The full picture
Standard accident & illness policies exclude wellness (vaccines, annual exams, flea/tick) unless a wellness add-on was purchased. Appeal only viable if the care was actually diagnostic/therapeutic, not preventive.
The winning argument
Reframe the visit. A sick-visit for vomiting that incidentally includes vaccines isn't a wellness visit. Itemize: which charges were diagnostic/treatment vs which were preventive.
What evidence wins this appeal
- ●Vet records showing diagnostic intent
- ●Clinical signs prompting the visit
- ●Distinction from a wellness exam
Step-by-step checklist
- 1Separate diagnostic from preventive charges
- 2Get vet to document presenting complaint
- 3Resubmit with sick-visit framing
What to ask your vet for
Please document the clinical reason for the visit on [DATE] — what symptoms or concerns prompted the appointment beyond routine preventive care?
If the first appeal fails
Resubmit corrected itemization → supervisor review.