Your typical pet insurance policy helps pay for expensive healthcare costs for your beloved household critter. Like any insurance policy, it doesn’t cover everything, which means you should understand what it does and doesn’t cover before signing up.
Common pet insurance exclusions
An exclusion is a treatment that is explicitly not covered by your pet insurance policy. We’ve collated some of the more common exclusions you may find on a common policy.
- Abuse: All insurers will not pay out claims when there’s evidence of a malicious act or negligence.
- Ambulance costs. Many vets will do callouts and transportation for ill/injured animals. These costs may not be covered by your pet insurance policy, especially if it doesn’t turn out to be an emergency (a non-essential hospital admission).
- Artificial limbs / other prosthetics. While you may find that your insurance covers a procedure to fit a prosthetic, the cost of the limb itself may not be.
- Bilateral conditions. If a pre-existing condition affects a body part to which your pet has two of (e.g. eyes), then an injury or illness affecting the opposite body part is generally not covered by your insurance policy.
- Dental issues. 85% of dogs four years and older suffer gum disease, according to VetWest. Because of this, many of us seek out pet insurance that covers dental treatment. Be careful, though, because many pet insurance policies will not cover some (or any) dental costs; like cleaning, orthodontics, oral disease, etc.
- Diseases with a known vaccine. This exclusion is designed to stop people from neglecting important vaccinations and preventative treatments (e.g. parovirus, canine cough, Hepatitis, deworming tablets). However, you may not be able to claim even if your pet is properly vaccinated and contracts the disease anyway.
- Elective procedures. This can include desexing, regular checkups, etc. If it’s not medically necessary treatment, you may not be able to claim for it. Comprehensive policies may cover routine care, while accident & illness policies exclude such cover.
- Organ transplants. Organ transplants can be particularly risky operations, not to mention organs may not be the easiest to source for certain animals. As such, these procedures may not be covered under your policy.
- Pregnancy/breeding. Treatments that are the result of pregnancy are usually not covered by your pet insurer. There are many reasons for this. For one, animals that aren’t desexed are at greater risk for developing certain healthcare conditions (e.g. urinary tract infections) and can be more aggressive towards other animals, which makes them higher claim risks.
N.B. The above doesn’t constitute an exhaustive list. Refer to your Product Disclosure Statement to learn the finer details of your policy.
There are many more instances where you may not be able to claim, which will vary based on your insurer and policy.
Other pet insurance restrictions you may encounter
Your ability to claim on your pet insurance is limited by terms and conditions, or ‘rules’. Some of these rules dictate that you cannot claim straight away on cover, but instead will have to wait until the future.
- Cruciate ligament conditions are fairly common and expensive to treat. However, there are that policies will let you seek treatment after you sit through a waiting period when first signing up for insurance (e.g. six months).
- Pre-existing conditions. Any conditions your pet had before you took out the policy will not be covered by your new insurance policy, unless otherwise stated by your insurer.
You are also unable to claim for treatments you’re currently sitting a waiting period for. Waiting periods can range from 30 days to six months.
Don’t wait for the right opportunity to get covered
When you shop around for pet insurance, you should be keeping all this in mind. However, what’s truly important is finding cover that insures your pet against as much as possible, as soon as possible. For all the things that pet insurance excludes from cover, there’s plenty more that it will cover.
Still sniffing around for pet insurance information? We’ve got your back.