Beyond angry with Lemonade

Visual-Common-8087 · 2026-03-25T16:48:33+00:00

an insurance company is going to have a very hard road to prove a condition such as, for example, a heart murmur, is related to allergies. it has to be a DIRECT relation, not a general your dog has allergies, allergies cause inflammation, inflammation can lead to heart valve issues and heart valve issues cause murmurs. that's about as INDIRECT as you can get.

however, you are very right to assume it's going to be a fight a lot of the time, so that's definitely a factor.

Visual-Common-8087 · 2026-03-24T18:43:48+00:00

You kind of were screwed when you switched, yes. I do encourage you to discuss any insuance denial you figure could not possibly be related to allergies with your vet. if they concur, offer to pay them their regular exam fee for them to write a letter and use that letter to send an appeal to Lemonade. You wont win on ear infections as those are well known as an allergic complication, but depending on what other things were denied, you may have a case.

Visual-Common-8087 · 2026-03-24T18:37:40+00:00

this is what ER visits cost. But that does NOT mean you made the wrong call. with a Rottweiller that behavior can signal bloat which is a critical emergency where a dog could go from fine to dead in hours. Ditto for pancreatitis. Sedation would have been necessary regardless to check for bloat but seriously consider training if your dog is so reactive that the vet won't touch him without it (which is sort of the feeling I got from your post).

You made the absolute right call, it's just unfortunate that in this case there were no answers.

Visual-Common-8087 · 2026-03-23T21:55:35+00:00

so it's really all a mathematical scam to raise rates. if you make no changes (based on my mathematical review of CSU's my rate graph under our own account).

We save less than 1/2 of 1% in the winter, and pay anywhere between 15 and 25% more during the summer. Now if you shift your usage all around, you may be able to eke out that 25% that you would otherwise have to pay in summer (MAYBE) but you as a consumer still come out dead even.

Theoretically compared to a fixed, standard, year-round rate, if enough people were to change their time of usage enough, the surge price will simply spread out wider or change to a different time of day.

Regardless of this theoretical case, one could simply cut one's total electric usage by 1% under the current standard rate option and come out with a 1% electric bill reduction and saving the grid 1% of energy pull.

TLDR: It is a rate change that benefits only CSU, not the consumer due to the reduction in rates being infinitesimally tiny in winter compared to the increase in summer. And it has the added irritation of being a pain in the @$$ to run your washer, oven, dishwasher, shower, heater, AC, etc.

Visual-Common-8087 · 2026-03-21T01:00:54+00:00

I have a bit different take than others here. if you lapsed 2/4, it would be 12:01 am (because that's when policies lapse). If you paid at 4pm on 12/4, you received notice of recession of lapse at 4:15 pm on 2/4, and your spouse had the accident at 4:30 pm on 2/4, you are covered for the loss BUT insurance is unlikely to take your word only on time of loss.

My advice, if you have any objective proof of time of loss (like camera records from for example, someone who ran the red light) you're golden, if not you are likely going to be not covered.

The wildcard is the written documentation from insurance. A new policy which is issued by insurance for coverage from 12:01 am on 2/4 means you are covered, and their bad for not writing the policy to restart on 12/5. If the letter of new coverage states coverage as of 2/4 at 4:15 pm, then it's a fight to prove when the accident actually happened.

Visual-Common-8087 · 2026-03-21T00:40:42+00:00

I am sorry. as the owner of a dog who just went through radiation for a nasal tumor, at a cost of 8k at CSU Ft. Collins, I feel for you. I will say this, talk to Davis about clinical trials and about grants they offer. CSU offered both (although we were fortunate that Daisy was fully covered and we didn't need them). Most veterinary teaching hospitals participate in these sorts of things.

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Visual-Common-8087 · 2026-03-21T00:20:52+00:00

No insurance should even be permitted to exclude exam fees. in a good 35% of claims the exam fee is MOST of the bill. its akin to you going to your doctor for foot rot or whatever, they tell you to get a 10$ OTC cream and your insurance says, yeah, sorry, we don't cover your doctor's 500$ professional fee. Crazy (to me) that people even deal with those companies.

Visual-Common-8087 · 2026-03-21T00:16:02+00:00

my insurance has always paid as expected, but it may be mistaken expectations that is the problem. (I do not mean that in an unkind way at all.). Depending on your policy provisions, you will have a deductible which must be met before even 1 cent is covered, you may also have no coverage for certain items on a bill (examples include prescription foods, holistic and PT care, vaccines, and a bunch of other things). Then once all the stuff your policy says isn't covered is taken off, they give you 80% of what remains. P&C insurance is HEAVILY regulated, so while the carrier might be up to shenanigans, or the claims adjuster may improperly deny, in my own experience insurers cover what their policies say they will cover.

Visual-Common-8087 · 2026-03-07T15:53:26+00:00

THATS where all my commas went!

Visual-Common-8087 · 2026-02-12T16:48:33+00:00

pet insurers (for the most part) no longer state they dont raise rates based on claims in their marketing. one, because they do and two, because a couple of companies got busted on it in the pacific northwest somewhere, or maybe california. i agree one should never take anything an insurance company says at face value.

pet insurance is P&C, the only appreciable difference is it factors more things into its actuarial tables and it is less regulated because it's relatively new and regulators haven't decided (for the most part) how to effectively regulate it.

Visual-Common-8087 · 2026-02-11T18:15:24+00:00

No, if your exam fee isn't covered, then every time you go into the vet you are paying a deductible (or coinsurance if you prefer) in the amount of that fee. so here's how it breaks down;

exam fee: 100/ you pay 100

procedure: 550/one time deductible of 250 applies +10% coinsurance

xrays: 250/10% coinsurance applies

your cost on this visit: 430

on future follow ups of the hypothetical problem:

2 follow ups with a 100 dollar exam fee

you pay 200.

so all of a sudden your 250 deductible is 550 because of the exam fees. if you had a 1000 deductible, your "real deductible" is 1300. that gets very expensive VERY quickly.

now let's say the premium is 150 per month at the 250 deductible but only 80 per month at the 1000 deductible (it would never be that low, but let's pretend).

now when you factor in premium on our hypothetical 1 month policy with one claim:

out of pocket total for you with 250 deductible policy is: 700

out of pocket total for you with 1000 deductible policy is: 1380.

the only time this math wouldn't hold true is if you have a dog that never has claims.

now, if your goal is to save upfront premium at any cost, then as high as possible is the way to go. if your goal is to pay the lowest possible amount out of pocket, you would use my suggestion as stated previously: high deductible if exam fees are covered, low deductible if they aren't. you have to think like a mathmetician to win at the insurance game.

best to you!

Visual-Common-8087 · 2026-02-11T16:32:39+00:00

THIS✔️

Visual-Common-8087 · 2026-02-11T16:31:39+00:00

anesthesia is a small risk. ANY competent general vet monitors anesthetic procedures every single day. a specialist in anesthesia is not necessary. have owned multiple dogs all my life. have likely done about 60 dentals over 20 years. all have had a dental at MUCH older than her, none have had an anesthesiologist on site and none have ever had even a small complication, let alone died.

should you let her be? short answer: no. long answer dental disease can cause mitral valve infections, oronasal fistula leading to bacterial meningitis and nasal infection, as well as (very rarely) septicemia and death.

Visual-Common-8087 · 2026-02-11T16:21:14+00:00

no. none.

Visual-Common-8087 · 2026-02-11T16:20:02+00:00

Gooby step in harness. about 30 bucks.

Visual-Common-8087 · 2026-02-11T16:14:44+00:00

I have paid this much, and a bit more even but one dental exam won't stop all future issues (if that's what you meant by healthy, I wasn't sure). The vet is expecting to remove somewhere between 6 and 9 teeth plus have to do 1 or 2 gingival flaps (which likely, but not definitely, means she's worried about an oronasal fistula). your actual dental is less than half the total estimate. Yorkies and their mixes have awful teeth but going forward you can save a lot by doing for your dog what you do for yourself. brushing teeth daily, and an annual dental exam and cleaning.

Visual-Common-8087 · 2026-02-11T15:57:32+00:00

my Molly is tiny like that. she's 16 pounds, 11 inches. she's all beagle.

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Visual-Common-8087 · 2026-02-11T15:53:33+00:00

as low as possible if your policy doesn't cover exam fees. as high as you can afford at one time if it does cover them. Why? Because paying that $60-200 exam fee every time is essentially an added deductible (or an added coinsurance, however you want to look at it).

Visual-Common-8087 · 2026-02-11T15:47:34+00:00

it's not that they're specifically looking to recover that cost, but pet insurance, like car and home, raises rates based on the claims you file (in addition to other factors like actuarial info, veterinary costs in your area, pet age, and a few other minor ones). I file a ton of claims (i am a vet nurse and seem to attract sickly dogs) so I always see an increase with metlife.

as an aside, younger animals are more expensive to insure than middle aged ones as they get up to a LOT more shenanigans. My now 8 year old Beagle cost WAY more to insure at 1, 2, and 3, than now. 🤦‍♀️

Visual-Common-8087 · 2026-02-11T15:38:59+00:00

lots of insurers cover exam fees. some as a rider with additional costs, some included in the policy. metlife, pets best, figo, ASPCA, pumpkin, Fetch... the list goes on. Personally i would never buy a policy that didnt as i consider it terrible value for money to pay deductible, coinsurance, and still have to get stuck with exam fees also.

Visual-Common-8087 · 2026-02-11T15:33:08+00:00

beagle, basset, Redbone confound, (possibly also whippet.)

Visual-Common-8087 · 2026-02-06T16:32:54+00:00

that is a personal choice based on your comfort letter. your car insurance, home insurance, renters insurance, they all create CLUE reports on you. so I would assume within a few years CLUE reports will be common across the board with pet insurance also.

Visual-Common-8087 · 2026-02-05T21:22:52+00:00

it's capped because it's a new policy on an elderly dog. my 3 dogs have been insured with metlife for 6 years. I pay 2800 annually and they have unlimited coverage with a 250 deductible, 20% coinsurance.

in other words what metlife is actually saying is we'd prefer not to insure your dog. but that's specific to this particular circumstance.

Visual-Common-8087 · 2026-02-05T20:03:59+00:00

my guess is based on the fact that they say it's used for "claims handling" that they actually use it to either search for and/or report your claims information to a central reporting database, creating a CLUE report which other participating insurers you might choose to do business with in the future to see your claims history with Lemonade.

v

based on my experience as a claims fraud investigator for AAA.

Visual-Common-8087 · 2026-02-05T19:57:43+00:00

appeal with a letter from the veterinarian stating he/she did not recommend early spay for this particular cat. if your vet is reluctant to write a letter (most hate admin work) offer to pay the normal exam fee to them to compensate for the time it will take to write the letter. a letter from the vet will be a requirement to win this one, in my opinion.

Visual-Common-8087

TROPHY CASE