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What is a “pre-existing condition” in pet insurance?


Pet insurance is an essential cover that should be taken out when you have a pet. It is recommended to help cover the costs such as surgery, medications and advanced imaging. It could be said that it is relatively simple to take out an insurance policy when you have a young animal, such as a puppy or kitten. As long as the animal has had no health problems since birth, then any health problems in the future should be covered. However, what is a pre-existing condition? Can this be covered by insurance? Let’s find out. 

Types of insurance cover

There are different types of pet insurance policies available and careful consideration should be undertaken when considering which policy to take out. There are two main policy types:

Annual cover: 

Annual policies run on a yearly basis and will often be cheaper than lifetime cover. They offer less comprehensive coverage than a lifetime policy and once a condition has been claimed for, this will then be excluded from future claims. For example, if you had a dog that was diagnosed with heart disease and needed medication for the rest of their life, the annual policy would only cover the medication for one year. After the year had passed, it would be down to the owner to pay for the medication. 

Lifetime cover: 

Lifetime policies offer considerable insurance coverage for your pet. The policy covers each new condition per year. There are often limits per condition, but these limits often refresh every year. The policy will need to be renewed yearly with no break between coverage. For example, if your cat was diagnosed with hyperthyroid and needed monthly medication, the insurer would cover the cost of the medication for the duration of their life. 

What is a “pre-existing” condition?

If you’re taking out a pet insurance policy, there is often an extensive set of questions which need to be answered truthfully. The insurers will want to know if your pet has suffered from any health condition previously, whether this was when they were younger or whether it was the week prior. A “pre-existing condition” will be any health concern that has been treated before the insurance policy was taken out. Do not be tempted to lie as the insurance company will often request the pet’s clinical history when a claim is made.

Scenario one

A dog was taken to the vet as it was suffering from seizures. The vet carried out tests on blood samples and prescribed life-long medications with regular 6-month checks. The owner then decided to take out pet insurance to cover the cost of the medications. However, seizures will be excluded from the policy as this will be counted as a pre-existing condition. Pet insurance will not cover any treatment or medications that is related to seizures, as they occurred prior to the insurance cover being taken out. 

Scenario two

A kitten is taken to their first consultation and receives a clean bill of health from the veterinary surgeon. The owner decides to insure the kitten on a lifetime policy. 4 years later, the cat is diagnosed with diabetes. As the owner has lifetime cover and diabetes was not present before the insurance policy was taken out, the insurers pay for the lifelong care of the cat regarding diabetes medications and health checks. 

Waiting period exclusion

On most policies, there is a waiting period exclusion which is usually 10-14 days after the policy is taken out. During this period of time, there is no insurance coverage for the animal. Unfortunately, if any accident or lifelong condition is diagnosed within this period of the exclusion, insurers will often not cover this condition. Occasionally, the insurer will cover accidents in this period, but not illness, but that depends on the small-print of the policy.

Preventable disease exclusion

If your pet falls ill due to a preventable disease, insurers will often not cover the condition. For example, a dog may fall ill with leptospirosis. This is a preventable disease that is vaccinated against yearly. If the owners had not kept up to date with annual vaccinations, then this would be excluded as the owners had not protected their pet adequately, which is usually in the policy’s conditions.

Congenital disease

A congenital disease means that the disease has been present from birth. Unfortunately, if a congenital disease was identified, this may be excluded from an insurance policy due to it being present before the policy was taken out.

Understand what cover you have taken out

No matter whether it’s car insurance, house insurance or pet insurance, always read the small print. Don’t just choose the cheapest option of cover. For some insurance policies, the insurer may consider covering a condition if symptoms ceased more than 2 years ago. Some insurers may also cover some minor pre-existing conditions. Before taking out a policy, it may be worth speaking with the insurer directly to discuss pre-existing conditions. 

If you take out a good policy with a reputable insurer you will be able to breathe a sigh of relief when it comes to claiming for a condition on your pet insurance.

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