ASPCA Pet Insurance is part of the Crum & Forster Pet Insurance Group, which is one of the U.S. pet insurance market’s four largest providers, according to Consumer Reports. The largest provider is Nationwide, followed by Trupanion, according to numbers provided by both companies to TCR in late November 2020.
Consumers should be aware that the American Society for the Prevention of Cruelty to Animals (ASPCA) has no administrative role in the ASPCA insurance product. ASPCA receives a fee from Crum & Forster, the insurance company, in exchange for the use of the nonprofit’s name and brand to sell insurance.
In 2019, the Washington state Insurance Commissioner cited United States Fire Insurance, the insurance underwriter (which sells pet insurance using the name “ASPCA Pet Health Insurance”) for, among other violations, practices seemingly designed to fool consumers into believing they were entering into an insurance relationship with the American Society for the Prevention of Cruelty to Animals (ASPCA). “United States Fire Insurance Co., Wilmington, Del.; fined $25,000, order 16-0192
United States Fire Insurance Co. sells pet insurance under the brand name ASPCA Pet Health Insurance,” the state regulator’s press release said in April 2019.
The Canine Review conveyed detailed email and phone requests for comment about the nature of the arrangement between ASPCA and Crum & Forster to ASPCA president and CEO Matthew Bershadker, ASPCA spokespersons Alexander Craig and Danielle Arnold, Crum & Forster spokesman Travis Reynolds, and Crum & Forster CEO Marc Adee. All parties declined multiple requests to comment. Our questions included whether there are any conditions apart from an exchange of fees to which Crum & Forster must adhere when using ASPCA’s name; what the license fees are; whether there exists any written or oral agreement between the ASPCA and Crum & Forster to administer insurance in keeping with the core values of ASPCA’s mission; how the insurance policy’s cancel clause and pattern of claims denials would be in keeping with that mission; and if it would be possible for The Canine Review to read ASPCA’s license agreement with Crum & Forster. The parties declined to answer.
ASPCA Pet Health Insurance is one of several brands operated by the Crum & Forster Pet Insurance Group, along with Hartville Pet Insurance, 24PetWatch, and PetPremium. Spot, Pumpkin and PrudentPet are also administered by Crum; however, they are not trademarks of U.S. Fire Insurance.
- ASPCA, the nonprofit, allows the insurance company, Crum & Forster, to license the ASPCA name for a fee. ASPCA, the nonprofit, has no administrative role or oversight in ASPCA Pet Insurance. In 2018, according to ASPCA’s financial filings, the non-profit earned $9.4 million “in royalties, licenses, and other.” Much of that came from a partnership in which Crum & Forster, a global multi-product insurer — pays licensing fees to sell pet insurance under the ASPCA name.
- There is a “cancel” clause in this policy and all pet insurance policies underwritten by United States Fire Insurance which states that the carrier “may also cancel your coverage by giving you at least 30 days notice for any of the following reasons….” c. “There is a material change that substantially increases the probability or severity of a covered loss.”
When asked about this clause by TCR reporters who did not reveal their identity, insurance customer suppport agents were adamant that they were certain that no person had ever had a policy cancelled due to the cost of claims.
- Consumers should be aware that whereas all policies available for enrollment on the provider’s website are tethered to annual reimbursement limits, the maximum annual reimbursement limit being $10,000, in fact, unlimited reimbursement plans are available if the customer calls and speaks with a live agent — an action that, statistically, less people take as opposed to enrolling online. Thus, it appears that one risk management strategy this company has adopted is simply to steer customers towards plans less likely to pay sufficiently for medical coverage for their pets.
- This insurance product pays claims by making a determination of the “usual and customary costs.” In other words, your costs are calculated by the insurance company, and not based on the amount that you actually paid your veterinarian for your dog’s medical care. Healthcare.gov provides the following definition of UCR (usual, customary, and reasonable costs): “The amount paid for a medical service in a geographic area based on what providers in the area usually charge for the same or similar medical service. The UCR amount sometimes is used to determine the allowed amount.” This is perhaps the most significant pitfall consumers should be aware of.
- This insurance product’s base policy excludes [“unless covered by an applicable endorsement] “any Hereditary, Genetic or Congenital Condition including those Conditions that are related, secondary, or resultant from any Hereditary.” Any number of medical events in an animal’s life could be characterized as “hereditary.” It’s a highly subjective exclusion, leaving much discretion to the provider.
- One of few pet insurance providers in the U.S. that offers medical insurance for horses.
- Accidents, Illness, and Wellness coverage are available
As discussed in the “Pitfalls” section, this insurance product appears to be steering potential subscribers towards its least valuable plan options. Although the product does offer plans with unlimited reimbursement options through its live customer service agents, there is no way the average consumer has of knowing this as this is not indicated or advertised anywhere online, but rather, known because current clients were able to obtain unlimited plans via telephone sign-up. On the provider’s website, however, the highest annual reimbursement limit is $10,000.
No, but an optional preventive care plan can be added to the base plan. Important to note, however, that wellness benefits are itemized and that the annual maximums listed [https://d3544la1u8djza.cloudfront.net/SamplePlans/v41/SAMPLE_v41_PrePrime.pdf] are a small fraction of what veterinary wellness care costs, in most major cities in the U.S.
There is an optional preventive care plan (can be added to the base accidents + illness plan).
There is an optional preventive care plan.
- 8 complaints in the last 12 months
- 16 total complaints in last 3 years