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本帖最后由 jackotman 于 2014-10-30 14:26 编辑
carl1985 发表于 2014-10-30 14:11 
这个得好好学习一下啊,请问楼主怎么像FOS投诉,可否给个投诉样本看看
我家Samuel的腿骨折,这前前后后各 ...
也没有什么模板。
但是你要自己列一下。 那天发生了什么事情。 vet 对你说什么。
还有就是你要问vet 要他们的notes.因为这些notes会给保险公司的。 如果notes上有什么对你不利的, 你要及时对vet 说。 让他改。就譬说, notes 上说什么 你狗原来就有这个病啊。 我们不推荐但owner 一定要做手术啊。什么什么的。因为这是保险公司不索赔的理由。
下面是我些给保险公司的投诉信。 请不要转载。 (英语不好,有语法错误不要笑话)
Dear Petplan Claim team
I am writing to express my deep dissatisfaction for your recent decision about rejecting my insurance claim for the Veterinary Fees of diagnostic and treatment for Tank’s illness (Hip laxity/early hip dysplasia).
Based on the letter dated on 20th Aug 2014, you wrote that the reason for rejecting my claim is due to:
"We are sorry we cannot pay this claim as the procedure you's submitting a claim for is a preventative surgery for hip dysplasia."
And also in the letter you refer me to page 8 of petplan PDS – exclusion point 3 (cost for Preventative) and point 4 (cost of elective procedures)
However I believed that your decision is lack of support and rash judgement based on the following reason:
4. Tank has Hip laxity/early hip dysplasia illness which cause him discomfort on hyperextension bilaterally. (Both Castle Hill Veterinary Hospital and Parramatta Veterinary Specialists confirmed the diagnosis based on the examination result.)
5. Tank was taken Veterinary Treatment - Juvenile Pubic Symphysiodesis (JPS) based on two Veterinary’s diagnostic and recommendation. The surgery performed by Dr David (orthopaedic Specialist Surgeon) in Parramatta Veterinary Specialists.
6. Tank’s illness and Veterinary Treatment meet the Definitions in your PDS as follow and there was no Preventative and elective procedures occurred within this claim.
“ Illness means any change(s) to a normal healthy state, sickness, disease, defects and abnormalities, including defects and abnormalities. Your Pet was born with or were passed on by its parents. “
“Treatment means Veterinary Treatment or Alternative or Complementary Treatment.”
“Veterinary Treatment means the cost of the following when required to treat an Illness or Injury,
• any examination, consultation, advice, tests, X-rays, diagnostic procedure, surgery and nursing carried out by a Vet, a Veterinary ………….”
Based on above 3 points and Petplan PDS SECTION 1A - Veterinary Fees,
“SECTION 1A - Veterinary Fees
Cover under this section applies in Australia and Agreed Countries only.
What We will pay
The cost of Veterinary Fees incurred for the Veterinary Treatment Your Pet has received to treat an Injury and/or Illness.
When referred and endorsed by Your Vet, this section also covers the cost of Physiotherapy to treat an Injury and/or Illness and the Treatment of a Behavioural
Illness.”
I believed that Petplan should accept my claim and pay me back the cost of Veterinary Fees incurred for the Veterinary Treatment based on PDS (total claim amount A$3328.00) ASAP.
As a part of my complain process, I also require Petplan must give me the FINAL DESCISION for this insurance claim in writing within 30 calendar days after you are deemed to have received this letter. You are deemed to have received this letter at the end of the day on which the letter was emailed to you.
If I don’t receive FINAL DESCISION in writing by the above date, this complaint will escalate to Financial Ombudsman without further notice.
I can be contacted via e-mail: XXXXXXXX, or by post at: XXXXXXXXXXXXXXXXXX.
If you require further information please feel free to contact me by email only.
Yours Kindly,
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