pet insurance claim denied suspected fraud Denial?
The insurance company is betting on your silence. They hope you see their "No" as final. We know better. Follow this tactical guide to force a reversal.
The Insurer's Playbook
Context: Pet Insurance
Cruelly often denied for "Pre-Existing Conditions." Since the ACA doesn't apply to pets, looks-back periods are strict. You need vet records showing a clear period of health before the policy started.
Their Strategy
Attrition. They expect you to give up after the first denial letter. 40% of people do.
Your Counter-Move
Persistence. A formal, evidence-backed appeal shifts your claim from the "auto-reject" pile to "needs legal review."
Strategic Analysis
Breaking Down Your Denial
"Suspected Fraud" or SIU Investigation
WARNING: This is serious. The Special Investigations Unit (SIU) thinks you are lying.
Action:
- Cooperate fully but carefully.
- Provide all requested proofs immediately.
- If they drag this out specific timelines, consult a lawyer. Bad faith laws punish insurers for using "fraud investigations" just to delay valid claims.
The Path to Victory
Execute these maneuvers precisely. Timing is everything.
"DO NOT ignore this or delay responding - it's serious."
"Cooperate fully with documentation requests but keep copies of everything."
"Consider consulting an insurance attorney before speaking with SIU investigators."
"Gather all evidence proving the legitimacy of your claim (photos, receipts, witnesses)."
"If the investigation drags past policy timelines, file a bad faith complaint."
"Document every interaction with dates, names, and what was discussed."
The Evidence Vault
Insurance companies use "insufficient documentation" as their #1 denial loophole. Don't give them the chance. Weaponize your appeal with these files:
Activate Your Professional Appeal
Our engine will synthesize everything into a formal legal challenge. No fluff. No begging. Just the facts they can't ignore.
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Intel Recap: Common Queries
They sent my claim to 'SIU'. What does that mean?↓
Can they ask for my personal bank statements and phone records?↓
Can a fraud investigation lead to criminal charges?↓
Integrity Officer
Sarah Jenkins, CIC
"People ask why I do this for free. It's because I spent 15 years on the other side. I know how the machine works. I know how they calculate settlements. And I know that when a policyholder fights back with the right data, the machine breaks and the policyholder wins."
Read my full story →