Some claims are closed or denied not because of what the records show, but because the insurer says it doesn't have the records it needs. This is often one of the more fixable situations, because the next step is usually practical: find out exactly what's missing and get it to them. This guide shows how.
Why insurers ask for records
Insurers typically review a pet's medical history to decide whether a claim is covered. Trupanion, for example, says publicly that when you enroll it will "request your pet's medical records from all veterinarians, hospitals, or specialists that have treated your pet in the past" (Trupanion). Other insurers have their own processes.
If records from any clinic are missing, the reviewer may not be able to finish the review.
Step 1: Find out exactly what's missing
Read the denial or closure letter for:
- Which clinic or clinics they want records from.
- Which date range.
- Whether they want full records or specific items (exam notes, lab results, invoices).
If the letter is vague, contact the insurer and ask in writing for a specific list. Keep their reply.
Step 2: List every clinic your pet has seen
Missing-records problems often come from a clinic that's easy to forget:
- Previous regular vets, including before you adopted, if you have that information.
- Emergency or overnight clinics.
- Specialists and referral hospitals.
- Shelter or rescue records.
- Mobile or vaccine clinics.
Write down each clinic's name, location and the approximate dates of visits.
Step 3: Request full records from each clinic
Ask each clinic for your pet's complete medical record for the date range needed, not a summary or vaccine history. Ask whether they can send records directly to the insurer as well as to you, so you have your own copy. Clinics have their own processes and may take time.
Step 4: Check the records before sending
When records arrive, check:
- Your pet's name and details are correct.
- Dates cover the full range requested.
- Pages aren't missing (look for page numbers).
- Exam notes are included, not only invoices.
If something looks wrong, such as another animal's notes or an obvious error, ask the clinic about it before sending.
Step 5: Resubmit with a short cover letter
Include:
- Policy number, claim number and pet's name.
- A line saying you're providing the records requested in the insurer's letter dated [date].
- A list of each clinic and date range enclosed.
- A request to reopen or review the claim, and a request for written confirmation it was received.
Step 6: Follow up
Note the date you sent everything and the method. If you don't hear back within the time the insurer indicates, follow up in writing and reference your earlier submission.
If the claim is then denied for another reason
Once records are reviewed, the insurer may make a decision on another basis, such as a pre-existing condition. If so, see our guide on appealing a pre-existing condition denial.
If you would like help pulling this together, you can start your appeal pack: upload your denial letter, policy and vet records, and we prepare the documents for you to review and send.
FAQ
Is a denial for missing records final? Often the insurer will review again once it has the records, but check your letter and policy for the exact process.
Can my vet send records straight to the insurer? Many clinics can. Ask them, and request a copy for yourself too.
What if a clinic has closed? Tell the insurer in writing and explain what you've tried. They may accept other evidence.
How long do I have to send records? It depends on your insurer and policy. Check your letter.
Pet Claim Appeal Aid is a document preparation service, not legal advice. We are not a law firm and are not affiliated with any insurer. Your policy documents and your insurer’s written instructions always take priority over this guide.