Red Sands Insurance Company (Europe) Limited · DRN-6046748

The complaint Miss A complains that Red Sands Insurance Company (Europe) Limited declined a claim on her pet insurance policy. What happened In March 2025 Miss A took out insurance for her cat. The policy started on 31 March and was underwritten by Red Sands. She went to the vet on 14 April because her cat was very unwell. Tests were carried out, which led to a diagnosis of diabetes. Miss A claimed for the treatment costs but the claim was declined. Red Sands said the condition had started before the policy was taken out and continued during the first 14 days of the policy, and there’s an exclusion for conditions that start before or during the first 14 days of the policy. When Miss A complained, our investigator said it was fair to decline the claim as the clinical evidence showed there had been symptoms during the first 14 days and Miss A would have been aware during that time something was wrong with her cat. Miss A has requested an ombudsman’s decision. In summary, she says: • The conclusion that her cat showed diabetic symptoms during the first 14 days is based on hindsight, not what was known at the time. • There was no reason for her to believe diabetes was present until the tests were carried out. It’s unreasonable to say she should have known these were symptoms of diabetes. She had been told by her vet the symptoms were side effects of the medication for an existing heart condition. • The deterioration on 14 April 2025 was sudden and that’s why she took her cat to the vet. What I’ve decided – and why I’ve considered all the available evidence and arguments to decide what’s fair and reasonable in the circumstances of this complaint. The relevant industry rules and guidance say insurers must deal with claims promptly and fairly, support a policyholder to make a claim, and not unreasonably reject a claim. The starting point when deciding whether the claim was declined fairly is the policy terms. While there is cover for vets’ fees, this is subject to the policy terms and conditions, and the policy terms say there is no cover for a condition that is present before the policy starts or “within 14 days from your initial policy start date”. The policy started on 31 March 2025, so the 14 day period would run until 14 April. Terms like this are not unusual and pet insurance generally wouldn’t cover something that was present before the insurance started or within 14 days of the policy starting.

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This was an extremely difficult time for Miss A. Her cat was very ill, and very sadly, he died soon after. Her claim was then declined and she had to deal with the vets’ fees. I have considered the circumstances very carefully and taken account of all her comments but I’m satisfied it was fair to decline the claim for the following reasons: • Miss A says the deterioration on 14 April 2025 was sudden and that’s why she took her cat to the vet. However, that isn’t supported by the evidence recorded at the time. • The clinical records on 14 April include the following notes: “cat constantly losing weight since January, now 2 kg lighter than last time (January).” “cat lethargic for a week and getting worse.” “Cat still having constant PU/PD. Cat STOP diuretic in February.” • And the clinical record on 15 April says: “Admitted yesterday evening due to a week long history of lethargy. Losing weight since January,” • So the records made at the time show her cat had been lethargic for a week and getting worse. The evidence is that her cat had been losing weight since January. Then during the 14 day period, her cat became worse and she was worried about this, so she arranged an appointment at the vet. • Miss A’s cat had been very ill in January with a serious heart condition, but that was treated. She says the ongoing symptoms were related to the diuretic prescribed then, but the clinical records show her cat had stopped taking those in February. • I appreciate she may not have known the symptoms were due to diabetes, which hadn’t yet been diagnosed. But the key point is not whether a diagnosis had been given, or Miss A knew what the cause of the problem was, simply that she knew something was wrong. • I’m satisfied from the evidence recorded at the time that Miss A knew her cat was unwell during the first 14 days of the policy, even if she didn’t know the cause. She went to the vet about that problem on the 14th day of cover and a diagnosis was given a few days later. • The evidence shows the condition that was confirmed to be diabetes was present during the first 14 days (and possibly earlier) and Miss A was aware of it then. So the exclusion applies. My final decision My decision is that I don’t uphold the complaint. Under the rules of the Financial Ombudsman Service, I’m required to ask Miss A to accept or reject my decision before 24 April 2026. Peter Whiteley Ombudsman

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