Bridgton, ME asked in Insurance Bad Faith and Animal / Dog Law for Maine

Q: Pet insurance denied my claim saying injury was due to illness with no explanation and I only have accidental coverage

My dog had knee surgery due to a torn ccl (acl). He was running and tore it. My insurance company is claiming it was due to an Illness. He has never been diagnosed with any sort of illness that would cause such a thing. I only have accident coverage and they won’t give me an explanation for the decision. Is there anything I can do to fight this? I was told to file an appeal but I don’t want to until I understand the process.

1 Lawyer Answer
Tim Akpinar
Tim Akpinar
  • Insurance Claims Lawyer
  • Little Neck, NY

A: A Maine attorney could advise best, but your question remains open for two weeks. Look at the policy and see what the provisions for dispute are - civil suit, arbitration, etc. A veterinarian is best qualified to make a call on the matter, but a ligament tear appears to be more accident-related than illness related. It looks like you have a valid position. Why not try reposting and adding Animal/Dog Law as a category - attorneys in that area of practice would have the best insight into these types of matters. I hope your dog has a good recovery. Good luck

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