Pre-existing conditions: excluded from pet insurance

In pet insurance, pre-existing conditions are defined as:

definition: any condition developed by your pet prior to the start of your pet insurance policy.

Usually, insurers exclude pre-existing conditions from their policies, meaning that should your pet require treatment for such a condition, you would have to cover the treatment costs yourself.l

1. Why are pre-existing conditions excluded?

When insurers calculate premiums, they assess the likelihood of your pet making a claim and the resulting costs (called ‘risk’). The higher the risk, the higher the premium. If that risk is too high, it doesn’t make sense for the insurer to provide a policy: they will be sure to pay more in claims than what they will earn in premiums.

Insurers reckon that a pet that has suffered from an injury or an illness in the past is highly likely to claim for that condition in the future. They do not want to take on the risk, so they will place an exclusion on pre-existing conditions but will still insure your pet.

2. Should I always disclose pre-existing conditions?

Yes, you must disclose them when you take out a policy, to the best of your knowledge of course. If the insurer finds out you were aware of a past condition when trying to claim for it, they will probably cancel your policy, leaving you with an expensive vet bill to pay. Remember, most insurance companies include in their terms and conditions the right to access your pet health record from the vet.

Golden rule: check terms and conditions before choosing your pet healthcare plan and if your pet has a pre-existing condition, then speak to different insurers to know exactly what will be excluded from the policy: is it the condition I claimed for? is it a part of my pet’s body? is it both?

3. What happens if I decide to change insurance provider?

The same rules apply whether you take out pet insurance for the first time or decide to change provider. If you haven’t claimed with your previous insurer, then don’t worry, you can easily switch. You will still have to disclose initial pre-existing conditions to the new insurer though, but that’s no problem.

If you have claimed on a lifelong pet insurance policy, then changing insurer can prove disastrous. Lifelong policies pay claims for ongoing condition every year and if you change provider the condition you’re currently claiming for will be excluded from your new policy.

If you are on a per 12-month or per condition policy, then once your time or vet fees limit has been reached, the condition will be excluded anyway. This means you could then switch provider worry-free if you feel your premium went up too much following your claims.

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