PetClaim logoPetClaim.
← All denial reasons
high difficulty~35% typical win rate

Pre-authorization not obtained

High-cost treatment denied because pre-authorization was required but not requested.

The full picture

Pre-auth is rarely required in pet insurance (unlike human), but some insurers require it for very expensive procedures. Appeal: argue emergency exception or that policy didn't clearly require pre-auth.

The winning argument

Argue emergency exception. Most policies waive pre-auth for true emergencies. Show timeline made pre-auth impossible.

What evidence wins this appeal

  • Emergency documentation
  • Policy review for pre-auth requirement
  • Timeline showing impossibility of pre-auth

Step-by-step checklist

  1. 1Document emergency status
  2. 2Cite policy emergency exception
  3. 3Show timeline

What to ask your vet for

Please document whether [TREATMENT] was emergent and whether delay for pre-authorization would have endangered [PET NAME].

If the first appeal fails

Supervisor review → DOI complaint.