How to speak pet insurance
Here are some of the key phrases you may come across when searching for a new pet insurance policy.
Accident means physical harm or injury arising from an accident. From a pet insurance perspective, accidents are usually limited to specific scenarios like a motor vehicle incident, a burn or electrocution, an allergic reaction to an insect or spider bite, a bone fracture, a snake bite, a traumatic ligament injury, a bite wound or lacerations. All coverable accidents will always be listed in the policy’s Product Disclosure Statement.
Benefit Limit means the total amount payable under your policy for each product selected. This is the annual maximum amount, inclusive of any applicable sub-limits (such as tick paralysis and cruciate ligament conditions) that the insurer will pay within the Policy Period as shown on your Certificate of Insurance.
Some policies may include an Annual Condition Limit, which outlines the most you can claim on each condition during your Policy Period. These limits reset on renewal each year. The Annual Condition Limit will be shown on your Certificate of Insurance. Refer to the relevant Product Disclosure Statement for further details.
Benefit Percentage means the stated percentage of each claim for eligible vet expenses for which the insurer will reimburse you, subject to any applicable Benefit Limits and Excesses. The applicable Benefit Percentage will be shown on your Certificate of Insurance. For example, for an 80% Benefit Percentage the insurer will reimburse you for up to 80% of the eligible vet expenses, subject to Benefit Limits and Excesses payable.
Consultation Fees mean the fee charged for an examination performed by or under the supervision of a Vet, including a physical consultation, in-patient examination, in-hospital examination, health certificate, consultation or re-check consultation/visit, referral/specialist consultation/visits, emergency and after-hours consultations/visits. Annual Sub-limits may apply to consultation fees or they may not be covered. Refer to the relevant Product Disclosure Statement for further details.
Cooling-off Period means the period from your policy start date (usually 21 or 30 days) to make sure you are happy with every aspect of your policy. During this time, you can cancel the policy and get a refund of any monies received, since commencement or renewal (provided you have not made any claims).
An Excess is a sum that you pay once per condition, per policy period (typically ranging from $50-$200). The excess is deducted from your claim payment, which is calculated using your benefit percentage. For example, on an eligible vet bill of $1,000 with an 80% benefit percentage (amounting to $800) and an excess of $100, your pet insurer pays $700 and you pay $300.
A sickness or disease which is not an Accidental Injury or related to a Pre-existing Condition.
Lifetime Cover means once your pet is insured, as long as you continue to insure him/her each year without a break in cover, you will be offered a renewal each year for the life of your pet.
A pre-existing condition refers to any health condition (diagnosed or otherwise) that your pet has shown signs of before the purchase of a pet insurance policy (or its applicable waiting period), meaning the condition will not be covered under the policy.
As some conditions can be cured with treatment and don’t require ongoing care however, pre-existing conditions are assessed differently depending on whether they are considered a temporary or a chronic condition.
A temporary pre-existing condition is a pet health condition that usually resolves with treatment, and is removed from your policy as an exclusion automatically if your pet hasn’t shown signs of that condition for 18 months or more.
A chronic pre-existing condition is a pet health condition that requires ongoing care or is more prolonged in nature, so if your pet displays one of these conditions prior to purchasing a pet insurance policy or its applicable waiting period, it will never be covered under the policy.
Some of these conditions include:
- Cruciate ligament conditions
- Intervertebral disc disease
- Hip dysplasia
- Elbow dysplasia
- Patella luxation
- Endocrine diseases
- Any other chronic condition.
An important reminder that these exclusions only relate to pre-existing conditions. If your pet requires treatment after the purchase of a pet insurance policy and its waiting period, all conditions outlined in the policy’s Product Disclosure Statement will be eligible for cover for the life of the policy.
Please refer to the Product Disclosure Statement (PDS) of the pet insurance policy for more details.