Pet Insurance – Navigating The Minefield!

Every year, Santa delivers fluffy bundles of joy to excited families on Christmas Day.

New pet owners usually expect the costs of vaccinations, wellness and development checks and routine desexing procedures within the first few months. But what happens when unexpected things happen?

For example, when a pup swallows stuffing from his new toy?  When the kitten that wants to test the boundaries jumps awkwardly off a ledge? When a puppy’s leg is accidentally stepped on by one of the kids during play? These incidents are seen all too often in our practices. When a fur baby requires treatment, the last thing any pet owner wants to be worrying about is whether they can afford the vet bills. A common vaccination and check-up can cost anywhere from $80 to $120. However, if your pet family member does require veterinary treatment for more serious conditions the costs may reach into the thousands. Pet insurance is key in providing both you and your veterinarian the freedom to choose the best possible treatment plan for your pet, without compromise.

Ten years ago, many of the life-saving techniques performed by veterinarians around the globe today, were simply, not on offer. As medical advancements have been made and as the expectations of pet owners on today’s veterinarians to perform new types of treatments grows, the requirements for general standards of care have vastly improved. Whilst improvements in veterinary medicine are, without doubt, saving lives, they come at a cost, making pet insurance one of the fastest-growing sectors of the insurance market.

How Does Pet Insurance Work?
Unless you use a service such as GapOnly, claims are lodged after paying your vet bill. Our reception team will happily submit a claim on your behalf, providing the request from you has been made in writing. We ask that you send us an email containing your policy number and the date and condition(s) you wish to claim for. We will ensure all claims include itemised tax invoices(s), payment receipt(s) and applicable consultation notes. After you have paid a veterinary bill, you are able to lodge a claim. This can be frustrating for clients, as it is believed that if the pet is insured, the entire vet bill will be covered and that no payment at the vet is necessary. In most cases, a vet bill must be processed before a claim can be lodged – and this can create stress because pet owners are still lumped with paying the account at the time of treatment. Alternatively, you may submit your own claims using an online portal (if this is a service your insurer offers), or by post. If submitting a claim via post, all claim documentation must be originals and must be accompanied by a completed claim form. Incomplete claim forms will likely be returned to you and this may result in a delay in processing your claim.

How much does Pet Insurance Cost?
You can choose a pet insurance policy to suit your budget. The costs can vary depending on a number of factors including the excess limit selected, the benefit percentage applicable to the cover you have chosen, the species, breed and age of your pet.

What Is A Pre-Existing Condition?
A ‘pre-existing condition’ is one, which has begun before, or during the relevant waiting period. A pre-existing condition may not be claimable for the lifetime of your pet. The best time to get pet insurance is as early as possible (most insurers cover pets from 8 weeks of age) and before any medical problems develop. Pets who have no markers for illness or injury at the time of sign up and during the waiting period, should, technically not be excluded from making future claims. In some circumstances, pre-existing conditions can be removed from the policy. For example, your pet may have had one ear infection before insurance was arranged. But, if no further signs of this condition were treated for a significant period of time (ie 18-24 months) you may be able to submit a letter to the insurance underwriter to have this condition removed as an exemption. Please note, it is illegal for a veterinarian to ‘leave out’ relevant information regarding your pet’s health status for insurance purposes.

Who Are The ‘Insurers’?
The majority of pet insurance companies in Australia companies fall under the PetSure ‘umbrella’ group, underwritten by Hollard. It includes market brands such as RSPCA, Woolworths, ProSure, Real, HCF, Medibank, AHM, PetMed, and Pet Insurance Australia. Other key players within the pet insurance industry include:

BowWowMeow – A part of the big PetSure group, this company has just brought out a nifty ‘Gap Only’ service (which is free for anyone who has a BowWow Meow policy). This service reviews and calculates your pet insurance claim while you’re still at the vet. You simply pay the gap (the difference between the vet’s invoice and the claim benefit under your policy) and go – similar to when you visit your doctor.

Pet Plan – Pet Plan offers a unique service; whereby pet owners pay excess to the vet (usually $125 for cats and $150 for dogs), then submit a claim, meaning the veterinary practice is reimbursed directly. We are always happy to oblige with this, but it is important to note that some items on your bill may not be claimable, leaving a remaining sum outstanding for you to cover. In this case, your insurer will contact you to notify you of the ‘difference’, which is to be settled through our hospitals. Pet Plan is underwritten by Lloyd’s.

*Trupanion – Whilst some pet insurance companies put a limit on how much you can claim per condition, Trupanion insurance provides customers with no annual, per condition, or lifetime payout limits. That means you get coverage for surgeries, diagnostic tests, medications, treatments, and hospital stays and they will pay eligible claims—no matter the cost. Underwritten by Hollard, Trupanion customers can take advantage of GapOnly services (meaning a claim can be made directly at the vet).

Knose –A fairly new player in the market, Knose is underwritten by ‘Allied World’. Knose allows you to choose whether you would like to claim 70%, 80% or 90% of veterinary bills back – and the monthly premiums will vary based on which option you select. They also allow clients who are a part of our ‘Pet Club’ (our monthly vet membership which targets the cost of routine vet care) to waive consultation fees when claiming (given they are already included at $0 in our internal plan) and which makes the monthly premiums for pet owners, slightly lower.

Additional Information:
It is important to note that we are not registered insurance brokers and will never recommend one pet insurance company over another. We do not receive financial incentives from companies to recommend their services. Before you sign on the dotted line, it is paramount that you read your Product Disclosure Statement or ‘PDS’, which tells you what you are and are not covered for under a specific policy. It highlights insured events, claim limits, exclusions, discounts, benefits and information on how the claims process works.

So, which company is best for you?
This largely depends on your individual situation, your budget and the level of cover required to suit your pet’s lifestyle. In short, we can’t advise you on this, other than to say it is important to do your own research and read the PDS’s for inclusions and exclusions.

We facilitate ALL claims; using whatever company you have chosen. We will contest a claim should we believe the insurance company is being unjust in their decision to decline a claim. Unfortunately, chasing these denied claims usually falls into the lap of the policyholder, who then has to chase the consulting veterinarian to write a letter of negotiation (which can be very time consuming for an already ‘run off their feet’ practitioner).

We respect the insurance companies for their work within the industry and will continue to recommend insurance despite any inadequacies, because, we know that it makes all the difference for clients operating within a tight budget.

Our Top Tips:

*Ensure you have a full understanding of what your policy does and does not cover.

*What other benefits are included? Whilst most policies do not cover ‘routine’ care items, some assist in rebates towards vaccinations or routine dental care extras.

*Always ask about waiting periods, financial caps, and pre-existing conditions before signing up. Not all conditions and treatments are covered by pet insurance (tick paralysis is a big one here!). Please refer to the applicable PDS of the company you are interested in joining for further information.

*If your pet has had any medical problems prior to signing up (even the most minor of conditions), you may be exempt from making claims relating to these issues.

*Some policies will only cover basic illnesses, while others will extend to more serious illnesses and accidents. The policy you choose and the level of cover you receive will be reflected in your monthly premiums.

*Make sure you claim after each medical issue. Some companies will not allow you to claim if a significant amount of time has lapsed since your pet was seen last.

*Speak with the insurer to find out if a ‘pre-existing condition’ can be removed from the exclusion list if no symptoms of the illness have reoccurred within a certain timeframe.