Pet Insurance Frequently Asked Questions – FAQs
What is a Pre-existing Condition?
A pre-existing condition is:
- A condition that existed or occurred prior to the commencement date of the first policy period or within any applicable waiting period.
- A condition that you or your vet were aware of, or a reasonable person in your circumstances would have been aware of. This is irrespective of whether the underlying or causative condition was diagnosed at the time.
Whether it is a pre-existing condition will depend on its nature and experience. If your pet has a temporary condition that has not existed, occurred or shown noticeable signs, symptoms or an abnormality in the 18-month period immediately prior to your claim treatment date, it will no longer be excluded from cover as a pre-existing condition. Chronic Conditions and several other specified Conditions cannot fall within this category.
See your Product Disclosure Statement for more information and examples of pre-existing conditions.
You can apply to have Pre-existing Conditions Reviewed. See the Pre-existing Conditions page for more information.
How do I apply for a Pre-existing Condition review?
If your pet has had a temporary condition that was subject to the pre-existing condition exclusion, you can apply to have it reviewed.
Your vet will need to certify and provide veterinary records verifying that the condition remains a temporary condition and has not existed, occurred or shown noticeable signs, symptoms or an abnormality for a period of 18 months.
This can also automatically be reviewed when you submit your first claim.
The pre-existing condition exclusion(s) will not be deemed to have been lifted unless agreed to by us in writing. You can download a copy of the Pre-existing Condition Review form here.
If your pet has a chronic condition that existed or occurred before the commencement date of the first policy period or during any applicable waiting period, that condition will always be excluded from your policy.
See Pre-Existing Conditions page for more information.
Can I seek pre-approval of my Pet’s upcoming Treatment?
Yes. If your pet requires treatment and you wish to seek pre-approval of those costs, you can provide us with the itemised estimate of costs from your vet, along with the treatment required and relevant clinical records and/or veterinary history, and we will respond to you in writing with the outcome.
What is defined as a specified accidental injury?
Specified accidental injury means physical harm or injury arising from an accident.
For the purposes of this policy, an accident is: – a single specific, unpredictable, unusual and unintended external event which occurs at a particular time and place, with no apparent or deliberate cause but with marked effects; and – is independent of any other cause including and Pre-existing Condition.
What is defined as an illness?
An Illness means a sickness or disease or specified illness which is not caused by injury to your pet. For example upset stomach, skin conditions, ear infection.
Do you cover hereditary and congenital defects?
Yes. Provided they have not shown noticeable signs, symptoms or an abnormality at any time before the Commencement Date of the First Policy Period or during any applicable Waiting Period.
What is a cruciate ligament?
There are two cruciate ligaments in the knee. They attach the thigh bone to the shin bone. They allow the knee to flex and extend and they stabilise the joint. If the cruciate ligament ruptures, the joint becomes unstable and as a result, there would be intense pain and inflammation would occur.
A cruciate ligament condition means partial or complete rupture of the cruciate ligament(s). This includes meniscal tears, any looseness of the cruciate ligaments along with any complications following treatment for this condition.
What waiting periods apply?
Some Conditions are covered from your policy Commencement Date while others have a thirty (30) day or 6 month period. Refer to the applicable Product Disclosure Statement for further information.
How are premiums calculated?
Your premium is calculated using a combination of factors about you and your pet. These factors can affect the premium amount up or down depending upon whether we believe it increases or decreases the risk to us, such as the cover you have chosen, the benefit percentage applicable to the cover you have chosen, where you and your pet permanently live, your age and the species, breed, gender of your pet, the current age of your pet, the age you first insured your pet, and other factors related to our cost of doing business.
Factors that are taken into consideration for renewal premium calculation include your pet’s age, breed, location, duration for which your pet has been insured, claims history, as well as data relating to the health of pets that are a similar age and breed. Each year your premiums are reviewed based on these factors to accommodate for the costs of possible treatment up to your annual benefit limit, in the event that your pet becomes injured or ill.
Will my premium increase every year?
Yes, your premium will increase each year. This is for two main reasons:
Reason #1: Just like humans, the older our pets get, the more likely they are to have health hiccups. Cats and dogs age faster than we do, which means that their likely veterinary treatment costs go up rapidly each year too. As a result, the cost of insuring your pet will also increase as they get older.
Reason #2: Advancements in Veterinary Treatments.
The overall cost of medical treatment for pets has increased in recent years due to the increased availability of medical treatments and technology-enabled services and ongoing demand for these services. The treatment options and advancements in technology are providing us with great opportunities to give our pets a great quality of life for longer.
While this is great news for the care of our pets, these treatments come at a significant cost. Year on year treatment costs increase, and this is factored into the cost of pet insurance.
Please see ‘How are premiums calculated?’ for more information about the calculation of premiums.
Is my premium calculated the same way as my Private Health Insurance?
No. Pet insurance does not work like health insurance. Health insurance is ‘community rated’, which means that everyone pays the same premium for their health insurance regardless of their individual health status, age or claims history. This is not the case for pet insurance.
Health insurance providers are able to community rate health insurance because there are many other factors at play in the human health care system, such as Medicare and government rebates and subsidies, which is not the case with veterinary care and pet insurance.
Pet insurance claim reimbursements are paid for purely by the premiums received by those who insure their pets. In order for each person to pay a fair price for their pet insurance, premiums vary depending on your and your pet’s risk factors.
How do I make a claim?
When you take out a Petinsurance.com.au policy, you will be able to register with a secure pet portal, where claiming is easy – simply upload a copy of your vet’s tax invoice and consultation notes. If it is your first claim you will need to attach a full veterinary history. You can call the friendly Petinsurance.com.au customer service team for claim forms if you do not have access to customer portal.
Can I use my own vet?
Yes. You can use any vet who is registered to practice in Australia.
How much of the vet bill will be covered?
Depending on the policy you choose, you will receive up to 80% of the total cost of eligible treatment for your dog or cat, up to the annual benefit limits. Certain expenses are not covered and these are set out in the Product Disclosure Statement (PDS).
Does my cover have an excess?
No, all Petsy together with Petinsurance.com.au policies have zero excess.
At what age can I start my pet’s insurance?
Puppy Accident Cover and Puppy Accident and Illness Cover
Your pet must be over the age of 8 weeks and under the age of 6 months when cover commences.
Unless you tell us otherwise, your cover will continue after the age of 6 months, as long as there is no break, lapse or change in the level of coverage, and as long as we continue to offer the cover, subject to the applicable terms and conditions.
Dog Accident Cover and Dog Accident and Illness Cover
You can apply for Dog Accident and Illness Cover if your pet is over the age of 6 months and under the age of 9 years when cover commences. Your pet must be over 6 months to apply for Dog Accident Cover. There is no upper age limit to qualify for Dog Accident Cover.
Unless you tell us otherwise, your cover will continue to renew after the age of 9 years, as long as there is no break, lapse or change in the coverage, and as long as we continue to offer the cover, subject to the applicable terms and conditions of the renewal policy.
Indoor Cat Illness Cover, Cat Accident Cover and Cat Accident and Illness Cover.
You can apply for Indoor Cat Illness Cover or Cat Accident and Illness Cover if your pet is over the age of 8 weeks and under the age of 9 years when cover commences. Your pet must be over 8 weeks of age to apply for Cat Accident Cover. There is no upper age limit to qualify for Cat Accident Cover.
Unless you tell us otherwise, your cover will continue to renew after the age of 9 years, as long as there is no break, lapse or change in the coverage, and as long a s we continue to offer the cover, subject to the applicable terms and conditions of the renewal policy.
What is not covered under my petinsurance.com.au policy?
As with most insurance products, there are certain situations where you will not be covered. There are some general exclusions such as pre-existing conditions, dental procedures, fractured teeth, routine or preventative treatments (unless Routine Care cover is purchased, which provides a contribution up to the Routine Care limits), some elective treatments and procedures and breeding or obstetrics. There may also be specific exclusions which may apply to specific levels of Cover. For a list of general exclusions refer to the general exclusions section of the applicable Product Disclosure Statement.
Can I insure more than one pet?
For your convenience you can insure multiple pets under your Petinsurance.com.au policy. Each pet can have their own policy with their individual choice of cover. To activate a multi-pet policy, you will need to call the friendly Petinsurance.com.au customer service team on 1300 855 663 who will be happy to organise it for you.
How can I pay my premiums?
You may pay your premiums either by credit card or direct debit. You also have the option to pay your premiums monthly or annually.
How do I renew my policy?
Unless you tell us that you do not want your policy renewed, we will automatically renew your policy on its expiry. We will send you a notice before your policy expires confirming when your insurance will expire and the terms on which your insurance will automatically renew. It will also remind you that you can opt-out of the automatic renewal process. This way, you don’t have to worry about your pet’s cover lapsing, unless you don’t pay the premiums when they are due.
What exclusions apply?
As with most insurance products, there are certain situations where you will not be covered. There are some general exclusions such as:
• Conditions which occurred prior to commencement of your policy or during any applicable waiting period (‘pre-existing conditions’)
• Routine or preventative Treatments
• some Elective Treatments and procedures and breeding or obstetrics.
There may also be specific exclusions which may apply to specific levels of Cover.
It is important that you read all of your policy documentation for full details (including Section 2 to Section 4, your Certificate of Insurance and ‘Section 5 – General Exclusions’ of your PDS).