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Pet insurance offers peace of mind, but to truly benefit from your policy, you need to understand not only what is covered but also what isn’t. These ‘not covered’ items are called exclusions.
Every pet insurance policy is different, and some insurers may exclude certain veterinary treatments, specific conditions, circumstances and vet bills. Insurers list these in each insurance policy’s Product Disclosure Statement (PDS). Exclusions are not intended to catch you out; they define the boundaries of the cover and help keep premiums manageable for everyone.
Pet insurance can cover your fur baby for life, for as long as the product is offered, provided there are no breaks in the cover over the whole policy period, and subject to the policy terms and conditions.
Most Australian pet insurance policies allow you to get insurance coverage for your pet from the time your pet is six weeks old and up until they reach eight or nine years old. Some insurers may have age limits, with policies becoming more expensive or harder to obtain as your pet gets older.
Many policies also include a waiting period, which can range from 30 days to six months, depending on the insurance product and the benefits you wish to claim. Insurance premiums will differ based on your pet’s age, your pet’s needs, your pet’s health and the pet insurance plan. Several terms and conditions may also impact your ability to claim.
Always read your Product Disclosure Statement (PDS) to understand your benefit limit and any sub-limits that apply to specific conditions or therapies. The Target Market Determination (TMD) can help you understand if the insurance policy is the right fit for you and your pet.
While exclusions vary between insurers and policies, there are some common exclusions across most pet insurance providers in Australia:
If your pet has been diagnosed or shown symptoms of a condition before the policy started (or during the waiting period), it’s generally considered a pre-existing condition and won’t be covered.
Therefore, it is important to consider taking out cover while your pet is as young as possible, so they’re covered before developing any pre-existing conditions.
Some policies may cover certain pre-existing conditions if your pet has been cured and symptom-free for a set period (e.g. 18 months), but this varies across different insurance providers and policies. Chronic conditions are often excluded from cover, even if your pet is symptom-free.
Depending on the insurance company and the level of cover on your pet’s policy, sometimes you may be able to claim reimbursement for routine care. However, standard policies typically don’t cover routine or preventative care unless you’ve purchased an optional wellness add-on. These include:
If your policy does cover routine care, make sure you understand your annual benefit limit.
Pet insurance is designed for pet owners rather than breeders, which means most pet policies don’t cover pregnancy, obstetrics, or difficulties that occur during breeding or labour.
Elective treatments that are not medically necessary, such as tail docking, ear cropping, or cosmetic surgeries, are generally excluded. This can include de-sexing and other therapies that aren’t medically necessary.
Most pet insurance policies do not cover dental treatments such as cleaning and therapy for oral diseases. However, some insurers allow you to add dental care as an optional extra to your policy to cover a portion of dental treatments. Some policies exclude dental disease altogether, while others only cover it if regular dental checks are documented. Coverage might exclude:
Pet insurance policies in Australia typically come with waiting periods (usually around 14 days for accidents and up to 30 days for illnesses). Waiting period prevents you from claiming soon after your policy commences and protects the insurer from paying for existing injuries or illnesses.
Pet insurance in Australia is typically structured around three levels of cover:
The key to finding the most suitable pet insurance for your furry friend is understanding the levels of cover for vet bills and selecting a cover option with an insurance benefit that balances cost with coverage based on your pet’s needs.
Before you buy a new policy, it’s important to read the underwriting of the policy and understand the exclusions, limitations, and waiting periods of your insurance plan. If your pet is prone to certain health issues, you may like to consider comprehensive plans with added benefits like routine care.
While exclusions are important to understand, it’s also crucial to know exactly what your policy covers as applicable waiting periods may still apply for many treatments and conditions.
Accident-only policies provide coverage for incidents where your pet sustains injuries due to unforeseen accidents. These policies do not cover vet visits for illnesses or medical conditions that develop over time.
Common conditions covered under accident-only policies include:
This more comprehensive coverage adds protection for a range of illnesses, which are typically excluded under accident-only policies.
Conditions commonly covered under accident and illness policies include:
Comprehensive plans provide the broadest coverage, including accident and illness treatment, as well as additional benefits for maintaining your pet’s overall health.
Routine care add-ons generally include coverage for:
It’s important to fully understand how the excess, premiums, and gaps work in your pet insurance policy to avoid unexpected costs and to ensure your pet’s healthcare is financially manageable:
As a General Insurance expert with over 13 years’ experience in financial services, Adrian Taylor knows that dogs and cats get themselves into all sorts of mischief. One part of Adrian’s work is to help empower consumers to understand how pet insurance can help save them from exorbitant vet bills when their pet gets injured or falls ill.