FREQUENTLY ASKED QUESTIONS & ANSWERS
We have provided answers to many commonly asked questions about our policies below. If you would like any more information, please call us on 1800 043 552.
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.
This means the first amount of a claim we do not pay and which you are required to pay yourself as shown on your Certificate of Insurance. You can choose an Excess of $0, $100, or $200 if you have Comprehensive or Major Medical Cover.
Note: The Excess applies per Condition per Policy Period and will be deducted for the benefit. Refer to your policy booklet in for an example of how claim payments are calculated. Refer to your policy booklet in for an example of how claim payments are calculated.
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.
With Accidental Injury Cover, you can cover your pet at any age from 8 weeks old. With Comprehensive and Major Medical Cover, pets need to be aged between 8 weeks and younger than 9 years of age when you purchase your policy.
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: 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 form here. Waiver of this waiting period is at the sole discretion of the insurer.
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 (which are Conditions that occurred prior to commencement of your first policy period or during any applicable waiting period)
• Dental procedures and fractured teeth (unless you have Comprehensive Cover which provides specified benefits up to the Routine Care limits)
• Routine or preventative Treatments (unless you have Comprehensive Cover which provides specified benefits 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.
It is important that you read all of your policy documentation for full details about what you are covered for and general exclusions in your PDS.
You can find more information in the Downloads section.
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 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 excess selected, 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 we review premiums based on these factors to ensure we can accommodate the costs of possible treatment up to your annual benefit limit, in the event that your pet becomes injured or ill.
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 do you calculate my premium’ for more information about calculation of premiums.
Every year, we review the cost of everyone’s insurance with regards to a combination of factors as well as claims inflation across all our insured pets. Increases in our claims costs due to increases in the range of available veterinary procedures, or due to an increased take-up of those services, impacts everyone’s premiums.
Your premium takes into account the average cost of care for pets like yours. To provide an example of this, a pet parent with a three-year-old French Bulldog will be affected by the trends we see in our data from hundreds of three-year-old French Bulldogs that we insure, as well as the specific claims history of their own pet.
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 either by cheque or 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.
We'll send you a Pet Insurance renewal notice 28 days before your renewal date. Your policy will then automatically renew unless you tell us otherwise prior to the policy renewal date. It will also remind you that you can opt-out of the automatic renewal process. For more information, refer to ‘Automatic Renewal of your policy’ in your Product Disclosure Statement.
Make sure you review your renewal notice, as premiums will increase from year to year due to factors such as the age and breed of your pet (refer to the PDS for further information on premium calculation). Make sure your details are correct and up to date. If you're happy with your renewal details, you don't need to do anything.
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 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. 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 your first policy period or during any applicable waiting period, that condition will always be excluded from your policy.
Click here for more information about Pre-existing Conditions.
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.
For more information on how to make a claim, click here.
We have recently made a change to our claims procedure. You no longer need to submit your claims within 90 days of treatment. There is no time limit to submitting a claim for your pet.
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