FREQUENTLY ASKED QUESTIONS and ANSWERS

Depending on the product that you choose:
• Pet Essentials will cover up to 90% of your eligible vet expenses up until your pet’s 8th birthday. You will be covered up to 65% after your pet turns 8. This is subject to any benefit limits and annual condition limits associated with your policy.
• Comprehensive Cover and Major Medical Cover will cover up to 80% of your eligible vet expenses, subject to any excess and annual benefit limits associated with your policy. Any applicable excess will be subtracted from your benefit amount.

Excess means an amount you contribute towards the cost of your claim(s), as shown on your certificate of insurance. The excess is calculated on a ‘per condition, per policy period’ basis. We do this for each condition treated that is unrelated to any other condition during the same policy period. Your excess also applies to each emergency boarding claim event. The excess will be deducted from your calculated claim benefits after we apply any benefit limit, sub-limit and the benefit percentage to your claimed amount.

Pets can be insured from 8 weeks of age. For Comprehensive and Major Medical cover your pet must have joined before its 9th birthday. For Pet Essentials, your pet must have joined before its 12th birthday.

Your policy will commence at 11.59pm on the date your application is accepted and is listed on your certificate of insurance. Please note that acceptance of your application is not guaranteed, so you should always check to see whether a policy has been issued before claiming.

You may make a claim for specified accidental injury as soon as your policy is effective.

A 30-day waiting period applies from the commencement date of your first policy period for illness condition claims.

Note: for Major Medical and Comprehensive plans, there is a 6 month waiting period from the commencement date of your first policy period for cruciate ligament (or related) conditions. However, you may request to have this period waived by having your pet examined by your vet and submitting the completed prescribed Cruciate Ligament Exam Form in support of this request.

Please download Cruciate Ligament Form here. Waiver of this waiting period is at the sole discretion of the insurer.

As with most insurance products, there are certain situations in which you will not be covered. There are some general exclusions such as:
• Pre-existing conditions
• Routine or preventative treatments (unless routine care (non-insurance benefit) is available on your level of cover and purchased, which provides a contribution up to the routine care limits)
• Some elective treatments and procedures
• Breeding or obstetrics
• Orthodontic treatment
• Genetic/chromosome testing
There may also be specific exclusions which may apply to specific levels of cover.
For a full list of exclusions and further details of the above exclusions, see your PDS which can be found under Downloads.

Hereditary and congenital conditions will eligible for cover if they have not shown noticeable signs, symptoms or an abnormality at any time before the first policy period or during any applicable waiting period.

Yes, you can use any vet who is licensed to practice in Australia other than yourself.

Your premium is calculated when your pet insurance policy begins, and at each policy renewal:

New policies
Your premium is calculated based on a combination of factors and these can affect the premium amount depending on whether we believe it increases or decreases the risk to us. These factors include the type of cover and options you have selected, as well as the breed and age of your pet. For example, the age and breed of your pet are risk factors we consider as when your pet gets older, the risk of your pet requiring treatment will increase and so the premium increases.

Your premium calculation may also include discounts or promotional offers that we provide. If you qualify for two or more discounts, we apply a specific order to our calculation of your final premium. Some discounts may apply only in the first year of coverage.

Renewing policies and changes to your policy
Each year, we’ll notify you of changes to your annual premium. We take into consideration the claims history for your pet and the average cost of care for pets like yours, as well as the claims experience across all our insured pets. We also consider how much your premium was previously, including any discounts that may have been applied. The same factors are also taken into consideration to calculate your premium if you choose to amend your coverage.

Further details on the factors used to calculate your premium are detailed in your PDS which can be found under Downloads.

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.

For information about how to make a claim – click here.

More details about the claim process can be found in your designated Pet Insurance Product Disclosure Statement, which can be found here.

Once we receive all required documentation, your claim will be processed as soon as possible and if approved, payment will be made directly into your nominated account.

For adopted Pets, if you can provide us with proof of adoption or transfer of ownership papers we will only request veterinary history from the date you took ownership onwards. Refer to the Claim section in your policy booklet for full details on how to submit a claim and required documents.

For your convenience and to ensure continuity of cover for your pet, we will automatically renew your policy each year for as long as we continue to provide this product and subject to the applicable terms and conditions of each policy.

We will send your renewal notice at least 14 days before your policy is due to expire and it will remind you to check your policy limits to see if the level of cover is still right for you.

You can opt-out of the automatic renewal process by contacting us. If you have chosen for your policy not to automatically renew, you will need to contact us each year to renew your cover.

A pre-existing condition is:
• A condition that existed or occurred prior to the commencement date of your 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.

You can apply to have Pre-existing Conditions Reviewed.

For more information about Pre-existing Conditions, click here.

If at any time you’d like us to check whether a pre-existing condition is covered, you can do so using the pre-existing condition review form which is available here or contact us for assistance.

Your vet will need to certify and provide veterinary records verifying that the condition has not existed, occurred or shown noticeable signs, symptoms or an abnormality for a period of 18 months (‘temporary condition').

If your pet has a chronic condition that existed or occurred before the commencement date of your first policy period or during any applicable waiting period, and otherwise falls within the definition of ‘pre-existing condition’, that condition will always be excluded from your policy and will not be lifted.

Once completed, you can email the form back to us and you will be notified of the outcome in writing.

To know if an upcoming or specific treatment for your pet will be covered, you will need to provide us with:
• An itemised estimate of costs from your vet for the upcoming treatment;
• Details of the treatment required; and
• Relevant clinical records and/or veterinary history.
To make it easier, you can complete this form and return to us with the above information.

Once received, you can expect to hear back from us within two business days. If the treatment has already started, a claim should be submitted.

Note: A pre-approval will not be deemed to be valid unless we have agreed to it in writing. The reimbursed amount may vary from the pre-approval if the treatment provided by your vet differs from the treatment request in the pre-approval. Refer to your PDS for further terms and conditions.

For more information or to submit a pre-approval of treatment costs, contact us via phone or email.

Submit claims at any time, provided the treatment date was during a policy period that you were insured.

Yes, you can visit any vet (other than yourself) that is licensed to legally practice as a veterinarian in Australia. Please note, although it is rare, if expenses incurred by you with respect to the Treatment significantly exceed what is reasonable and expected, having regard to the circumstances in which the Treatment was provided, then claim payments may be adjusted to the amount of reasonable and expected expenses.

If your Pet requires treatment, you can seek a claim pre-approval, whereby we can provide you with the details of your claim reimbursement. To request a pre-approval, simply call us on 1800 043 552

You may cancel your policy at any time. We understand circumstances can change and would like to see if we can help keep your cover active. Please call our customer service team on 1800 043 052 or send us an email at [email protected] so we can discuss your options.

If you do decide to cancel, we will issue a pro-rata refund for the uninsured period where premiums are paid annually, less any applicable government or statutory charges. If you pay by instalments, we will not deduct any further premiums after the date of cancellation.

VetChat connects you with trusted Australian vets via online chat or video call, within minutes, anytime, anywhere. Whether it's providing vet advice, setting up at-home treatment plans, or confirming if you need to visit a vet in person, you can have peace of mind knowing you can get vet advice when you need it.

As an added perk to having a policy with us, you can get access to a VetChat consult membership. That means you get access to VetChat when you need it with up to 4 consults per month for your entire current policy period.

Please note, VetChat is a non-insurance product that is separate from your pet insurance policy and is separately provided by VetChat Services Pty Ltd. Visit https://petinsuranceaustralia.vetchat.com.au/ for more information and T&Cs.

If you’ve registered for VetChat already, there’s nothing else you need to do, just sign in as you’ve done previously. If you’re not already registered, visit here to create an account and access vet care online anytime, anywhere. All you need is your email address and policy number.

A waiting period is the period that your pet is not covered starting from the commencement date of the first policy period in which you obtained cover for the applicable condition or benefit.

Depending on your level of cover, there may be different waiting periods that apply. Please see your PDS to get an overview of your waiting periods.

If a condition exists or occurs within an applicable waiting period, it will be excluded from cover during the waiting period as a pre-existing condition and will also be deemed to be a pre-existing condition thereafter.

Some conditions are eligible for review – check your PDS and certificate of insurance for further information.

If your pet has a chronic condition that existed or occurred before the commencement date of your first policy period or during any applicable waiting period, and otherwise falls within the definition of ‘pre-existing condition’, that condition will always be excluded from your policy and will not be lifted. Depending on your level of cover, there may be different waiting periods that apply. Please see your PDS to get an overview of your waiting periods.

If your vet is GapOnly® enabled, you can claim on the spot with GapOnly.® Once the claim has been processed and if approved, you simply pay the gap (the difference between the vet’s invoice and the calculated benefit under your policy). Alternatively, if you’re unable to wait, you can ask your vet to submit an eClaim on your behalf. Contact our team on 1800 043 552 if you’d like more information.