Service Animals Cost as Much as $50,000. Will Your Insurance Cover It?

We've written before about service animals and the important role they play in accommodating disability. They open a new world of access for people who are otherwise limited. But if people need a service animal, how are they expected to pay for it? The average service dog costs $15,000 to $30,000 but can range as high as $50,000 depending on the required training. This high price can be beyond the reach of many suffering people. No one should ever have to choose between suffering from a disability and crushing economic debt.

As the service dog typically relates to a diagnosed disability, will your insurance company pay for the same? The answer is not quite clear. We can predict that most insurance companies will reject any initial application and then fight any appeal. This fight will come down to how, exactly, a court views a service dog. Is it considered a piece of durable medical equipment (DME), a prosthetic, or is it something else entirely? The answer to that question may dictate whether or not your insurance policy must cover the expense. In New Jersey, DME is defined as meaning equipment, including repair and replacement parts, but not including mobility enhancing equipment, that: (1) can withstand repeated use; (2) is primarily and customarily used to serve a medical purpose; (3) is generally not useful to a person in the absence of illness or injury; and (4) is not worn in or on the body. A prosthetic device means a replacement, corrective, or supportive device including repair and replacement parts for same worn on or in the body in order to: (1) artificially replace a missing portion of the body; or (2) prevent or correct a physical disability; or (3) support a weak or disabled portion of the body. We believe a strong argument can be made that a service animal fights both definitions.

We have, for years, argued that a service dog is essentially a "fuzzy wheelchair" that should be given the same assessment as any other device that aids a disabled person. No New Jersey court has answered this question head on. Around the country this remains an open question. For instance, a Washington State court found that a service dog was neither durable medical equipment nor a prosthetic and as such no coverage would be required. On the other hand, certain federal statutes appear to define a seeing eye dog as a prosthetic. New Jersey has always been at the forefront of civil liberties in this country and we are hopeful that when a court had the opportunity to consider this question it will be in favor of disability rights.

Just because your insurance company says "no" does not mean the fight is over. Remember that the insurance company has an economic incentive to deny claims. A certain number of individuals will never file an appeal or fight, and, as a result, the insurance companies potentially save millions of dollars by denying otherwise valid claims. The attorneys at Costello & Mains have decades of experience standing up for disability rights and fighting the interests of insurance companies. Contact us to see how we can help. Get the benefits you deserve.