ComplaintsforPTZ Insurance Agency, Ltd.

• Initial Complaint

  09/05/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  My 8 year old chocolate lab named ***** was diagnosed with both liver and kidney disease in 2017. One of the medications he is on for his liver is called Hepato Support. I purchase this medication from my veterinarian, ******************************, located at *************************************. ***** health insurance has always paid for this medication until recently. First, they coded it as a "professional service" instead of a medication and then asked for the records. The veterinarian's office sent ******* entire records to the ***** several times. They are still saying its a professional service. I have gone back and forth with the ***** several times and nothing has changed. I called this morning and asked to speak with a supervisor. They said they would have one call me back and I have not received a phone call. I told them if tI didn't hear back by 10am that I would file a complaint with the AG's office because this is basically insurance fraud and it's the insurance company that is being fraudulent.

  Business response

  09/19/2024

  Please refer to attached.

  Customer response

  09/23/2024

   
  Complaint: 22242739
  
  I am rejecting this response because:

  
  He was diagnosed in September of 2017 with Liver Disease. He has been on this medication since then. I have been reimbursed for this medication in the past.

  
  Sincerely,
  
  ****** *********

  Business response

  09/25/2024

  Please see attached response.

  Customer response

  09/30/2024

   
  Complaint: 22242739
  
  I am rejecting this response because: They are stating he no longer needs a medication he has been on for years. He has liver disease and the medication is working to keep his enzyme levels down. Taking him off the medication could possibly lead to his death.
  
  Sincerely,
  
  ****** *********

• Initial Complaint

  08/27/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  First time I called, the agent MULTIPLE times if there was a free option, she told me there was NO free option to update the chip information. I had to pay the fee. I heard from another pet owner that there was a free option.So, I called back twice to and asked AGAIN about the free option and they again LIED to **** emailed them regarding my compaint and have NOT heard back after 2 weeks.I want my money back. *****

  Business response

  09/10/2024

  please see attached letter. 

  Business response

  09/11/2024

  see attached. 

• Initial Complaint

  08/01/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  Bought pet insurance. Months after purchase dog was injured needed surgery. They claimed preexisting even though there was nothing beforehand. Vet made an error on paperwork that was used simply as an estimate. I durance trying to use estimate not actual claim paperwork which was correct paperwork. They denied. Filed appeal and have heard nothing back for over 2 months. This is a rip off company and they are trying to wait out a clock. We followed their rules and yet they refuse to pay. Never wanted our dog injured but she is a hard playing dog. It happens and they do not uphold their end of agreement.

  Business response

  08/14/2024

  Please refer to attached.

• Initial Complaint

  06/28/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  Purchase pet insurance named SPOT on or about February 2024. Auto deposit of $59 per month deducted from checking account. 80% reimbursement was in contract of insurance however, I have filed three or more claims and never reimbursed as SPOT claims I have not sent my pets full medical records. I have faxed full medical records as well as **** hard copy of medical records to them. **** will not reimburse as promised in contract therefore I want full refund of payments I have made to them to date appt $240 .In my opinion they are a scam pet insurance I appreciate your assistance thank you

  Business response

  07/24/2024

  See attached response

  Customer response

  07/27/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ***********************

• Initial Complaint

  06/25/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  Re: Policy Number: A6790211 Claim Number: ******* In December 2023, my dog suffered CCL tear while playing catch in the back yard grass, she was seen by her veterinarian and underwent TPLO surgery and had her joint repaired. My dog is an otherwise healthy and young 4 year old dog; she has seizure disorder that is well controlled on medication and seizure free for more than two years. She has annual physical and blood work by her veterinarian clinic, which knows her well. In fact, my dog had completely normal physical exam and blood work less than 2 months prior to the occurrence of injury.When I filed for reimbursement of services related to this injury, including initial office visit after the injury, orthopedic surgeon consultation, pre-op visit, operation, post-op visit, my claim was denied and when I appealed, it was denied again. Of note, the insurance policy does not exclude coverage of ligamentous injury if not a pre-existing condition and the mechanism of my dogs injury falls within the definition of accident as stated in the policy itself "a sudden, unexpected or unintended action or event with a specific time and place which results in injury."My issue with the denial of my claim is that while as owner and the veterinarian are well aware that my dog is young and healthy without any pre-existing joint illness, the insurance company is attempting to build a narrative that her injury is classified as illness in order to avoid to be held accountable in reimbursement. It is unreasonable for the insurance company to issue denial without any evidence that my dog actual had prior ligamentous illness, only able to make such an assumption based on literature that it was not able to provide. It is shameful and reprehensible that while my dogs injury was completely accidental, the insurance company is portraying this accident as the result of pre-existing condition to avoid their responsibility to a paying customer.

  Business response

  07/09/2024

  We are in receipt of your June 25, 2024, inquiry relative to the above-mentioned policy holder regarding his Accident Policy (PET-P-20000-CA-0921)for his dog. Per the Better Business Bureau direction, we have removed any reference that will personally identify our customer. The pet ********************** policy is a personal lines property and casualty product filed under inland marine.

  The customer expresses concern pertaining to the denial of a claim for treatment of his dog's Cranial Cruciate Ligament tear under the Accident only policy.

  This determination was based on the veterinary records, which did not document an accident occurred which would result in a cruciate ligament rupture. Running around outside and playing ball is considered a normal activity. The medical records also document the pet had effusion in both knees indicative of a degenerative process affecting both sides of the body as opposed to a direct injury to the left stifle.

  Based upon this information,the claim was processed in accordance with the terms and conditions of the policy. We hope that the information provided in response to your inquiry is satisfactory. Thank you for the opportunity to respond to this matter.

  Sincerely,

  ASPCA Pet Health Insurance

• Initial Complaint

  04/30/2024

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  I rescued a pup yesterday and the rescue group told me they changed the dogs chip into my name. I then noticed an email from 24 pet watch that said I needed to verify my information. I tried to do it online and had trouble so I called. I told the person on the phone I just wanted to add my name and number to the chip. He insisted the only way I could do that was to have a membership. After questioning him numerous times he answered me every time with the fact that I must have a membership in order to have my information on the chip. he directed me towards a lifetime membership because otherwise I would be charged $20 a year for the lifetime of my pet. The lifetime membership was $125. I ended up doing it because I wanted to make sure my information was on the chip. After seeing his confirmation emails I realized that whatever he had given me had nothing to do with my name on the chip and everything to do with services that I did not want. He was a complete and total liar. He never ever once answered me with the truth when I question the fact that the dog rescue told me I just needed to add my information. He also insisted I needed to buy another tag that the tag that I had from my Rescue inappropriate. Trying to get a refund but I cant seem to contact anybody and its a Friday night. There are no email addresses and to leave a message on the phone. As I googled I noticed I was not the only one that happened to this is the way they do business. It is deceiving.

  Business response

  06/03/2024

  Thank you for taking the time to write into us with your concerns *****. We value your feedback and take these matters seriously.
  
  I had the pleasure of connecting with you where you confirmed that you have already received a full refund, and actually still received the bytetag that I confirmed you can still set up.
  
  I re-added the Lifetime Protection Plan complimentary back on to Dashs file and he is now covered for life!
  
  We reviewed the basic registration which is free vs the live recovery and we also discussed our new FI collar partnership which you will follow up on.
  
  ***** as per my phone call and email you do have access to reach out directly if you have any questions or concerns.
  
  Best Regards,
  
  Ena

  Customer response

  06/04/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  *********************

• Initial Complaint

  03/22/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  This is a Pet Insurance Company. On Feb 20th 2024 my dog had to be euthanized. Also on this day, this company withdrew $273.76. On Feb 21st 2024, I cancelled my policy on their website to avoid further withdrawals. I had no intention of making a claim for the cost of the Euthanasia of $182.47 nor did I. On Mar 20th 2024, this company withdrew another $273.76 from my checking account without my authorization and a month after I cancelled the policy. I called to request a refund and to stop further withdrawals. They responded by telling me they needed the invoice for the Euthanasia. I explained to them that I just wanted the policy cancelled and a refund. I do not want to submit a claim for the Euthanasia. I sent them the invoice for Euthanasia and against my wishes, they opened a claim in an attempt to keep my policy active so they can continue to withdraw $273.76 from my account. They then send a request for additional documents for the claim which I never agreed to submit. This is all an attempt to delay cancelling my policy and collect further payment. I want my money refunded for February and March and my policy terminated with no further withdrawals.

  Business response

  03/25/2024

  We apologize for the customers disappointment with their 24PetWatch experience. 
  
  We have been in contact with ****************** and have addressed his concerns, should he have any further questions he can reach us1-866-597-2424. Our hours are: 9:00 AM- 9:00 PM EST Monday to Friday.

  
  We would like to thank ****************** for taking the time to provide his feedback. We take our customers feedback seriously as we are constantly looking to improve our product and service offerings.

• Initial Complaint

  03/11/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  On March 11, 2024 I was checking my bank account and saw a charge from this company for $99.95. I have never even heard of this company before, went back in my bank statements for over a year and I have never sent this company any money. Probably scam! Thankfully my bank declined the transaction.

  Business response

  03/25/2024

  We apologize for the customers disappointment with their 24PetWatch experience.
  We were unable to locate a policy with the information provided. We encourage the customer to reach out to our office ************** so we can further assist. Our hours are: 9:00 AM- 9:00 PM EST Monday to Friday.
  
  We would like to thank ************** for taking the time to provide her feedback. We take our customers feedback very seriously as we are constantly looking to improve our product and service offerings.

• Initial Complaint

  03/03/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  I had ASPCA pet insurance for my cat from 3/21 to 3/23. While insured, he got cancer and ultimately died in 2/23. While he was alive, I submitted a partial claim for his cancer care and was reimbursed. After his death, I submitted the remainder of the claim within a year of the end of his coverage as required by *****. This requirement was prominently displayed as a colored, bolded alert banner at the top of the front page of my account when logged in. It stated You have one year to submit any remaining expenses for reimbursement on this claim. I took those words to heart and carried them with me for nearly a year before submitting the remainder of the claim, due to the grief associated with the loss of my pet and emotional turmoil having to relive his last months of treatment and ultimate euthanasia.Within the one-year required timeframe, I diligently submitted all the remaining receipts, totaling $402.46. Days later, I received a denial for the entire claim. When I reviewed the *** denial, ASPCA had coded my claim as Claims must be submitted within 270 days of the date of service. Claims exceeding 270 days are not eligible for coverage. Had I known, I absolutely would have complied. However, ASPCA unethically took advantage of me as a customer by throwing misleading advertising a prominently displayed alert message on my account that I had a full year to submit any remainder of the claim. ASPCA behaved badly by pushing an untrue narrative in hopes of avoiding reimbursing the remainder of my claim. I want my promised reimbursement/refund, yet I am also filing this Complaint to help prevent other pet parents, in their state of grief, from falling into ASPCAs trap of misleading information. I ask ASPCA to change their practice by clearly stating a 270-day coverage limitation message instead of a 1-year implied promise of reimbursement message on customer accounts with open claims.

  Business response

  03/18/2024

  Dear Customer Relations:

  We are in receipt of your March 4, 2024, inquiry relative to the above-mentioned policy holder regarding her Accident and Illness Policy (PET-P-20030-0920-(3)) for her cat.  Per the Better Business Bureau direction, we have removed any reference that will personally identify our customer.  The pet ********************** policy is a personal lines property and casualty product filed under inland marine.

  The customer expresses concern regarding coverage of her submitted claim, which was initially excluded as exceeding the designated submission time of 270 days.  Please refer to the applicable excerpts from the Accident and Illness policy (PET-P-20030-0920-(3)).
  
  CLAIMS
  
  Submit a Claim
  
  
  
  You must submit your claim within 270 days from the date of service.
  
  The disputed claim received on February 20, 2024, was for services rendered January 21 and 23 as well as February 7 and 12, 2023. As such, the claim was processed in accordance with the terms and conditions of the policy.  Additionally, the customer refers to an alert message she received advising she has one year to submit any remaining expenses.  We are not aware of the message shes referring to, however, the receipt date of the claim vs. the services rendered exceeds 365 days as well.
  
  Notwithstanding,to resolve the matter, the company agrees to honor the customers desired resolution.  We hope that the information provided in response to your inquiry is satisfactory.  Please accept our deepest condolences.
  
  Thank you for the opportunity to respond to this matter.  If you have any questions or need additional information, please contact me at ************. 
  
  Sincerely,
  
  ***************************** | Compliance Specialist
  *********************************

  Customer response

  03/21/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

  I will await the refund; thank you.
  
  Sincerely,
  
  *********************************

• Initial Complaint

  01/23/2024

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  Company has been increasing monthly insurance premium for my dogs policy (~$10-20) each year. They provide a generic explanation (shes getting older) rather than acknowledge that its because were using our policy *** as intended. With each claim I file the required itemized bill and my claims were always processed with a delay.This year they doubled my monthly premium (from $80 monthly to $165) even though my policy is unchanged. I emailed them twice to ask for a detailed insurance analysis of why my pets monthly premium was increased and they never responded. When I spoke to a representative on the phone they said they dont have to provide me with a detailed explanation. They need to provide a detailed explanation as to why my specific pets policy premium doubled. If they dont have this detailed explanation what did they base their decision on.

  Business response

  02/06/2024

  We are in receipt of your January 24, ****, inquiry relative to the above-mentioned policy holder regarding their Accident and Illness Policy (PET-P-20000-NY-0920) for her dog,Nova.  Per the Better Business Bureau direction, we have removed any reference that will personally identify our customer.  The pet ********************** policy is a personal lines property and casualty product filed under inland marine.

  The customer expressed concern regarding the premium increase.

  The customers premium increases are a result of an insurance rate increase filed and approved with the New *************** of Insurance.  The customers insurance rate is also determined by the individual coverage selected, age, breed, and zip code territory. We applied the customers increased insurance rate for the current Accident and Illness Policy (PET-P-20000-NY-0920) only after receiving approval from the New *************** of Insurance, and pursuant to those approved filings.  The most significant factors impacting this customers increase are age (dog turning 9) and address change (updated zip code).

  Further,these premium increases are clearly communicated to the customer prior to implementation.  As stated in the policy, unless the customer notifies us that they wish for the policy not to be renewed, the policy will automatically renew on an annual basis.  At least 60 days prior to the automatic renewal, we provide policy documentation to the customer,which includes a cover letter as well as a copy of the Declarations page providing a breakdown of the customers premium owed for the upcoming policy year.  This allows our customer the opportunity to decide if the benefits of coverage live within their means and allows the opportunity to contact us and discuss other potential coverage and pricing options.
  
  Lastly, the customer information provided with this inquiry reflects a different address than what we have on file.  As such, we will be in direct contact with the customer to verify the primary residence in accordance with the GENERAL CONDITION, ************* Restriction of the policy.
  
  We hope that the information provided in response to your inquiry is satisfactory.  Thank you for the opportunity to respond to this matter.  

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