Pet Insurance Don't Get Done Get Dom

I've been fighting your consumer battles for years,

but there are still many companies out there trying to get one over on you.

As long as the cash register goes "ching, ching, ching", that's all they care about.

Thousands of you are still subject to an array of unfair treatment,

from poor customer service to hidden small print

and faulty products.

What can we do? Make a complaint maybe that will get lost in the telecommunications abyss.

'These companies simply don't seem to care and are causing you,

'the consumer, a lot of unnecessary stress, but never fear...'

I'll take on your consumer battles to make sure that you don't get done.

Whenever you get a new pet, you'll welcome it into your house like another member of the family.

And being a responsible pet owner, you'll probably want to get pet insurance,

but just when you think you're automatically covered for a claim,

you might find you're barking

up the wrong tree. Eh, Freddie? Barking up the wrong tree... I know!

'This is Carolyn Veebel who lives with her two sons, Ross and Luke, in Leicester.

'They have a dog, Archie, a young and chirpy spaniel that they all adore,

'but looking after him has proved to be more challenging than any of them were expecting.'

We bought Archie in March 2011

and we did go to see him when he was a tiny puppy.

And then we went to pick him up in the March of 2011,

brought him back here

and he became a significant part of the family.

They give you a reason to get up in the mornings.

They give you a reason to come home.

When you come in the front door, they're always excited to see you.

'As a responsible pet owner, Carolyn had Archie fully insured as soon as she got him.

'She had insurance via The Kennel Club and when it came close to renewal time,

'she looked on the internet and found a similar policy was available from someone she trusted.'

I read down the list of the various different insurance premiums

and I saw that Sainsbury's was on there and as Sainsbury's is one of my trusted companies...

I shop with them, I have my house insurance with them, I've had all sorts with them over the years.

They provided insurance for long-term care. Their premium was reasonable, so I chose to go with Sainsbury's.

Archie, come on, walk!

'Archie's new insurance policy was set to start on the same day his old one ran out.

'It seemed a straightforward decision, but to Carolyn's horror,

'it later had massive significance.

'A short time after the new policy started, Archie was diagnosed with cancer.'

I did think we might lose him.

You do start to think then that it might have spread,

then you start worrying about what you're going to do with him.

'She hadn't expected to have to make a claim on her new insurance so soon, but when she did,

'she was in for a shock.'

And it wasn't until just after Archie had had

all the initial investigations with the vets at Solihull

that they turned round and said no, they weren't paying.

I was devastated. I wasn't sure what I was going to do.

The boys, Luke and Ross, were just adamant

that he should go ahead and have all the care that he needed

and I shouldn't think about the cost.

'Claiming on the insurance didn't go as smoothly as Carolyn hoped and she has ended up having to call me in.'

Poor little old Archie, the Springer spaniel has been a little bit Tom and Dick - sick,

so I've come to Leicestershire to meet his proud owner Carolyn

and find out about the problems she's had with Sainsbury's pet insurance.

KNOCKS ON DOOR

-Morning! Carolyn?

-Hello. Pleased to meet you.

-And lovely to meet you.

-It's taters out here. Can I come in?

-Come in.

-Taters in mould - cold!

-Where did the name Archie come from?

-The boys chose it.

-OK.

-I wanted to call him Logan.

-They wouldn't let me. They chose Archie. I don't know why. They just wanted to.

-Cool enough name.

'There's an awful lot of love for Archie in this family, but not a lot of money.

'I need to establish a few facts to see why the family's pet insurance won't pay out

'when their pet needs it most.'

So when did his Kennel Club insurance run out and the Sainsbury's one start?

-On the 7th of April.

-That's when the Kennel Club insurance ran out?

-Yes.

-When did you get the Sainsbury's one to start?

-On the 7th of April.

-So there was no period when he wasn't insured?

-No.

-Good for you.

So what went wrong?

About a week after the Sainsbury's insurance started,

my eldest son came running out of the house carrying Archie

-because in his saliva he'd got blood running down his face.

-Right.

We took him inside, bathed his mouth, looked inside his mouth, couldn't see

anything, assumed he'd scratched himself as he'd been in the garden.

And that was it, no more sign of any blood.

But to be on the safe side, on the Monday, I rang the vet

and said, could I come down and have Archie checked out?

And they said that he'd got a lump on his gum

which had become infected, hence the blood.

At this point, how old was Archie?

-A year and five months.

-So he should be really in the prime of his life and very healthy?

-Yes.

So they then had him in to our local vet's to do a biopsy and X-rays.

The biopsy was sent off to the labs, but at this point, they then knew that it was almost certainly cancer

because the X-rays showed that the bone was too light.

On the X-ray, you get a dark to light and the bone was too light.

At this point, had you been paying the vets for these inspections?

Yes, at this point, I'd been paying them, but I had made Sainsbury's aware after the biopsy

that it was likely that he might have something wrong with him

and at no point did they say you weren't covered.

Were you also quite confident that, whatever the problem was,

you had an insurance policy that would pay for it?

Yes. The only thing that was worrying me was that Sainsbury's weren't coming back to me.

They weren't saying anything, and every time I phoned to say, "Is the claim OK,

"can I take him to the specialists,"

they were saying, "It's still being looked at."

'With the list of expensive treatments for Archie building up,

'no wonder Carolyn was keen to get confirmation from Sainsbury's that they were covered.'

-How many times did you have to chase them?

-Ten times, probably.

-Easily.

-And when you told them how much the bill was likely to be, how much was that?

At this stage, I think we were on about 2,500.

Are you saying by that it's still rising?

Yes. The vets warned me that if they could operate, it would be another £3,000.

-£5,500?

-Yes.

Can you afford that?

No, I can't afford it.

'And with the bills rolling in, Carolyn heard from Sainsbury's.'

At this point, had Sainsbury's said to you they wouldn't cover Archie?

Yes. Once they got the actual invoices from the specialist vets

for this initial CAT scan and everything, they turned round and said they weren't covering him.

'It seems there was a clause in Archie's insurance policy.'

What was the exclusion, written in the T's and C's, obviously? What exactly was it?

That if an animal has a condition which then becomes apparent within the first 14 days of that policy,

they will not pay anything towards that condition at all, ever.

How do you feel about that?

I think it's disgusting. If you had no knowledge of an animal being ill when you took that insurance out

and you had insurance up to the day that you took the new insurance out,

how can they say you should be aware of a pre-existing condition and that they won't cover it?

It completely negates the reason for having insurance.

'The clause is designed to stop people taking insurance out when they find their pet is already ill,

'but that's not what happened here.'

Common sense says if you knew something was in the background, you wouldn't suddenly change company.

-No.

-It ain't rocket science.

-No.

Sainsbury's should be looking at this sympathetically.

'Carolyn didn't have any savings to cover the cost of the treatment, so someone else paid Archie's bill.'

It came down to my son to give up his savings that we had been saving for him since he was a baby.

-How old is your son?

-16.

What was he saving up for?

It was for his future, so, for university, house, car.

'But for Ross, it was a no-brainer.'

Ever since I heard that he had cancer, I was devastated, absolutely devastated.

The insurance wouldn't pay for it, so Mum was saying, "What are we going to do, then?"

I said, "The only option is my savings." I offered.

I didn't care about the money. I just wanted him to be safe.

What have Sainsbury's said? Have you had a moan at them about it?

I went down the correct route. I wrote to them and said I wasn't prepared to accept

that they weren't going to cover him and that I would take it further. They were warned.

Having got an answer from them for that, I went on the Insurance Ombudsman's site.

It recommended on the Insurance Ombudsman's site that before you wrote to the Ombudsman,

you had to contact the insurers and get their underwriter to look at it.

'She contacted Sainsbury's, hoping their underwriter would look at it,

'as the Ombudsman's website had advised.

'After a long wait, the only reply she received was to tell her that she should be writing to AXA

'as they underwrite Sainsbury's pet insurance. The letter has been sent

'and Carolyn is still waiting for a reply.'

-What does Sainsbury's as a brand mean to you?

-We do all our shopping there.

My parents and I have always shopped at Sainsbury's.

They started the financial services. I have their Nectar card. I have had their credit card.

I've had loans from them.

I have my house insurance through them and I've had car insurance through them before.

-You liked them, you trusted them and you did everything you could do via them?

-Yeah.

'Rules or no rules, I think Sainsbury's is in danger of losing a good customer here,

'but I want to get involved for her sake, Archie's and her son's savings.'

When I get on to Sainsbury's insurance company, I can't say to them they've done anything wrong.

It seems very, very unfair. I can see why they've got it in there.

What I can do is explain your situation which I'm hoping might be what's happened.

Yours has gone into the system, it's happened within 14 days, not covered, please tell her, end of.

I think people need to look at your case on its merits.

The dog was insured, he's very young, you knew nothing about it, you were very honest,

you reported the illness the second you saw it,

you had insurance prior to that and you're an existing and very loyal customer to Sainsbury's.

But don't hold your breath because it's the sort of thing we might not be able to sort out.

-It might be all we can do is highlight it to people.

-That's fine.

-OK, I'll see what I can do for you.

-Lovely. Thank you very much.

-OK.

Oh, a bit of an awkward one, this, because Sainsbury's haven't actually done anything wrong.

They're just sticking to their rules and the T's and C's, but Carolyn is way out of pocket.

I've got to try and get Sainsbury's to turn their decision round. That'll be a tough one.

'Sainsbury's is, of course, one of Britain's biggest food retailers,

'but they're also putting their name to insurance products,

'in this case backed up by the giant AXA group,

'another household name.

'The size of those two might put some people off, but that's exactly why I want to highlight this case.

'I want to get Sainsbury's on the phone. Carolyn found their insurance department tricky to get hold of,

'but I'm hoping to be able to jump the queue and get through to the right people.'

Hi, it's Dominic Littlewood calling from the BBC.

I wanted to speak to somebody about a customer who has a complaint with pet insurance. Who would that be?

I do. Carolyn Veebel.

'I can't play the call centre worker's voice to you, but she wants me to send over some e-mail details.'

She seemed to go totally on the defence when she realised it was me.

She didn't want to give names out and was very...

She sounded like she was shook a little bit just by the name.

Whether it was the BBC or mine, I don't know.

'Maybe I'll try a different line of questioning.'

You might be able to help me. I might not even need to ring them.

With your yearly insurance policies with pets, when it says "yearly", does it cover you for 52 weeks?

'There's a lot of "umming" and "ahhing" on the other end of the phone, but no straight answer.

'Someone's going to call me back.'

Can't you even answer that question?

'More "umming" and "ahhing" and she's still refusing to answer a simple question.'

OK, that simple question you can't even answer.

'She's absolutely insistent that someone else will have to answer my very simple question.'

Thanks for your time. Bye-bye.

You heard the question. I said, "How long does your yearly insurance plan cover somebody for?

"52 weeks?" I even gave her the answer and she said, "Somebody else will give you the answer to that."

They're on the back foot. This is a big company. Come on, Sainsbury's!

' I've been told I need to ring Sainsbury's Bank Press Office.

'Sainsbury's have done nothing wrong here and I want to explain that we understand their policy

'of not paying out for new diseases is to stop potential fraudsters,

'but when I get through, I want to explain to their press officer, Natasha,

'that there was clearly never an attempt at fraud here.'

I think that's right and what you're doing is covering yourselves 100% for new policies.

In her case, it's pretty obvious that wasn't what happened

because no-one would change insurance companies

if they knew they were about to make a claim.

No-one in their right mind. You'd agree, Natasha?

'And she's telling me... Well, nothing much, actually, because she won't comment.'

Yeah, OK. I know you don't want to actually say it,

but no-one would change their policy if they knew their animal was about to become ill.

We can safely say this is just an unfortunate set of circumstances.

'I want to give Sainsbury's an idea of what sort of person Carolyn is

'if I'm to stand any chance of changing their minds.'

She's not just insured her dog with you.

She's also currently got her house insurance with Sainsbury's.

She's had a Sainsbury's credit card, she's had her car insurance and a loan with Sainsbury's,

plus she shops there weekly and she can prove that with her Nectar card statement.

She's as loyal as she could be to Sainsbury's. I'll let you know what I'm hoping for as an outcome.

I would just love Sainsbury's to look at this case sympathetically

and take into account everything that's happened,

her history with Sainsbury's, it's pretty obvious it's not a scam,

and see if you could, however you want to word it, put it as a goodwill gesture or whatever,

if we could try and get this bill paid.

Thanks, Natasha. Bye-bye, then.

What I like about this job is when you eventually speak to somebody who's really nice and charming.

That was a lady called Natasha. She called me back from Sainsbury's, so I returned her call.

She was 100% lovely, charming,

and I feel relieved because most of my calls are full of aggravation.

We know that Carolyn's dog wasn't covered for illness in the first two weeks of her policy

and we've seen just how badly that all turned out.

But the question is, had she used a completely different insurance company altogether,

would she have avoided the problems?

'I've given Carolyn a bit of a homework assignment.

'She's going to research three insurance policies provided by completely different companies

'and see if they would have covered Archie for the first two weeks.

'She'll feel pretty sick if she finds out that all the other

'companies would have paid her costs.'

We're starting with Aviva.

'Carolyn's looking through their site

'to see if it actually displays the information about what they won't cover you for.'

I've found it. It's saying if your animal falls ill

within the first ten days of the policy, you are not covered.

'Ten days. And how easy is it to find out important details like that?'

If you were taking out this insurance and you actually went and had a look at the policy conditions,

you would have to search through until page 16

and read the whole policy and understand it.

'Let's see what other insurers are offering.

'How about another household name?'

I'm going to search Tesco's pet insurance and see if they have any general exclusions.

I found it. It is on page 16.

This time, it is Section three.

"The cost of any treatment for an illness that first showed clinical signs

"within 14 days of the date your pet's insurance started," you are not covered.

'So, Tesco's insurance also has an exclusion period at the start of a policy.

'The next insurance company up is Petplan and again we're checking if there are any exclusions

'at the beginning of their cover period.

'Carolyn's finding it hard to get that crucial information on exclusions.'

If I can't find it within the next couple of pages, it looks as though I'll have to ring them to ask them.

Hello, yes... I'm looking at your policy terms and conditions.

'I think the information is there, but Carolyn can't find it.

'I'm beginning to see it's not so simple to find out what's excluded from your policy.'

What I need to know is whether there's an exclusion

in terms of an amount of days when the policy first starts.

'Sure enough, like the other two, they also have an exclusion period.

'It looks like Carolyn didn't just choose a duff policy. Exclusions like hers are common practice.'

Right, so that's the same as everyone else.

They have a 14-day exclusion policy

and she actually stated

that if your dog was diagnosed with diabetes eight days into the policy

that that diabetes would not be covered under the policy as a pre-existing condition.

It shocks me that the insurance industry as a whole actually all apply this exclusion clause

and that they have been allowed to do it.

'So, Archie here wouldn't have been covered by any annual policy

'which bugs Carolyn and probably other dog owners too.

'Maybe an expert can explain why policies are set up like that.

'I've come to the Association of British Insurers.

'I'm here to meet Adeola Ajayi, their media relations executive.'

-Adeola, lovely to meet you.

-Good to meet you.

'I hope she can shed light on why an unpopular practice is so common with pet insurance companies.'

Why is it that some insurers, if not all of them,

are putting a two-week clause in at the beginning of a policy?

The first thing is insurers want you to understand your policy when you take it out.

It is standard, however, for pet insurance policies to have a two-week period

where you can't claim for any illnesses. Any injury is covered in that two-week period.

To put it frankly, it's to prevent fraud.

That means people are paying for 52 weeks' cover, but they're only covered for 50 weeks,

as far as illness is concerned.

I think it's important to remember that in the first two weeks of a pet insurance policy,

you are covered if your pet has an accident or an injury.

Now, we don't have this cover for the illness in the first two weeks and there's very valid reasons for that

in terms of preventing fraud.

Last year, I think we detected about £800,000-worth of pet fraud,

but most claimants are honest and we want to make sure they don't end up paying for those that are not honest.

'The insurance companies think not covering the first two weeks

'will stop people from discovering their pet has an illness,

'then taking out an insurance policy to cover vets' bills.

'That would be classed as fraud, but most people don't seem to realise about this exclusion

'and insurers aren't exactly shouting about it.'

I think people, yes, do need to be aware of the exclusion.

So, the only way somebody can be 100%-insured all the time is never to change policy?

You're still insured during the two weeks for injury,

but not for pre-existing conditions to prevent fraud.

Or not for any new illnesses that rear their ugly head in that period?

But you can claim after the 14-day period has ended.

I need to hammer this home - only if the illness rears its ugly head after the 14-day period.

'We've asked Sainsbury's if they would reconsider their decision

'and they came back to us with an offer of around £3,000,

'but the total bill came to £5,000.

'I've had to e-mail them back and ask if they would increase their offer - awkward.

'I've heard back from them and I'll be updating Carolyn in a moment.

'Now, I think this is an issue that could be affecting thousands of pet owners.'

With so many different pet insurance companies out there,

what exactly should we be looking for when we're thinking about taking out a policy?

And how can we be sure we're paying the right money for the best one?

'Robin Hargreaves is President-Elect of the British Veterinary Association.'

If a problem arises during the waiting period, they won't be covered

and that's disappointing if you've taken out a policy and are committed to a 12-month standing order.

There's very little you can do about that. The best prevention is to get the healthiest puppy you can.

Go to a reputable breeder, do your research.

Get something that looks right. If it looks right, there's a better chance that it is right.

'But is insurance for pets the right idea?'

The key benefits of pet insurance

are obviously worry-free access to the best care your vet can offer you.

You'll get third-party liability in case your pet causes an accident on the street.

'Robin has a warning for all of us.'

Be careful about shopping around for insurance. We're all encouraged to look for lower premiums

for house and car insurance, but it's a different game with pet insurance because of pre-existing conditions.

If you shop around and find a cheaper policy,

anything recorded on your history at your veterinary surgeon before that date is a pre-existing condition.

This won't be obvious when you go on a comparison website.

The danger is you go for a cheaper premium and you lose the cover for pre-existing conditions.

'Think hard about whether you need to make that change. It turned into a lot of trouble for Carolyn.

'Speaking of Carolyn, I've got some news to give her from Sainsbury's.

'And I'm looking forward to seeing my buddy Archie as well.'

-Hi, Carolyn. How are you doing?

-Hello.

-Archie, come on in, buddy. How are you doing?

-Come on, then.

-He's all excited, isn't he?

Come on, then.

Archie, I've got to say, you are looking very, very well-behaved.

The last time we met, your situation wasn't that great.

You were £5,500 out of pocket for operations on Archie,

-money which you didn't have, so you had to borrow it off your son.

-Yes.

He was only 16, so it came out of his savings for university.

-It was all a bit of a mess, wasn't it?

-Yeah.

-There was no real light at the end of the tunnel.

-That's right.

You had a very good argument. He was insured right up to the point when you took out Sainsbury's insurance

and that's what I said to them when I spoke to them.

I had to be quite careful about what I said.

I said to them, "Carolyn has been an exceptional customer,

"she's had store cards, loans, she shops with you, her parents shopped with you.

"She likes you as a company, she changed her insurance to you and lo and behold, you've not covered her.

"It's in your T's and C's, but I think your case needs looking at."

-That's what you've been arguing all along.

-Exactly.

Well, Sainsbury's have got back to us.

I was talking to them this morning on the phone because I want them to address the situation

and say, "Are you going to change this policy?" I haven't got a "yes or no" answer on it.

It's still something I've posed to them as a question and they haven't given me an answer.

That's something you felt strongly about. You want to see this changed.

I do. I want it changed, if not completely changed, at least changed in a certain way.

-£5,500 you spent on his operation, didn't you?

-Yeah.

-You didn't have the money.

-No.

-You had to borrow it off your son.

-I did.

Our only option, apart from putting him down, was to borrow Ross's money.

-Right.

-And he's probably 18 months from going to university.

-Sainsbury's have sent you a letter.

-Right.

-It hasn't arrived yet?

-No.

So I'm going to tell you what it says.

-It says they're going to give you all your money back.

-Oh, wow!

SHE LAUGHS

That's fantastic.

That's unbelievable!

Very, very happy.

-How happy?

-Do you want me to do this again?

Do whatever you want to do. Go on, then.

-Thank you so much.

-Not a worry.

-That's such brilliant news.

-I thought you'd be pleased with that one.

That so...so helps.

It really does help.

You're going to get all the money back. They're not obliged to do so.

-No.

-They're doing it as a gesture of goodwill. You know that, don't you?

-I do know that.

They did listen to the points I raised with them

and I think they've shown sympathy and they've done the right thing.

-Yeah.

-OK, that's fair enough, then. Archie looks quite content, look, there on the floor.

-Is it a big relief?

-A big relief. A massive, massive relief.

Yeah, yeah, huge.

Got a message for Sainsbury's?

-Thank you. Just thank you so much.

-Yeah.

Please, please look at... The whole industry, please look at what you're doing to people.

Point well said.

'We asked Sainsbury's for a statement and they told us...'

-And how's Archie today?

-As bouncy as ever.

-Yeah.

-He's got a spring in his step.

-He has. He's definitely a Springer.

-You've got a big smile on your face, so it's probably time for me to leave.

-Thank you so much.

My pleasure. See you later, Archie. You behave yourself.

'I knew that would make her happy.'

Carolyn is chuffed to pieces, Archie is looking a fine figure of a dog and there's a lesson for all of us.

If you're taking out pet insurance, have a look at those T's and C's.