Claim was manually filed, so there was no claim media provided.
Next
Claim Overview
Policy Information:
Policy Started On: 9/12/2023
Illness Eligible From: 9/26/2023
Cruciate Coverage Eligible From: 3/12/2024
Policy Type: OG, Vet Visit Fee add-on
Claim Information:
Claim Filed On: 4/11/2025
Occurrence Date Per PH: 3/19/2025
Vet Visit Date Per PH: 3/19/2025
Claimed Condition: Patella Luxation (MPL or LPL)
MRR?:
MRR was completed previously
Pre-Existing Conditions?:
Otitis externa, inappropriate elimination
Next
Invoice
The submitted invoice is below (client information intentionally omitted):
How would you proceed with this claim with the information provided to you? Do we need additional medical records? Why or why not? Think about it before proceeding to the following page!
Next
Claim Investigation Determination
Done thinking? Click on the image below to see how you should proceed with this claim!
Do we need additional medical records?
Defend your reasoning!
End
Do we need MR: No Why?: Even though a patella luxation is an AHC and this breed is highly predisposed to patella luxations, an MRR was previously performed and found no orthopedic issues/patella issues. Due to that and the fact that the pet is well outside of the CCL WP, there's no reason for us to delay settling this claim.
Claim Advo CE - Scenario #9 - Poppy
Lemonade
Created on October 16, 2025
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Transcript
Scenario #9
Poppy
Start
TL;DR + Claim Media
Claim was manually filed, so there was no claim media provided.
Next
Claim Overview
Next
Invoice
The submitted invoice is below (client information intentionally omitted):
How would you proceed with this claim with the information provided to you? Do we need additional medical records? Why or why not? Think about it before proceeding to the following page!
Next
Claim Investigation Determination
Done thinking? Click on the image below to see how you should proceed with this claim!
Do we need additional medical records?
Defend your reasoning!
End
Do we need MR: No Why?: Even though a patella luxation is an AHC and this breed is highly predisposed to patella luxations, an MRR was previously performed and found no orthopedic issues/patella issues. Due to that and the fact that the pet is well outside of the CCL WP, there's no reason for us to delay settling this claim.