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Pet Insurance Claim Denials: A 157-Case Benchmark

Three things from inside the paid report, so you can judge the quality before ordering: the table of contents, the nine denial reason codes, and three case excerpts with their original sources.

Contents (13 sections + 2 appendices)

  1. What this report is (and who it is for)
  2. Method: how cases were collected and coded
  3. The sample at a glance
  4. Why claims get denied: the nine reason codes
  5. The pre-existing problem: 48 of 83 denials
  6. Documentation and records fights: 15 cases
  7. Waiting periods, bilateral clauses and relabeled diagnoses
  8. Appeals: what 22 case summaries show
  9. Carrier distribution
  10. Money: the amounts stated in the posts
  11. State overlays: Florida and California
  12. What this data cannot tell you
  13. How to cite, license and order a custom slice

Appendix A — Reason code definitions · Appendix B — Case counts by carrier and outcome

The nine denial reason codes (all 83 denials)

Every denial in the log carries one primary reason, coded as stated by the insurer in the original post:

Reason codeCasesWhat it means in practice
Pre-existing condition46Insurer says the condition showed signs before cover began, or during the waiting window
Documentation & records fights15Missing or disputed records, EOB contradictions, a vet request that never arrived
Policy structure trap5A rule in the policy — failed-treatment clauses, per-condition deductibles — used to deny
Policy exclusion (dental/preventive)4Condition falls under an exclusion or sub-limit
Waiting period4Signs noted inside the waiting window
Diagnosis relabeled4The insurer's label differs from the treating vet's
Bilateral clause2One side affected before cover, the other side treated as pre-existing
Reason not stated in post2Denial letter quoted without a reason — we code what the post shows, not what we infer
Filed past deadline1Claim submitted outside the policy's filing window

Total: 83. The full report gives a coded example case for every row.

Three case excerpts (of 157)

Trupanion · Dog · emergency surgery · $4,500

"Switched carriers mid-life; old records showed brief vomiting episodes. 'The next insurance will have a lot more to deny' — the switcher's trap." Denied as pre-existing.

Case 1vs7mrf · r/petinsurancereviews · reported 2026-08 · original post

Healthy Paws · Puppy · Giardia · $3,000+ denied in total

"Insured since weeks old, yet everything was marked pre-existing; the diagnostic test that found the Giardia was classified as 'wellness and preventative'. An appeal took 40 days."

Case bbb-9775d6f1 · BBB review · reported 2026-04 · original post

Carrier not named · Cat (male) · 2× urinary blockage (FLUTD)

"All claims denied as pre-existing, and the appeal denied too — even with a veterinary letter stating an earlier incident was unrelated to FLUTD." Amount: emergency bills plus a planned perineal urethrostomy surgery.

Case 1k4tvlw · r/rescuecats · reported 2025-04 · original post

Why you can trust these numbers: every case in the report links back to its original public post, the same way the three excerpts above do. The full dataset (157 cases, CC BY 4.0) is free at petclaimlog.com/claims — check any figure yourself. These are self-reported accounts, not adjudicated rulings, and the report's limits section says so in plain terms.

Get the full report — from $149

How We Verify · The Claim Log · For Journalists