Q: Seeking advice on a Pet Insurance Claim. My policy covers Congenital Heart Disease. A defect occurring at birth.
My policy w/MetLife started the day I brought my Rottweiler home at 8 wks.Comprehensive Wellness & Accident & Illness.No heart murmur was heard at the 6wk check w/her breeder.I took her to her first wellness visit A heart murmur was noted but no real concern as murmurs are very common in large breed dogs & they typically resolve by 6 mnth. It was still there at 9 months so we went to a cardiologist & had an EKG. Diagnosed as Congenital Heart Disease. MetLife denied claim stating “pre-existing” because the murmur was “heard” during the 2 wk waiting period on accident & illness. The Wellness started immediately & covers all vet exams & diagnostics. Congenital HD & the resulting heart murmur in its very nature is “pre-existing” since it’s a birth defect. How can it be subject to the waiting period if it’s a covered disease that is present at birth? The policy was in effect prior to any clinical signs. It is not something that happened or began during the waiting period.
Lawyers, want to be a Justia Connect Pro too? Learn more ›
- Ohio
- (216) 417-5111
- View Profile
- Answered
A: You may have a claim for bad-faith insurance coverage against met-life for refusing coverage. This can result in hefty punitive damages and attorney fees for refusing to reasonably provide insurance coverage.
1 user found this answer helpful
Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.
The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.
Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.
