retire to nature
Recycles dryer sheets
- Joined
- Aug 10, 2018
- Messages
- 383
Hi
My dog got hypothyroidism in 2019, and started seizure 2021. And I bought Embrace pet insurance.
My dog got many seizures in Oct 2022, and on the same week, he fell a few times from my bed. He fell at night, I was wondering why he kept falling from bed but I didnt light up or anything, but picked him upto my bed and we went to sleep back because a couple days later, he had an appt to the vet.
His seizure was always grandmal but he started partial seizure before the appt. So the vet added phenobarbital. he started one side weakness. And I found he had been hanging his head at the edge of bed lately. I was concerned head injury and went to see a neurologist. The vet saw my dog when he started seizures, but I didnt do much tests at that time because i didnt see any other symptoms. So this time I did mri and ultrasound.
He had brain tumor, thyroid tumor, and pancreatic cysts. At the treatment consultation, since I was an RN, I kept saying in human healthcare system to decide the radiation therapy, I was told so many times that in veterinary field they dont do that etc.
In Nov, he had radiation therapy for brain and thyroid tumor. the oncology vet said thyroid tumor is not related with hypothyroidism so he said I can claim the insurance. and I did it. But the insurance declined saying he had preexisting of seizure, and it related to brain tumor and the hypothyroidism can relate to thyroid tumor. The vet helped me to appeal saying seizure is related to brain tumor but hypothyroidism is not related to thyroid tumor.
But they declined again all kept saying same thing again preexisting condition. I talked to the adjuster after appeal and I kinda understood as since thyroid tumor was not biopsied they cant exclude as mets possibility. So I talked to the vet and he said in veterinary field, biopsy for brain is none and thyroid tumor is also very rare.
So I thought embrace is asking not possible process to prove the thyroid tumor is related to the brain tumor. Also, my dog's brain tumor was very rare kind. I reported to BBB and below is embrace response.
===(my dog name) continued to have seizures and was eventually diagnosed with a brain tumor of an unknown cellular type (presumed to be meningioma). Claims related to Teddy’s brain tumor were not eligible for coverage due to is pre-existing seizure activity.
An MRI was performed with not only a brain tumor but also a thyroid tumor. Neither of these masses have been definitively diagnosed. Therefore, we are unable to determine if the thyroid tumor is of the same cellular type as the brain tumor. As the clinical signs of the brain tumor (seizures) were present prior to the policy start coverage for the brain tumor (and any related conditions and/or clinical signs) are not eligible for coverage, including but not limited to tumors of the same cellular type. Unless both tumors are definitively diagnosed, we are unable to determine if they are unrelated.
..the vet... on appeal stating that while he understands why the brain tumor would be ineligible for coverage due to Teddy’s pre-existing seizure activity, he would not relate the thyroid tumor to Teddy’s pre-existing hypothyroidism. We explained that the hypothyroidism is not the factor determining why the thyroid tumor is ineligible for coverage, rather the pre-existing undiagnosed brain tumor.
Therefore, unless we receive documentation that the brain tumor is of a different cellular type than the thyroid tumor we cannot determine if the tumors are related or not; leaving both tumors ineligible for coverage.===
So I appealed to BBB, since there is no way brain tumor cellular type would know for dogs since due to high risk, they dont do any biopsy or surgical removal, Embrace is declining illogic way which human healthcare system applied to veterinary field. And I used to work in radiology dept, so I know how to diagnose human cancer. So my case was mri dye take up and he had CT for radiation therapy. and radiologist made a report of both tumors were definitive (but of course no cellular type). So I submitted the report, but they declined it again.
Now i got the second response saying.
=== There is no evidence in ****’s medical records indicating that these tumors are of different cellular types. Upon further extensive research hypothyroidism can be a clinical sign of a thyroid tumor. Therefore, as clinical signs were present for both the brain tumor (seizures) as well as the thyroid tumor (hypothyroidism), coverage is not available under Teddy’s accident and illness policy.===
They are saying the same thing. my question is how the cellular type would know if the vet saying they dont do biopsy in the veterinary field. And I dont see any research saying hypothyroidism is clinical sign of thyorid tumor. but HYPERthyroidism have some relation not hypothyroidism.
I am glad I could afford his treatment without any financial issue and he is still alive. But my gut got some bothered with the illogic.
What do you think? how would you respond to?
My dog got hypothyroidism in 2019, and started seizure 2021. And I bought Embrace pet insurance.
My dog got many seizures in Oct 2022, and on the same week, he fell a few times from my bed. He fell at night, I was wondering why he kept falling from bed but I didnt light up or anything, but picked him upto my bed and we went to sleep back because a couple days later, he had an appt to the vet.
His seizure was always grandmal but he started partial seizure before the appt. So the vet added phenobarbital. he started one side weakness. And I found he had been hanging his head at the edge of bed lately. I was concerned head injury and went to see a neurologist. The vet saw my dog when he started seizures, but I didnt do much tests at that time because i didnt see any other symptoms. So this time I did mri and ultrasound.
He had brain tumor, thyroid tumor, and pancreatic cysts. At the treatment consultation, since I was an RN, I kept saying in human healthcare system to decide the radiation therapy, I was told so many times that in veterinary field they dont do that etc.
In Nov, he had radiation therapy for brain and thyroid tumor. the oncology vet said thyroid tumor is not related with hypothyroidism so he said I can claim the insurance. and I did it. But the insurance declined saying he had preexisting of seizure, and it related to brain tumor and the hypothyroidism can relate to thyroid tumor. The vet helped me to appeal saying seizure is related to brain tumor but hypothyroidism is not related to thyroid tumor.
But they declined again all kept saying same thing again preexisting condition. I talked to the adjuster after appeal and I kinda understood as since thyroid tumor was not biopsied they cant exclude as mets possibility. So I talked to the vet and he said in veterinary field, biopsy for brain is none and thyroid tumor is also very rare.
So I thought embrace is asking not possible process to prove the thyroid tumor is related to the brain tumor. Also, my dog's brain tumor was very rare kind. I reported to BBB and below is embrace response.
===(my dog name) continued to have seizures and was eventually diagnosed with a brain tumor of an unknown cellular type (presumed to be meningioma). Claims related to Teddy’s brain tumor were not eligible for coverage due to is pre-existing seizure activity.
An MRI was performed with not only a brain tumor but also a thyroid tumor. Neither of these masses have been definitively diagnosed. Therefore, we are unable to determine if the thyroid tumor is of the same cellular type as the brain tumor. As the clinical signs of the brain tumor (seizures) were present prior to the policy start coverage for the brain tumor (and any related conditions and/or clinical signs) are not eligible for coverage, including but not limited to tumors of the same cellular type. Unless both tumors are definitively diagnosed, we are unable to determine if they are unrelated.
..the vet... on appeal stating that while he understands why the brain tumor would be ineligible for coverage due to Teddy’s pre-existing seizure activity, he would not relate the thyroid tumor to Teddy’s pre-existing hypothyroidism. We explained that the hypothyroidism is not the factor determining why the thyroid tumor is ineligible for coverage, rather the pre-existing undiagnosed brain tumor.
Therefore, unless we receive documentation that the brain tumor is of a different cellular type than the thyroid tumor we cannot determine if the tumors are related or not; leaving both tumors ineligible for coverage.===
So I appealed to BBB, since there is no way brain tumor cellular type would know for dogs since due to high risk, they dont do any biopsy or surgical removal, Embrace is declining illogic way which human healthcare system applied to veterinary field. And I used to work in radiology dept, so I know how to diagnose human cancer. So my case was mri dye take up and he had CT for radiation therapy. and radiologist made a report of both tumors were definitive (but of course no cellular type). So I submitted the report, but they declined it again.
Now i got the second response saying.
=== There is no evidence in ****’s medical records indicating that these tumors are of different cellular types. Upon further extensive research hypothyroidism can be a clinical sign of a thyroid tumor. Therefore, as clinical signs were present for both the brain tumor (seizures) as well as the thyroid tumor (hypothyroidism), coverage is not available under Teddy’s accident and illness policy.===
They are saying the same thing. my question is how the cellular type would know if the vet saying they dont do biopsy in the veterinary field. And I dont see any research saying hypothyroidism is clinical sign of thyorid tumor. but HYPERthyroidism have some relation not hypothyroidism.
I am glad I could afford his treatment without any financial issue and he is still alive. But my gut got some bothered with the illogic.
What do you think? how would you respond to?
