Petsy Pet Insurance Explained

What is pet insurance?

According to Animal Medicines Australia, about 61% of Aussie households own pets and as many as 90% of households have had pets at some point in time. We are a pet-loving nation! Dogs and cats are by far the most popular pets. They enrich our lives, and they are great companions. Yet the cost of pet ownership can add up fast. It’s not just the food, toys and treats, but also the cost of veterinary treatment that can take many pet owners by surprise. And that is where pet insurance may help.

Petsy Pet Insurance is designed to help you manage those vet costs for treatment when your dog or cat suffers from unexpected illness or injury.

Why might you want pet insurance?

No matter how good a pet parent you are, pets have a way of getting themselves in tricky situations, for example, eating things they shouldn’t, or simply getting sick.

If you’re unsure if pet insurance is worth purchasing, consider how you might deal with an unexpected bill for vet costs. Vet costs vary depending on the extent of an injury or illness, the required treatment, as well as where you live, and these costs can often run into thousands of dollars.

Not everyone is in a position to cover these unanticipated costs on their own and therefore you might want to consider whether you need pet insurance in your own circumstances. Pet insurance doesn’t cover everything, and there are limits, conditions and exclusions, but knowing you have cover for the unexpected can be reassuring.

What’s covered and what’s not covered, when it comes to Petsy Pet Insurance?

A Petsy Pet Insurance policy is designed to provide cover for a portion (80% or 90%) of the cost of necessary treatment provided to your pet by, or under the supervision of a vet to relieve or cure an illness or injury. This may include, but is not limited to, hospitalisation, surgery, x-rays, medication, diagnostic tests, nursing and other care and procedures.

There are waiting periods applicable to different conditions and there are some things that are not included as standard, but you have an option of including them in your cover. 

It is important to note that Petsy Pet Insurance is designed to provide cover for the vet costs of treatment that is required to relieve or cure an unexpected illness or injury.

This means:

• Preventative and routine items & treatments, such as general check-ups and vaccinations, things you would expect to do in order to keep your pet healthy, are not covered. 
• Treatment of conditions that have occurred, have shown signs or symptoms and/or you knew about the condition (or a reasonable person in the circumstances could be expected to have known) prior to purchasing your policy or during an applicable waiting period are considered Pre-existing Conditions, and are not covered. You can request for a Pre-existing Condition Assessment to be completed.
• Elective procedures, including desexing or additional vet costs, such as after-hours treatment and house calls when a vet doesn’t consider there was an emergency, are not covered.

There are other exclusions applicable, and you can see a summary of all of the exclusions below.

Optional Extra Benefits

There is no cover for alternative therapies, dental illness or behavioural problems, unless you choose to include them in your policy.

You will be provided with an option to include Optional Extra Benefits, as part of the process of getting your quote.

The Optional Extra Benefits available are:

• Alternative Therapies
• Dental Illness
• Behavioural Problems

Vet Consultations

As part of your coverage, you will have cover for the cost of vet consultations related to required treatment of an injury or illness. There is no cover for the cost of vet consultations or other vet costs related to preventative and routine items, Pre-existing Conditions, elective procedures and/or other exclusions.

As some vets offer client membership plans that include a certain number of free or pre-paid consultations, we also offer the option to exclude costs of vet consultations from your policy upon phone request. To remove the costs of vet consultations, please call us on 1300 952 790 or email [email protected]

What is a waiting period and how does it affect your cover?

A waiting period is the amount of time during which no benefit is payable under the policy and this means you cannot claim for vet costs for treatment your pet receives in relation to an illness or injury which occurs during a waiting period.

So for any condition that occurs, has shown signs or symptoms and/or you come to know about it during a waiting period, will meet the definition of a Pre-existing Condition and will therefore be excluded from your cover. Such an exclusion may be reviewable or non-reviewable. 

Waiting periods apply from the time your policy starts, even if you have decided to switch to Petsy Pet Insurance from another provider’s pet insurance policy, and also when you upgrade your level of cover with Petsy.

If you upgrade your level of cover or decide to add Optional Extra Benefits after the initial purchase of your Petsy policy, then waiting periods will apply from the time of the upgrade or addition of Optional Extra Benefits. You will still be entitled to the benefits payable under your previous level of cover during the waiting period for the higher or additional benefits.

 The waiting periods are:

Why do waiting periods exist?

If waiting periods didn’t exist, people could take out pet insurance or upgrade their cover only when they know or suspect that they might need cover, and then immediately make a claim. If these customers then cancelled (or downgraded) their cover after making a claim, it would not only be unfair to other customers, but it could also lead to increased premiums for all customers.

Is it possible to apply to have the waiting periods reduced?

Yes! We offer customers the chance to submit an additional application to request the 6-month waiting period for the Specified Conditions (and others, e.g. Dental Illness) to be reduced.

To consider whether a reduction of the waiting period can be provided, we require:

• a completed request form from you, which will require you to have your pet examined by a vet at your own expense; and
• copies of your pet’s medical history & clinical notes. You will need to assist us in the process of obtaining these, for example, by providing details of any vets your pet has seen in the past.

During our assessment of the application, we will review the available information, and if sufficient, confirm whether there are any identified or suspected Specified Conditions (and others). Where we are comfortable that there aren’t any identified or suspected Specified Conditions (and others), we will reduce or waive the waiting period for those conditions.

We will confirm the outcome of your application and if we decide to approve the reduction of the waiting period, we will provide you with an updated Certificate of Insurance which lists the agreed Specified Conditions (and others) and the new reduced waiting period applicable.

What conditions does Petsy Pet Insurance not cover?

• Pre-existing Conditions: There is no cover for vet costs associated with the treatment of conditions your pet had before your pet’s first date of cover under a Petsy Pet Insurance policy or which arises during an applicable waiting period.
  • There is a definition for what is a Pre-existing Condition in the Product Disclosure Statement and it’s important you understand this. See Understanding Pre-existing Conditions for more details.
  • A condition is considered a Pre-existing Condition, even if it’s not been officially diagnosed or identified.   
  • We may confirm, in certain circumstances, that a condition is no longer considered a Pre-existing Condition. This will usually occur when we are satisfied that the condition has been successfully resolved. This is typically done after a specified time period has elapsed during which your pet was free of symptoms as confirmed by a vet.
• Vaccinatable diseases: There is no cover for vet costs associated with the treatment of a disease which is vaccinatable if you have not maintained your pet’s vaccinations (preventative Treatment). 
• Any conditions that are the result of intentional harm or neglect.
• Any conditions that are the result of or requiring ongoing or repeat treatment due to you not following your vet’s advice.
• Any conditions that are related to an epidemic, pandemic, or new influenza.
• Vet costs for the treatment of Behavioural Problems (including any injury or illness which arises as a result of a Behavioural Problem) or Dental Illness, unless you have Optional Extra Benefits included in your cover. Other limits, exclusions and conditions still apply.
• Even if you have included Optional Extra Benefits and have cover for Dental Illness, there is no cover for vet costs associated with the removal of deciduous teeth.

What Treatments does Petsy Pet Insurance not cover?

Petsy Pet Insurance was designed to offer extensive cover, but even if an injury or illness is covered under your Policy, there are certain treatments which are not covered:

• Treatment during an applicable waiting period.
• Any vet costs resulting from breeding, pregnancy, whelping or queening.
• Any vet costs for desexing. We do, however, cover additional vet costs for treatment of complex cryptorchid (undescended testicles). If this is the case, we will reduce the vet costs by the amount the vet would have charged for neutering when calculating the payable benefit.
• Non-customary and experimental treatments, such as prosthetic limbs and devices and organ or valve transplants.
• Medications that are not registered or approved in Australia.
• Alternative Therapies, unless you have included Optional Extra Benefits included in your cover.
• There is no cover for the cost of vet consultations or other vet costs related to preventative and routine items, Pre-existing Conditions, elective procedures and/or other exclusions. Also, if you have elected to remove vet consultations from your cover all together (can only be removed if specifically requested) then there would be no cover for vet consultations for any reason.
• Expenses to board or transport your pet including by ambulance. However, we do cover boarding costs in specified circumstances.
• Costs incurred after your pet’s death, including storing, transporting or disposing of your pet’s remains and autopsy, burial, cremation, funeral or other procedures.

Are there any other exclusions?

There are certain exceptional circumstances in which Petsy Pet Insurance does not provide cover for required treatment. For example, there is no cover when an injury or illness is due to:

• Nuclear or radioactive weapons, materials or radiation.
• Utilisation of nuclear, chemical or biological weapons of mass destruction.
• Acts of war or civil unrest.

How can I get confirmation on whether a condition or treatment is going to be covered?

After consideration of what is covered and what is not covered, you may want to confirm whether a specific condition or treatment for your pet is covered. 

If a condition or treatment is not excluded under your policy, then it is covered.

Please remember if it is a Pre-existing Condition, it occurs during an applicable waiting period or another exclusion applies, then there is no cover.

To help you better understand the coverage, we’ve created the following table to show the types of things we cover, subject to determining if there is an exclusion, as explained above.