A claim denial usually comes down to one of a few common reasons.
Common reasons for a denial
- Your pet's condition was diagnosed, or showed symptoms, before your coverage started or during the waiting period. We call this a pre-existing condition.
- Your base policy doesn't cover the service, such as routine checkups, vaccines, or grooming, unless you added an optional add-on for it.
- You haven't met your annual deductible for the current policy year yet.
- Our claims team is still waiting on complete medical charts, SOAP notes, or itemized invoices from your veterinary clinic.
- You submitted the claim after the deadline in your policy terms.
- Your claim may involve a specific policy exclusion, or it may exceed a benefit limit.
If none of these match your claim
If none of these match your situation, check the automatic denial letter (ADL) sent by your insurance provider. This lists the exact reason code for the denial.