How We Process Claims
While we never want pets to be ill or have accidents, when they do, we want pet owners to have the best possible experience with our claims process so they can focus on your recommendations for care. We pride ourselves on being fair to our customers in the same way as you do with your clients.
We always look for ways to pay claims. This is the reason we ask for medical records at the time of the claim. The most common reason a claim is denied is due to what’s known as a “pre-existing condition” – a claim made for a condition in which clinical signs, observations or diagnoses were present prior to enrollment. We ask for medical records, in part, because we can often show that a clinical sign present prior to enrollment is not related to the illness being claimed.
For example, just because a puppy had soft stools for a few days prior to enrollment, this would not necessarily be related to an IBD diagnosis at 2 years of age. If the medical records showed that there was no pattern of clinical signs or treatment in between, our claims team would likely pay the claim. When you send in medical records with a claim, our assessment is typically faster and more accurate.
Our team at Trupanion is dedicated to helping pet owners, pets, and veterinarians. Our claims team is comprised of dedicated and experienced veterinary staff members including registered/certified veterinary technicians and veterinary assistants. We also have staff veterinarians who help on more complicated medical cases and have conversations with veterinarians whenever needed. Often the attending veterinarian on a case has insight that may not be clear to our team from the medical records alone, so your input to this process is needed and welcomed.
In cases where the claimed condition is rare or complicated, we have an independent panel of 25 board-certified veterinarians who will review the case and give their opinion. If they determine a claim should be paid, we pay it.
We are continuously streamlining our processes to minimize the administrative work for your team while improving the experience for your clients. We value your opinion and feedback, so if you have a recommendation or comment on our claims process, please let us know!
Together we can help more pet owners see the value of having Trupanion so they can experience the incredible care you are capable of delivering. Our goal is to help make practice more rewarding by allowing more clients to say “yes” to your best diagnostic and treatment plans.
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