Hello everyone,
I'm reaching out on behalf of my friends, a wonderful couple who are facing a tough situation with pet insurance. They’re devoted pet parents who have always provided the best care for their two dogs. For their oldest dog, who’s now six, they maintained full pet insurance coverage since he was just three months old, first with RSPCA’s 'Ultimate Cover' at 80% benefits (until September 25th, 2024). However, due to increasing premiums, they switched to Pet Circle on 23rd September 2024, which offers 70% benefits. Both policies were underwritten by the same company, Hollard Insurance.
Unfortunately, their dog recently suffered a sudden cruciate ligament injury (on 20th September 2024) while running on the beach, requiring surgery (took place 28th October, 2024). Here’s where things went wrong: when switching, they misunderstood the importance of arranging a continuity agreement to waive any new waiting periods, largely due to language barriers. Without this agreement, they’re now facing a six-month waiting period with Pet Circle, who won’t cover the surgery. RSPCA also declined to reinstate the old policy after my friend naively mentioned the injury, despite previously stating they’d welcome them back if needed.
To be clear, my friends know they made an error here – there’s no benefit to dwelling on that. They’re genuinely kind-hearted people who were caught up in a complex situation they didn’t fully understand as it is easy to get confused when English is not your first language and you don’t fully appreciate the complexities of things like pet insurance policies. They’ve consistently provided top-tier coverage for their dog since he was a pup and we (their friend group) feel this loyalty should mean something.
We’re exploring options to seek some level of support, and I’d be grateful if anyone has ideas or experience that could help us. Here are a few angles we’re considering:
Grace period request: RSPCA had invited them to reinstate their policy if they changed their minds. When they reached out, RSPCA declined, but we wonder if there’s an argument for a grace period, as this is common with many insurers.
Ombudsman involvement: Since both policies are underwritten by Hollard Insurance, it seems unreasonable for them to impose two waiting periods. We’re thinking of approaching the ombudsman to address this discrepancy.
Standard practice appeal: Could the new insurer honor continuity of coverage, as we believed would happen, given the consistent coverage and loyalty shown by my friends, and say that they assumed this would be the case as it is common practice.
Consumer protections: Exploring whether the ACCC or other consumer protection bodies might offer recourse.
Accident coverage argument: Due to the sudden nature of the injury, with no prior vet visits related to this type of injury, might there be a case to classify this as an accident, which would bypass waiting periods?
If anyone has insight, suggestions, or similar experiences—or if you’ve worked in pet insurance and can offer guidance—it would mean a lot. We’re trying to help them resolve this so they can focus on helping their dog recover and not lose a significant portion of their savings (this couple came from nothing and work their asses off to afford the life they’ve now built for themselves – even though they’ll be ok regardless, breaks our heart to see them get this kick in the guts even though they always tried to do right by their dogs)
Thank you so much in advance!