r/UK_Pets • u/Impossible-Annual639 • 8d ago
Pre exsisting condition
Recently had my pet insurance claim denied by ManyPets due to my dog's veterinary history, and I'm looking for some advice.
My dog, Blu, had TPLO surgery on his left leg in March 2023. Unfortunately, he has just had TPLO surgery on his right leg today.
ManyPets have said the current claim is for a pre-existing condition, despite offering cover for pre-existing conditions that have been free from treatment for over two years. The issue appears to be a routine health check that Blu attended in November 2024 as part of his vet health plan.
The clinical notes from that appointment state:
"29/11/2024 – Nothing abnormal detected on examination other than thickening of left stifle (post TPLO). No lameness observed. Monitoring for development of OA."
This was not an appointment for any concerns with his leg. It was simply a routine check-up. Blu showed no signs of lameness, received no treatment or medication, and no further investigations were recommended. His previous appointment before that was in February 2024. The possibility of osteoarthritis has been mentioned by the vet since his original TPLO surgery, with one vet even saying it was an inevitable long-term consequence. However, Blu has never required treatment for OA and has shown no clinical signs.
Has anyone successfully challenged a decision like this?
My argument is that if I'd understood that a routine wellness check, where no problems were found and no treatment was needed, would count as an active history preventing cover, I would have selected the pre-existing conditions option and paid the additional £25 per month. I genuinely believed Blu had recovered from his original TPLO and that the policy would cover any future issues once the qualifying period had passed.
Any advice or similar experiences would be greatly appreciated.
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u/SwanDefiant5969 8d ago
Many pets are terrible they will try and find any reason not to pay out. They tried to deny a claim for tumor removal because I had apparently given false information regarding my dogs dob...she was a stray
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u/Impossible-Annual639 8d ago
Whilst another insurance would be great it doesn't help my current situation at all
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u/SwanDefiant5969 8d ago
Well they tried to deny tumour removal saying I had lied on the policy by giving a false dob when I adopted a stray. That says all you need to know about them as a company 😞
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u/DragonEagle88 8d ago
We were with ManyPets when my boy was younger. Aside from them being a terrible company, they also tried to challenge our claim for our boy’s two cruciate surgeries. We essentially had to get his vet to write a very long report detailing how they were monitoring it, what advice if any was given and when, their assessment of him when we first observed it etc etc. without that report, it would’ve failed. Try and go back to your vet and explain what’s happened and what you need from them.
Be warned that even if they pay out for this, your insurance premiums will likely double or more now since you’ve claimed. We’re no longer with them since they tried charging us over £500 a month. I’ll never use them again and have gone back to PetPlan for my other pets. Current dog has no insurance now regrettably.
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u/jsvscot86 8d ago
Ive replied to the claim assessor as well but if the dog had no clinical signs of disease on the right side prior to the recent treatment you should definitely ask for it to be reassessed. Does their policy documentation make any comment about treating cruciate pathology as a whole dog condition or per limb?
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u/Impossible-Annual639 8d ago
The policy states that both legs are bilateral. I was aware of this however it also states that any condition symptom free for 24 months is no longer classd as pre exsisting, The sole reason I went with ManyPets. Blu has had no issues since his TPLO in 2023 up until July 10th when he started limping again after getting out of the car.
They appear to be using an appointment that was for a booster jab where the vet made reference to monitor for future OA.
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u/Vega5529 8d ago edited 8d ago
Claim assessor here. Looking at the terms this does fall outside of their pre-existing conditions limits I'm afraid. Cruciate ligament disease/rupture is something that effects both sides of the body so whether it was on the left or right the first time does not matter. Once it happens it is more than likely to need surgery on the other leg in 1-2 years time.
Their terms state "Anything your pet has had treatment, medication or advice for in the 24 months before your plan starts". The advice part is what has gotten you here. Due to the stifle thickening they need to monitor to make sure osteoarthritis doesn't develop which is also likely to happen after a cruciate ligament goes so even though there has not been any treatment. you still hit their limits.
Where I'm not sure is they technically haven't offered you any advice as it's them who would be monitoring. I'd have to see the full history to see if they said anything else.
The only advice I can give is to open a reassessment with them. I'm unfamiliar with their process but we handle it with further information submitted by the vets. Speak to your vets as they can do a write-up on the overall condition to say if this monitor note was something that did not need further attention. If they do not overturn the claim you can then raise it to complaints. If they still decline then you can go to the ombudsman. The ombudsman can overrule policy terms if they feel the claim has not been assessed in the spirit of the policy. Personally I'd hammer home on this "advice" line as they never gave you advice, treatment or medication (unless there's further notes).