you can complain to the Financial Ombudsman Service (FOS).
The FOS is an independent body for resolving disputes with financial companies. If the Ombudsman finds in your favour, it will tell your insurer what it needs to do to put things right.
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You can complain to the FOS for free without using a third party, which may charge fees. If you need help making a claim, the FOS should be able to guide you through the process.
You can ring the FOS on its helpline on 0800 023 4567.
You can also join our new Sun Money Facebook group to share stories and tips and engage with the consumer team and other group members.
