Common reasons for pet insurance claim rejections

There are many reasons why pet insurance policies won’t pay out. For example, you likely won’t be able to claim for treatment for pre-existing medical conditions – these are conditions that your pet already had when you took the policy out.

Claims for routine check-ups and dental treatment likely won’t be covered either. There are also age and commercial use restrictions to consider.

Let’s look in detail at why your pet insurance claim may be denied.

 

Claims for non-covered items on pet insurance

When you take out pet insurance, some things won’t be covered by your insurance, such as:

• Routine check-ups
• Pre-existing conditions
• Vaccinations
• Dental treatments
• Flea and worm treatments
• Neutering or spaying
• Burial or cremation costs
  
  

It’s important to check the policy wording thoroughly before making a claim. If you claim for any of the excluded conditions, your pet insurance claim will be rejected.

 

Pre-existing condition exclusions on pet insurance

Pet insurance is designed to provide financial help with vet bills if your pet gets ill or is injured unexpectedly. But if they already have a condition, it’s unlikely you’ll be able to get cover for this.

Each insurer has a slightly different definition of what a pre-existing condition is, so you’ll need to check the details of your policy thoroughly. In most cases, a condition is considered pre-existing if your pet is already showing symptoms when you take out the policy. An illness could also be considered pre-existing if it results from or is closely related to a condition your pet already has.

Standard pet insurance policies won’t cover pre-existing conditions, so if you claim for an illness that falls into this category, your claim is likely to be denied. You can sometimes get pet insurance that covers pre-existing conditions, but often you will need to use a specialist provider.

 

Time limits on pet insurance policy claims

Depending on the type of policy you choose, there may be time limits for how long you can claim for a condition. For example, if you choose a time-limited policy, there is usually a 12-month limit for making claims.

If your pet suffers from an illness and you make a claim to pay for their treatment, your insurer will pay for it for 12 months (or up to a certain monetary amount). After the 12-month period, the insurer will stop paying for the treatment and you won’t be able to claim for this illness again.

This differs from a Maximum Benefit policy, where you can claim for a certain amount of vet fees for a specific condition, say £8,000. Once you hit this limit, you can’t claim for this condition again.

Lifetime policies provide the highest level of cover. It will cover you for vet fees up to a certain amount every year, so long as you renew your policy for the same amount annually.

 

Initial waiting periods on pet insurance claims

Pet insurance policies usually have waiting periods before you can submit a claim. It depends on the insurer and the policy. For illness, this is usually between 10 and 15 days. For injuries or accidents, it’s usually 24 hours.

Any claims made within the waiting period are likely to be rejected.

 

Routine and preventative care exclusions on pet insurance claims

Pet insurance is in place to help with unexpected vet bills after an illness or injury. It’s not designed to help cover the cost of routine treatments or preventative care.

Examples of this include:

• Vaccinations
• Spaying
• Castration
• Flea, worm and tick treatments
• Grooming
• Claw clipping
• Routine dental treatment and maintenance

 

Age-related pet insurance claim restrictions

Some insurers state that once a pet reaches the age of 8 or 9, they are considered an older pet. And just like humans, as pets get older, they are more likely to need medical treatment. Pet insurance premiums tend to be higher for older pets.

Some insurers have maximum age limits where they won’t insure pets over a certain age. Others don’t have a maximum age limit, but the insurance will be more expensive. Many pet insurers have a minimum age too. Often, they won’t insure pets younger than four weeks.

Even if you have pet insurance to cover your older pet, there are some things you might not be able to claim for. For example, often you can’t claim for death from illness for pets over a certain age. As your pet ages, the likelihood of death from illness increases – this means insurers don’t always view it as an unexpected illness or accident.

 

Commercial use exclusions on pet insurance claims

Standard pet insurance won’t cover pets used for commercial purposes. This includes things like security, track racing, and breeding. If you use your dog for track racing, for example, and make a claim on your pet insurance policy for an injury that happens on the track, it’s likely your claim would be denied.

You’ll usually need specialist pet insurance to cover your pet for commercial uses.

 

Importance of accurate pet information

When you take out a pet insurance policy, the insurer will ask a range of questions about your pet and their medical history. You must give complete and accurate information and declare any pre-existing conditions.

For example, if you need to make a claim on your pet insurance, your insurer will likely ask for your pet’s medical records. From there, it will be clear to see if the condition was pre-existing or not. If it was pre-existing and meets the insurer’s definition of pre-existing, it’s likely your claim will be rejected. If you haven’t declared this condition, it will invalidate your policy. Plus, you could also be liable for insurance fraud.

 

Steps to take if your pet insurance claim is refused

If your claim has been rejected by your insurer, the first thing to do is check the policy to see if it covers the reasons for the rejection. Check:

• Whether you gave full and accurate information when you took out the policy
• The exact wording of the policy
• Whether the wording of the policy is ambiguous or poorly explained
• If the insurance company asked for all the information that they are now saying you should have voluntarily disclosed
  
  

Next, you will need to contact the insurance company either through their complaint’s procedure or with a formal complaint letter.

If you’re still unhappy with the outcome, you can take your claim to the Financial Ombudsman Service.

 

How to choose the right pet insurance policy

Take time to consider the following factors before taking out a pet insurance policy:

Your pet’s age: Yes, it may be more expensive to insure your older pet, but it’s essential to have appropriate cover in place for any illnesses or injuries that occur as they get older.

The length of cover: Time-limited may be cheaper, but if treatment for a condition goes on for longer than 12 months, you’ll likely have to pay for it out of your own pocket.

The level of cover: Lifetime insurance may be a more expensive option, but it will ensure that your pet is covered for treatment for a specific condition for the rest of their life.

Pre-existing conditions: If your pet has pre-existing conditions, you may have to take out specialist pet insurance.

 

How do I protect my pet and how can Asda Money help?

With the right pet insurance policy in place, you’ll have peace of mind that you’ll be covered for unexpected vet expenses. At Asda Money, we work with a trusted insurance administrator and provide a selection of Pet Insurance products to suit your pet’s needs. Simply compare our different cover types to get the right cover for you.

Use our helpful jargon buster to help understand any pet insurance terms and check out our FAQs to answer any questions you may have.