My pet insurance denied my dog's claim as a pre-existing condition. How do I appeal?

Pre-existing conditions are rarely covered by pet plans [1]. A denial may rest on that point. The denial letter should tell you why. Here is one example from Washington. An insurer must not deny a claim on a specific policy term unless the denial points to that term [2]. The denial must be given to you in writing [2]. Other states have their own rules.

The sources do not describe a set appeal process or an appeal deadline for pet plans. Your policy or the denial letter may have one. If it does, follow it. If not, write to the insurer. Ask it to look at the claim again. Send your vet records that show when the problem began.

If the insurer will not change its answer, you can complain to your state insurance department. In Texas, the department asks the company to respond to your complaint, and companies have 15 days to respond to the department [3]. The department cannot make a company pay a claim unless not paying breaks a law or the terms of your policy [4].

Your policy and denial letter show whether the plan has its own appeal steps and time limits. Look at how the policy defines a pre-existing condition and any waiting period. The sources do not describe a pet-plan appeal process or the rule for your state — "Don't know yet". Look for your state on the TDI complaint page or your own department's site.