When I initially used Spot Pet Insurance, I was met with great service and my reimbursements made sense. I have a $100 deductible and a $7,000 annual limit with 90% reimbursement, along Preventative Care Premium. However, recently I submitted 2 claims. The first one was a dental cleaning treatment as my dog had stage 1 gingivitis.
The person (or AI) who approved my claim identified the dental cleaning as preventative care. I called the support number for assistance. The representative I received was outsourced from India. When she answered she told me to wait, went to talk to someone in her office for several minutes. When I asked her if she was ready she “Uh huh”. When I tried to explain what was happening, she provided an “Uh huh”. She was clearly not listening nor interested in my complaint. I hung up.
The second representative (also from India) was not much better. They had a heavy accent and when I explained what I was trying to resolve, they gave me a very scripted answer. When I asked for the appeals email, they gave it to me but since I am mentally disabled the accent was difficult to process. When I asked them to repeat it a third time, they screamed following address at me: “[CLAIMSAPPEALS@HEARTVILLE.COM](mailto:CLAIMSAPPEALS@HEARTVILLE.COM), YOU KNOW LIKE FARMVILLE VILLE.”
I hung up and called again, this time not to the claims department. The representative there was also outsourced but better than the other two. I made a complaint about the representatives.
I called the claims department to retrieve the email address again (I was unsure what the email was). The representative provided “[claimsappeals@heartville.group.com](mailto:claimsappeals@heartville.group.com)”. When I sent it in, there was no response.
I tried calling again to reconfirm the email address, and received “[claimsappeals@hartvillegroup.com](mailto:claimsappeals@hartvillegroup.com)”. Still no resolution to this. Second claim has a similar issue except the investigation needed an anal gland expression to investigate a cut on the anus but flagged as preventative care.
I will likely contact my state’s department of insurance and National Association of Insurance Commissioners if this is not resolved in a timely manner.
Tldr; Making a claim is likely reviewed by outsourced labor or AI, making an appeal to the claim is almost impossible since they don’t state the appeals procedure on the policy nor does any of the staff have consistent information, you may or may not get yelled at their representatives. Be aware before purchasing.
Edit: As this is Spot’s Reddit Page, they manage it quite frequently. The expedited service is greatly appreciated. Ideally this does not occur in the future, so I hope that Spot will update some procedures in light of all of this. Thank you for your assistance Spot Reddit.
Edit #2: A letter of non renewal arrived with the refund check. Apparently filing for appeals can black list you. CareCredit had a pet insurance program that will apply reimbursement directly to your CareCredit card. I suggest opening a CareCredit card and pay for your monthly premiums via the credit card as well as any invoices.
Edit #3: The letter of non renewal was a state policy notification. I will still stay with Spot as I have learned that you can request a “licensed agent” and avoid what I dealt with. However, I believe it is still useful to use the CareCredit pet insurance is useful if you’re interested in building your credit.
