COBB COUNTY, Ga. - Pet health insurance is a billion-dollar industry that's expected to double in the next three years.
Channel 2 consumer investigator Jim Strickland found complaints that one well-known company allegedly refused to pay legitimate claims.
"Pets are like members of the family and you love them, and when they get sick it’s scary," said Jodie Knapton of Sandy Springs.
Knapton bought insurance from Nationwide to cover her rabbit's vet bills.
When the animal, named Cookie, stopped eating and showed signs of a digestive problem, Dr. Stuart Colby found the bunny's rear teeth were overgrown and painful.
"That was either the cause or exacerbating why Cookie wasn’t feeling well. And when they don’t feel well, they don’t eat," Colby said.
A lab test also showed the rabbit had common parasites called coccidia. Colby says that was a non-issue.
"I didn’t even consider the coccidia a pathogenic problem, so I didn’t even treat for it," he said.
But Nationwide, citing an exclusion for parasites in the policy, denied the largest part of the claim.
Knapton ended up paying nearly $690.
"I freaked out," she said.
"We think insurance is a safety net, and they found a way out," Colby said.
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Colby said Nationwide never asked whether parasites were the issue.
"That’s very disappointing to hear. Because at minimum you would think that Nationwide would pick the phone up and have a brief conversation with the veterinarian," Georgia Insurance Commissioner Jim Beck said.
According to consumeraffairs.com, Nationwide's pet insurance has earned dozens of one-star reviews in the past year because of denied claims and delayed reimbursements.
When Strickland got involved, Nationwide told him the "...claim was reprocessed, and Ms. Knapton will be reimbursed."
Nationwide pays claims based on a set of charges it considers reasonable for each diagnosis. The list was formulated in the year 2000 never updated.
In Cookie's case, Nationwide would pay $81 after deductible on a $510 dollar bill.,
The dental work was an additional $105 dollars. Nationwide offered to pay $18.
"If this is how you have to make money, you don’t have a viable business model," Knapton said.
About their outdated prices, Nationwide told Strickland, "We look forward to evolving plan options for avian and exotic pet owners in the near future."
Strickland sent the dated payment schedule to the insurance commissioner. It's now part of his investigation.
"This idea of sort of saying no and making you jump through a bunch of hoops to get it covered, that’s not how it’s supposed to work," Colby said.
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