Dotsure - terrible payout scheme - Policyholder liable for 48% for each claim (Accident)

PETP***

Dear Petsure,

I’ve been informed about the outcome of the attached claim and that we are only getting paid out over R 6 000.00, with this being said – I hereby want to express my how deeply disappointed I am with the outcome of the claim. The agent which contacted me, I could barely hear as it was a bad line.

Our policy has been transferred from Paws24, twice now – and now we are with Dotsure.

You are saying that we have Accidental cover of R 12 600 per claim and then you bring in sublimits of the below

Medication R 950 Per Claim Radiology R 950 Per Claim Pathology R 950 Per Claim Hospitalisation R 1 260 Per Claim **Non-Elective Procedures R 5 050 Per Claim

And then the excess – 10% of the Claim

With reference to my Invoice & then my calculation – I have allocated the benefits to the Invoice I’ve received.

My concerns are as follows:

With reference to this specific Accident – there was a requirement for 4 Ultrasounds to ensure that whatever the patient swallowed has either dissolved or passed to avoid surgery, you are only covering 1 – which means if they just had an operation from the start Dotsure would have covered R 6 300 for the operation and there wouldn’t have been need for more Ultrasounds – so the patient is worse off and more recovery time – this is not in my pets favour but rather for your pocket. So, is surgery the better option for my pet?

Medications relating to this specific accident and for the hospitalization stay period – you are only covering R 950, that is if I understand this correctly – should this be part of the R 12 600 – and then the medication prescribed after the release of the pet – that should be part of the R 950. It was mostly drips with very few administrations of medicine – this is not even an extreme case – Dotsure is not covering much

Examinations, Consultations & Consumables – where does this now fall into the policy – as I’m sure most accidents happen after hours

Dotsure is not allowing me to give my pet the best medical care in the event of an Accident “Cover your BFF, workout buddy, and fur-child with insurance that protects them…”

Lastly, this brings me to your marketing and why I was happy to stay with Doture prior to this incident – look at the below picture whereby Dotsure is referring to Gastroenteritis – you are showing here that George was saved from a R 29 900 bill – expressing the excess buster – I don’t believe at all with the benefits and policy that Dotsure will even pay out 50% of the below – and where you show George only paid R 2 900.00. Medication, examination, pathology and or radiology for the below – was not capped / limited to R 950 for each category. I put it to you – that George was not saved!

I hereby request you to look at my calculations attached (check if I understand my policy benefits) and then to revise this claim as a matter of urgency. I don’t have comfort that Dotsure has the best interest at heart for my pet or for myself.

From this accident – I’m liable for 48% - this does not indicate that my “BFF, workout buddy, and-fur child” are insured.

Please revise my claim with urgent feedback – and I would like for someone more senior to look at this