How to Make a Claim

FIND OUT HOW GOOD YOUR INSURER REALLY IS

You only find out how good your insurer really is when you need to make a claim on the policy that you purchased from them. Our commitment to dealing efficiently with all requests for reimbursement of veterinary costs, means that our clients can look forward to a swift resolution of any claims that they may make.

88% of claims processed within 1 day, 98% processed within 5 days*
*After all documentation received. Source: PetSure data Feb-23 to Jan-24

What's Covered in Select & Protect

What is Covered in all Plans

Specified Accidental injuries and illnesses

Tick paralysis

Cancer treatment

Skin conditions

Hereditary and congenital conditions

Emergency boarding

Eye and ear conditions

Cruciate ligament conditions (6 month waiting period applies but may be waived on application)
Exclusions

Certain pre-existing conditions

Dental procedures ($2,500 with Booster Care13)

Behavioural problems ($2,500 with Booster Care13)

Elective treatments and procedures

Food and diets

Grooming

Pregnancy

Pet accessories

How quickly do you want to be reimbursed for eligible claims?

When it comes time to submit a pet insurance claim, chances are you’ll be a little stressed with your pet being unwell, so you’ll want a process that’s simple and gets your expenses reimbursed as quickly as possible. There are a few different ways to submit a pet insurance claim, with options and time taken to be reimbursed varying by providers, so research is key depending on what’s most important to you. Let’s look at the ways to submit a pet insurance claim:

CLAIM PRE-APPROVAL

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,
  • • with the treatment required and
  • • relevant clinical records and/or veterinary history.

We will respond to you in writing with the outcome.

A pre-approval shall 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.

To request a pre-approval:
Call us: 1800 043 552
Email us: [email protected]

WANT TO KNOW IF YOU ARE COVERED PRIOR TO TREATMENT?

You can check out the Pet portal for a summary of your coverage or refer to your PDS and Certificate of Insurance for all your coverage information.

Pre-approvals aren’t mandatory, but can provide you with additional reassurance, so if you want to know if an upcoming or specific treatment for your pet will be covered, all we need is for you to email us at [email protected] with the following:

  • • Policy number or Policy Holder and Pet Name
  • • Name of the condition being treated and the proposed procedure
  • • Name of your regular vet and the vet where the procedure will take place
  • • An itemised estimate of costs relating to the procedure (optional- if you have it!)              

Once we receive this information, you can expect to hear back from us within two business days.

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.

ON THE SPOT WITH GAPONLY®

GapOnly® is the latest pet insurance claims technology available at participating vets that helps pet owners access their pet insurance benefit right away on eligible claims. Claims are submitted by the vet while you’re still in-clinic, and are settled in around 10 minutes. This has been a long-awaited feature by pet parents, as on-the-spot claims processing on eligible claims means less upfront expense.

The service is currently available for all PIA Pet Insurance policyholders, with the latest list of participating vets available at gaponly.com.au

ELECTRONICALLY BY YOUR VET

More than 1,050 vets across Australia can submit your pet insurance claim for you in-clinic electronically – otherwise known as an eClaim. Apart from the GapOnly® claims service, this is the next fastest way to claim, with claims typically processed within five business days. This service is available with all PIA pet insurance policies

ELECTRONICALLY THROUGH AN ONLINE CUSTOMER SERVICE PORTAL

All PIA pet insurance policies will come with access to an online customer service portal, that conveniently houses key policy documents for easy reference, and features to submit a pet insurance claim online and track its progress in real-time. Outside of GapOnly® and submitting an eClaim through your vet, this is the next fastest way to claim, with the added benefit of being available 24/7 online.

POSTING A PAPER CLAIM

The final way to submit a pet insurance claim is to fill out a claim form together with your vet, and ensure supporting vet invoices and clinical notes are included for assessment before posting it in. Once the claim is received in the mail it will typically be processed within five business days, so it may take a little longer for you to be reimbursed for eligible claims compared to the other methods.

Common and Past Claims

Accident or IllnessAverage Claim AmountMaximum Claim Amount
Traumatic Injury$408.50$20,114.10
Foreign Body Ingestion$953.67$17,955.80
Neoplasia (Tumour)$912.99$16,168.56
Fractures$550.63$14,957.15
Gastrointestinal Conditions$463.77$12,652.40
Ear Conditions$231.99$11,172.11
Cruciate Disease$996.20$9,543.29
Arthritis$181.67$6,930.56
Eye Conditions$226.13$6,594.66
Snake Bite$1,242.87$6,196.96
Skin Conditions$248.27$5,811.07
Insect Bite$304.58$5,780.39
* PetSure claims data from June 2022 – July 2023. Amounts include GST.

How to Make a Claim Online via Pet Portal

If you are:
  • An existing member: please visit the pet portal to submit your claim.
  • A new member: you will be sent an e-mail/text message to sign up to pet portal.
Steps to make a claim:
  1. Simply upload a copy of both the itemised invoice and the consultation notes from your vet visit.
  2. In some instances, we may require more information to process your claim, such as previous medical history or pathology/laboratory results. If this is the case, we will contact you for this information.
  3. If your pet was adopted at an older age, please supply adoption paperwork and relevant medical records since adoption.

How to Make a Paper Claim via Post

If you would prefer to send us your claim through the post, please ensure you have completed the following additional steps:
Print a claim form and fill in your details.

Take it with you to the vet and ask them to fill out Section 2. Both you and your vet will need to sign the form.

Attach the original itemised invoices, payment receipts and consultation notes and post them to the following address:

Pet Insurance Australia
Locked Bag 9021
Castle Hill NSW 1765

Other Forms That may Interest You

PET INSURANCE AUSTRALIA CLAIM FORMDOWNLOAD PDF
PET INSURANCE AUSTRALIA CRUCIATE LIGAMENT EXAM FORMDOWNLOAD PDF
PRE-EXISTING CONDITION REVIEW FORMDOWNLOAD PDF

1 - Terms & Conditions Apply. 2 Month Offer Terms & Conditions can be viewed by clicking here

2 - Depending on your level of cover. Policy T&Cs, limits, exclusions, waiting periods and excess may apply.

3 - You may be eligible for a higher limit; if so, this will be specified in your certificate of insurance.

4 – Applies per Policy Period and is deducted from the benefit payable to you, depending on the cover option chosen. Please note the $600 excess option is not available with a 70% benefit percentage.

5 – T&Cs Apply. MyPetPass® is a rewards programme provided by PetSure (Australia) Pty Ltd ABN 95 075 949 923 (PetSure). Available to holders of active policies. myPetPass® perks are provided by PetSure and third-party suppliers and also subject to these third-party suppliers’ terms and conditions. myPetPass® perks may be amended or withdrawn any time without notice. PetSure does not guarantee that any particular third-party providers will continue to participate in myPetPass® through the offer or provision of perks, or that the myPetPass® rewards programme or any myPetPass® perks or features of myPetPass® will continue to be available. Full Terms & Conditions available at mypetpass.com.au/terms.

6 – After all documentation received.

7 - A separate limit applies to the non-insurance Routine Care item. Routine Care limits apply to specific routine care items. Click here for more info.

8 - There is a 6-month waiting period for cruciate ligament claims. This waiting period may be waived at our discretion. For details on the waiver process, refer to the applicable Product Disclosure Statement.

9 - Terms & Conditions Apply. 3 Month Offer Terms & Conditions can be viewed by clicking here

10 - Live Vet Support is a service provided by PetSure that gives you 24/7 access to general veterinary telehealth advice for your insured pet(s) via online video or chat, via the Customer Portals owned and operated by PetSure. Access to Live Vet Support consultations subject to the Customer Portal terms of use.

11 - Available at participating vets, find your nearest GapOnly® Vet at gaponly.com.au. The gap is the difference between the vet’s invoice and the eligible claim benefit under your pet insurance policy. GapOnly® is a trademark owned by PetSure (Australia) Pty Ltd ABN 95 075 949 923, AFSL 420183. GapOnly® is available on eligible claims at participating vets with a pet insurance policy from a GapOnly® pet insurance partner.

12 - A 5% discount off your second pet insured, 10% discount off your third pet insured, 15% discount off your fourth and subsequent pets insured. For full terms and conditions of this discount, click here

13 - Policy T&Cs, Booster Care limit, applicable benefit percentage, waiting periods and exclusions apply. Annual excess may apply.

14 - Policy T&Cs, limits, exclusions and waiting periods apply. Annual excess may apply.

15 - Depending on the level of cover chosen

Pet Insurance Australia policies entered into for the first time prior to 8 May 2023 and subsequent renewals of those policies are issued by The Hollard Insurance Company Pty Ltd ABN 78 090 584 473, AFSL 241436, arranged and administered by PetSure (Australia) Pty Ltd ABN 95 075 949 923, AFSL 420183 (PetSure) and promoted, distributed and arranged by PetSure’s Authorised Representative (AR) Pet Insurance Australia Pty Ltd ABN 85 113 507 850, AR 326233 (PIA). Pet Insurance Australia policies entered into for the first time on or after 8 May 2023 and subsequent renewals of those policies are issued by PetSure and promoted, distributed and arranged by PetSure’s AR, PIA. Any advice provided is general only and does not take into account your individual objectives, financial situation or needs. Please consider the Product Disclosure Statement (PDS) to ensure this product meets your needs before purchasing, or choosing to continue with the product. the PDS and Target Market Determination available at petinsuranceaustralia.com.au.

We understand that there are times when our customers may be feeling vulnerable due to a range of factors. In these situations, we are committed to taking extra care and recognise these vulnerabilities can give rise to unique needs, which can change over time or in response to particular situations. If you are experiencing vulnerability and would like more information on the extra care we can provide please email us on [email protected]. You can also access our underwriter’s Family Violence Policy here, and their website also contains additional accessible ways you can contact us.

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