French bulldog owner loses pre-existing condition dispute
A pet owner who sought cover for expenses related to a planned surgery has lost their claims dispute.
On November 8 last year, the complainant sought pre-approval from her insurer for desexing procedures and surgery relating to stenotic nares (narrow nostrils) for her French bulldog, referred to as Barkley.
Hollard-owned PetSure accepted limited cover for the desexing procedure but denied paying for expenses relating to the stenotic nares, saying its policy did not cover pre-existing conditions.
The insurer says it covers expenses relating to illness incurred while the policy was active and that prior to the commencement, the owner had been aware of the condition.
The Australian Financial Complaints Authority (AFCA) sided with PetSure, saying that the complainant was reasonably aware of the dog’s condition, and the policy appropriately outlined it does not cover pre-existing conditions.
PetSure referred to vet notes from July 30 last year that observed restrictive nares on Barkley and that the vet discussed corrective surgery when the dog was full grown. The policy came into effect on August 5 last year.
On March 16 this year, the complainant said Barkley had never been examined for stenotic nares and that the issue was only brought up because of his breed.
AFCA noted that these comments were inconsistent with emails she sent earlier in the year that said it was “likely” that Barkley would need corrective surgery.
“Yes, [Barkley] had this condition [stenotic nares] before joining you,” the complainant said in an email to PetSure on March 14 this year.
The pet owner said she received assurances from the insurer before the policy commenced that the policy would cover the stenotic nares, but there were no records of this conversation occurring.
The complainant, who had cover from a previous insurer, said she would not have taken out the policy if she had been aware the cover would not have transferred in full.
AFCA determined these arguments to be irrelevant to the facts of the case and said the complainant could have cancelled the policy during the 21-day cooling period.
It also dismissed the complainant’s argument that the insurer should not cover brachycephalic breeds (such as French bulldogs) because of their increased predisposition to breathing-related conditions.
The insurer said that it does not assume all brachycephalic breeds have stenotic nares or other breathing conditions and that it offers coverage for those conditions if they have not been shown before policy commencement.
Click here for the full ruling.
