Injured dog - insurance exclusion?

[ivrytwr3]

Our dog has recently sustained an injury, in that when she was jumping in the car, she mis-judged and fell back injuring her back leg.

We waited a little while and as it wasn't getting better we have taken her to the vets, she has been diagnosed as suffering a cruciate ligament injury requiring an operation at approx £2k.

We have always insured her, however, reading the finer details of the policy it states:

"you accept the policy will not insure:

blah
blah
any cruciate ligament problems, however caused (accident only)."

I'm unsure as to whether we are insured for the operation as the injury sustained was caused by an accident.

Any ideas?!

 

[Thekwango]

Reads to me as they won’t pay out for it if it has been caused by an accident, irrespective of how the accident happened. I assume they would however if the injury occurred naturally (is that even possible though)

 

[Mercutio]

I think they'd probably cover anything where they'd have someone else to blame, who could reasonably pay up. So... accidents, being basically blameless... I dunno, but I think you might be out of luck Hope the pooch is better soon one way or another. Sucks as it's gotta be fixed, will check my dogs policy and see what they want to add it

 

[Brizzles]

Our dog has recently sustained an injury, in that when she was jumping in the car, she mis-judged and fell back injuring her back leg.

We waited a little while and as it wasn't getting better we have taken her to the vets, she has been diagnosed as suffering a cruciate ligament injury requiring an operation at approx £2k.

We have always insured her, however, reading the finer details of the policy it states:

"you accept the policy will not insure:

blah
blah
any cruciate ligament problems, however caused (accident only)."

I'm unsure as to whether we are insured for the operation as the injury sustained was caused by an accident.

Any ideas?!

From a totally non professional point of view, the underlined points say no.

Sorry to hear about your dog, hope it gets sorted

 

[Malevolence]

I'm unsure as to whether we are insured for the operation as the injury sustained was caused by an accident.

How difficult would it be to simply say you were out walking the dog when it suddenly started to yelp and couldn't walk properly? Just don't mention the jumping about in the car part, it's not like the dog is going to slip up and land you in the **** is it?

 

[Pestilence]

How difficult would it be to simply say you were out walking the dog when it suddenly started to yelp and couldn't walk properly? Just don't mention the jumping about in the car part, it's not like the dog is going to slip up and land you in the **** is it?

This.

 

[woppy101]

How difficult would it be to simply say you were out walking the dog when it suddenly started to yelp and couldn't walk properly? Just don't mention the jumping about in the car part, it's not like the dog is going to slip up and land you in the **** is it?

This ^^^^^ the ******* rinse us out of enough, it’s about time we got some back

 

[touch]

How difficult would it be to simply say you were out walking the dog when it suddenly started to yelp and couldn't walk properly? Just don't mention the jumping about in the car part, it's not like the dog is going to slip up and land you in the **** is it?

That's still going to go down as an accident though. The only difference being that in your story he doesn't see the accident happen. A vet is going to be able to tell if the injury is a result of a recent event or an underlying condition.

 

[ivrytwr3]

That's it, I don't actually understand the wording - the first part says it doesn't cover this type of injury and then in brackets it does if it is an accident?

If so, what constitutes an accident?

 

[jpaul]

presumably there are no optional policy options ? that the clause 'accident only' refers to.
eg an accident only versus a long-term/genetic illness (fully-comp) option.
so provided you toook all the options, the crutiate would not be excluded.

... post more of the policy ?

 

[dowie]

any cruciate ligament problems, however caused (accident only)."

I'm unsure as to whether we are insured for the operation as the injury sustained was caused by an accident.

Any ideas?!

Well you don't know for sure that it was an accident, that she didn't have an ongoing issue and that jumping in the car was the last straw... I mean I'm not sure that a dog doing normal dog things (jumping around, falling over) is really an "accident" per say?

I mean if you hadn't witnessed the car incident that you're assuming caused it what would you be doing now? Presumably you'd be making a claim and telling the vet that she's just recently started limping and you don't know what caused it.

I'd personally be tempted to do the same here and just say you took her out of the car one day after a journey and she was limping.


Just one thing - are you sure that accidents aren't the exception - i.e. that it does cover them? I mean that would make more sense i.e. not covering the general issues lots of dogs might get as they grow old but do cover the one off events.

 

[Pestilence]

Well you don't know for sure that it was an accident, that she didn't have an ongoing issue and that jumping in the car was the last straw... I mean I'm not sure that a dog doing normal dog things (jumping around, falling over) is really an "accident" per say?

I mean if you hadn't witnessed the car incident that you're assuming caused it what would you be doing now? Presumably you'd be making a claim and telling the vet that she's just recently started limping and you don't know what caused it.

I'd personally be tempted to do the same here and just say you took her out of the car one day after a journey and she was limping.


Just one thing - are you sure that accidents aren't the exception - i.e. that it does cover them? I mean that would make more sense i.e. not covering the general issues lots of dogs might get as they grow old but do cover the one off events.

It could go either way, so I'd lead the conversation with that question: What's the exclusion all about?

If they say it's because accidents are excluded, then you say "good to hear, because we've just had her diagnosed with the issue and it was sudden onset while out for a walk. Nothing unusual."

If they say it's because ONLY accidents are covered, then you tell them the dog missed the car jump and got hurt.

 

[Minstadave]

That's still going to go down as an accident though. The only difference being that in your story he doesn't see the accident happen. A vet is going to be able to tell if the injury is a result of a recent event or an underlying condition.

I'm not sure vets are that good. I'm always surprised by the lack of competence shown by a lot of vets.

Your regular vet isn't going to be an expert on cruciate ligament disease in a dog.

 

[ivrytwr3]

OK, i think i have figured this out. The Accident Only in brackets refers to the Accident Only policy ie there are different levels of cover, Premier, Classic, Basic and Accident Only.

We have the Classic cover and reading the full policy for Classic it states: Any treatment for cruciate ligament (within the knee) problems within the first 14 days of your cover start date will not be covered.

So I think we are ok to claim!!!!!

 

[jpaul]

OK, i think i have figured this out

just surprised how the folks who replied are unfamiliar with the way policies are written. ... you should read them when you take them out,

 

[mattyy]

"you accept the policy will not insure:

blah
blah
any cruciate ligament problems, however caused (accident only)."

I read that as the policy does not cover any cruciate ligament problems with the dog unless caused by an accident.

Having read the above reply, my interpretation would also tally up if it was only a clause for the 'accident only' cover.

 

[Haggisman]

OK, i think i have figured this out. The Accident Only in brackets refers to the Accident Only policy ie there are different levels of cover, Premier, Classic, Basic and Accident Only.

We have the Classic cover and reading the full policy for Classic it states: Any treatment for cruciate ligament (within the knee) problems within the first 14 days of your cover start date will not be covered.

So I think we are ok to claim!!!!!

Was about to post this, pretty sure I've seen a similar clause in a policy before, is it Tesco by any chance?

 

[ivrytwr3]

Was about to post this, pretty sure I've seen a similar clause in a policy before, is it Tesco by any chance?

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