Call Kurtis: One Sick Puppy - Judgment Day

STOCKTON (CBS13) -- Pet insurance sounds like a good idea.

 If your dog or cat gets sick their vet bills would be covered.

 But a viewer in Stockton found out that may not be the case when her insurance company refused to pay for her dog's surgery.

"When she's like this I'm happy," Lisa Lopez told us back in January; she was playing with her dog Roxy Heart, who was apparently feeling well that day.

 But that wasn't the case in June, 2010, two weeks after Lisa and her son Isiah brought her home.

"When she first got sick we were just watching her and crying and crying. I was like I don't know, she's gonna die and I said no, no we can't let her die, let's take her to [the] E.R."

 Over the next several months Roxy was in and out of the vet's office and undergoing tests.

 By November 1st a C.A.T. scan confirmed she had a "liver shunt."

 That's a congenital condition where a vein bypasses the liver, preventing it from filtering out toxins from the animal's blood stream.

 The resulting illness can shorten the dog's life, or lead to death.

 Lisa's vets recommended surgery.

 The Trupanion Pet Insurance she'd bought when she got Roxy states online it covered congenital disorders.

 But when Lisa sent Trupanion the diagnosis they called her.

"And she said well, we're saying that it's pre-existing, pre-existing during the waiting period."

 That 30 day waiting period ended on July 14th; her insurance was "in effect."

 And even though Roxy wasn't diagnosed until 31/2 months later Trupanion said it would not cover the $7,000 surgery.

"Uh, I was just in shock. I said that's not right. You know, how can you do that?"

"Please remain seated. Come to order. Department 17 is now in session" said the court clerk in San Joaquin's small claims court.
 
 Lisa sued Trupanion's parent company, American Pet Insurance.

"I think that they're just trying to find a loophole" Lisa told the commissioner (in lieu of a judge.)

 Both sides argued their case.

John Stine, Trupanion's representative, told the court "we don't go based on the diagnosis; we go based on the symptoms."

 Two months later Lisa got her judgment.

 The commissioner dismissed her case saying "if the plaintiff had spent the money and had the surgery on roxy this court could decide..."
 
 But since Lisa hadn't she said "this case is not ripe for this court..."

"Now that's a classic situation where the judge should rule and should give you an order that either it's covered or it's not" says consumer lawyer Stuart Talley.

He says since the court didn't rule Lisa can appeal the decision in superior court.

 And she doesn't need a lawyer to do it, although consulting one would be very helpful.

 After her day in court Lisa reflected on what she calls Trupanion's misleading sales pitch.
 
"I'm mad, it's a lie. Don't believe everything you read."

 Lisa doesn't have the money to pay for the surgery.

 But small claims court told her she can't sue unless she's already paid for the surgery.

 Lisa can either find a way to get her dog the surgery then return to small claims court, or she can appeal to superior court to try to get a check up front before having the surgery.