It seems that every company is dipping their fingers in the pet insurance pie these days, with so many insurance policies to choose from, how will you know which policy to choose? When choosing an insurance policy, make sure that you read the fine print of what you’re covered for, and what you’re not. There will be no benefit in buying a cheap insurance cover if you are covered for virtually nothing, or if your expensive insurance cover doesn’t cover a disease or condition that your pet’s breed is predisposed to! This page is designed to make sense of insurance policies, so that you may make the best decision on pet cover based on your financial situation.

Types of cover:

1. 12 month plans

These plans will only cover 12 months from the start of the policy. When the cover expires, a new policy will have to be taken out. If there are any conditions that are diagnosed within the 12 months that your cover is valid, you cannot claim against them under the next policy, as it is deemed ‘pre-existing’, and will be excluded.

2. Accident only Cover

These plans are limited to only situations that the insurance policy deems ‘accident’, no matter the intention behind how the injury is received. They include (but are not always limited to, depending on the company providing the insurance)
? Motor Vehicle accidents
? Burns or electrocution
? Falling from an elevated position
? Injuries inflicted by another animal
? Snake bites
? Allergic reaction from an insect bite other than fleas or ticks.

3. Routine Care cover

Routine Care plans are provided to decrease the cost of routine veterinary visits, such as vaccinations, heartworm control, flea preventatives, council registration fees and cleaning of your pet’s teeth. Although routine care cover is not very expensive, weigh up the amount of money you pay vs the money that you would receive back from your vet bills. These plans will not cover your pet if your pet gets sick for any reason.

4. Maximum Benefit Policy

These plans usually state that they will cover your pet for the value of $X (varies, depending on the company who provides the cover). This is the total amount that the policy will pay you, either over the life of your pet or every year, either in one claim, or over several claims. Some policies may roll this amount over each year. Once this amount has been reached, your policy expires and you cannot claim any more veterinary fees. Sometimes this policy may expire completely once the pet has reached 8 years old (or over 5 years in selected breeds). Please read the fine print of your policy, make sure that you will be guaranteed renewal of the policy, and avoid policies which expire as your pet reaches ‘senior’ status (which is most likely when pets will have the most problems).

5. Covered for Life Cover

Covered for life policies provide lifetime cover with wide-ranging cover for vet fees. Covered for life policies are designed for pet owners concerned about their pet developing a long-term, chronic or recurring illness (ie. Arthritis, eczema, diabetes, heart conditions, skin conditions, etc) which would need treatment by a vet for the life of your pet. These policies give you a maximum amount to spend per year for treatment for your pet, starting from $10,000 to $20,000. This amount rolls over each year, rather than a set amount to spend for the lifetime of your pet. This cover is the most comprehensive, gives you the best cover, and the most amount of money back, but may be more expensive than others.

Exclusions

Check with your insurance company, but listed below are some things which may be excluded from your insurance policy.

  • Any condition that has been diagnosed before taking out the policy (pre-existing). i.e. If the pet has previously had a cruciate ligament repaired on one leg, you cannot claim against a cruciate ligament repair in either leg. This can also apply to diseases which have a long period of creation i.e. arthritis, discospondylitis, periodontal disease. It also applies to seasonal conditions, whether or not the pet was affected by the condition at the time of the policy commencement.
  • Certain breeds (Bandog, Beauceron, Bernese Mountain Dog, all Bulldog breeds, American Bullldog, Bull Arab, Deerhound, Dogue de Bordeaux, Estrela Mountain Dog, Great Dane, Irish Wolfhound, Leonberger, all Mastiff breeds, Newfoundland, Miniature Bulldog, Old English Sheepdog, Pyrenean Mountain Dog, Rottweiler, Shar Pei, St Bernard, or any crosses of the above breeds). If you have a dog breed listed above, you may need to pay a higher premium.
  • Diseases caused by parasites in which there are preventatives available (diseases caused by fleas, ticks, worms, heartworm)
  • Preventable diseases in which there is a vaccine available (canine hepatitis, kennel cough, distemper, adenovirus, parvovirus, feline cat flu, chlamydia, feline leukaemia, feline infectious peritonitis, feline immunodeficiency virus)
  • Any pet which is not vaccinated.
  • Inconclusive diagnoses, where a diagnosis cannot be made
  • Multiple foreign body surgeries (watch out Retriever owners, Staffy and Beagle owners!)
  • Treatment for a condition in which you have not taken reasonable precautions to protect your pet from situations in which may result in injury or illness.
  • Negligence or a malicious act caused by you or anyone living with you, an immediate family member or anyone acting on your behalf.
  • Breeding, pregnancy, or pregnancy related conditions.
  • Behavioural conditions requiring treatment.
  • Prophylactic teeth cleaning or dental issues, including dental disease, teeth fractures or oral disease (depends on the insurance company, check with your insurance provider).
  • Elective treatment, experimental treatment, cosmetic procedures.
  • Routine procedures (vaccinations, desexing, microchipping, etc) will not be covered unless a routine care police is taken out, or added to an illness cover.
  • Any condition diagnosed within a set waiting period of any cover. This is classed as ‘pre-existing’ and will not be covered.
  • House calls, unless in an emergency situation
  • Banned/restricted/dangerous dogs prohibited by any Australian government sector
  • Transplants, including feline kidney transplants, prosthesis, including prosthetic testicles, eye implants.
  • Any cost of treatment which the treatment is not recommended by your vet, or cost of treatment incurred by failing to give a treatment which was recommended by your vet.
  • Any services for your pet which is not provided by a veterinarian i.e. boarding, grooming, behavioural therapy or hydrotherapy, any retail products relating to your pet including food (unless hills s/d for urine dissolution), housing, carrying cages, etc.
  • Any pandemic disease causing widespread illness, death or destruction affecting dogs and cats.

Any insurance company has the right to deny a claim, and/or cancel your policy if you submit a fraudulent claim, or solicit your veterinarian to behave in a fraudulent manner.

 

Sub-limits

Sub-limits occur in a policy when the insurance cover will limit the amount you can claim, between the categories of the policy. For example, if a Maximum benefit policy covers accident and illness, to the value of $8,000, it may be divided between accident cover and illness cover, for a total of $4,000 each. The claim is then subjected to the conditions listed for the ‘accident’ cover.

 

IMPORTANT QUESTIONS TO ASK YOUR INSURANCE PROVIDER

  • How long has the company been in business?
  • What policy exclusions or restrictions will be applied to the policy at the time of renewal?
  • Who underwrites the policy, and what experience do they have in pet insurance?
  • How long will it take to be reimbursed for a claim?
  • Will your insurance company pay you, or your veterinarian, if you have a claim?
  • Does the company operate as a broker, and do they have their policies underwritten by a third party who control what is covered and what is not?
  • Does the policy have an age limit for joining?
  • Does the policy guarantee lifetime renewal?
  • Does the policy stop cover once your pet reaches a certain age, or does the cover decrease as your pet ages?
  • Does the policy offer routine care?