13 Pet Insurance Exclusions: Pre-existing Conditions, Pregnancy & Age

Pet insurance is increasingly popular but there are some potential exclusions you need to be aware of

According to the Australian Veterinary Association, Australians spend around $673 million a year on pet products and accessories – and then there’s the cost of veterinary treatment which can range anywhere from not much at all to thousands of dollars, depending on what mischief your pet gets up to in a given year!

Pet insurance can be a sensible way to help smooth the costs associated with caring for your pets. With a choice of accident-only cover, accident and illness cover and premium cover (see our types of pet insurance article for further information) pet owners can choose an insurance that suits both their needs and their budget.

Pet insurance: What doesn’t it cover?

Pet insurance, much like health insurance for humans, does not cover every possible illness and injury. The things that are expressly listed as not covered by the insurance provider are known as exclusions. This article lists 10 of the most common pet insurance exclusions you need to know about.

As with any form of insurance, there are some common exclusions and conditions to be aware of when it comes to pet insurance. These might include:

1. Pre-existing conditions

Once your animal has undergone treatment for a particular condition or illness, you may be face with that illness being counted as a pre-existing condition if you apply for a different insurance policy. In that instance, you would have to fund all future bills relating to that condition on your own (gulp). Your other option is to stick with your current insurer, who should continue to cover any conditions that have arisen since taking out the policy.

Examples of pre-existing conditions could be as simple as an eye irritation that required eyedrops as a puppy resulting in an exclusion against covering cataracts or glaucoma down the road. Other commonly excluded pre-existing conditions include a heart condition, kennel cough, or ligament damage.

2. The age of your pet

Some pet insurance products will not accept an application for insurance cover after your pet reaches a certain age (commonly around nine years of age). They may also not allow you to reinsure if your cover lapses at any point after this age.

3. Diseases for which there is a known vaccine

Not keeping up to date with your pet’s vaccinations could result in an unhappy and costly surprise if Spot or Mittens succumbs to something nasty that could have been prevented with a jab.

This also applies to Kennel Cough, so don’t forget to get your dog vaccinated for that particular nasty if you ever plan on boarding him in kennels while you’re away on holidays.

A good example for cats is that cat breeds at risk of feline leukaemia are required to have the vaccine against this virus.

Common pet insurance exclusions - Vaccine against feline leukaemia

Some insurance providers treat preventative treatments such as worming tablets to be vaccines for heartworm prevention, so they require you to keep up-to-date with your cat or dog’s worm tablets in order to cover heartworm or other worms.

4. Pregnancy

Pregnancy is a common exclusion with pet insurances

As pet insurance is designed for pet owners rather than breeders, policies do not usually cover pregnancy, obstetrics, difficulty giving birth, or other breeding conditions. Now seeing as, in the words of the RSPCA, “de-sexing your pet is part of your responsibility as a responsible pet owner”, this shouldn’t be a problem.

But if you haven’t de-sexed your pet, it is not uncommon for some breeds to have difficulties during pregnancy and labour, that require expensive vet treatment. For example, Pugs always require C-section surgery to deliver a litter. This breed has been bred for a certain appearance, and their round heads are simply too big – even as a baby – to fit through their narrow pelvic canal.

5. Failure to take due care

Keeping a dog with no road sense in an unfenced yard, leaving your cat outside with no water or food for a weekend while you are away or delaying a vet visit for a sick animal are all actions that could void your insurance.

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6. Owning a banned breed

A breed or cross-breed of dog that is banned by either the government or a local authority will generally not be eligible for insurance. Similarly, if your dog is declared dangerous or registered under the Dangerous Dog Act, insurance may not be obtainable.

Other common exclusions for pet insurance:

  1. Dental procedures
  2. Elective procedures and treatments
  3. Ambulance or non-essential hospital admission
  4. Organ transplant or artificial limbs
  5. Genetic chromosome testing
  6. Cell replacement therapies
  7. Regular prescription diets

Check the terms and conditions

Remember, whichever policy you opt for, and however comprehensive it may seem, always be sure to carefully read the terms and conditions. You don’t want to sign up for a policy, only to find out that common health problems for your breed or other potential issues are excluded, and see yourself shelling out vast sums of money in the future.

You can read about the different types of pet insurance policies here.

Compare Pet Insurance with CANSTAR

Other things to know about pet insurance

In addition to possible exclusions, you should also make yourself aware of any out of pocket costs you may have in the event that a claim is successful. Two things you need to know about are the excess and the benefit limit.

The co-share percentage or excess

The “co-share” or “excess” are the minimum percentage of the veterinary fee that you will be expected to cover. For example, a 20% co-share of a $100 account would cost you $20. Understand your co-share duties, to ensure that the cost of veterinary treatment will be affordable for you.

The benefit limit

Be aware that many policies may have lifetime benefit limits for certain conditions. Once you have reached the limit allowable, you will be faced with out of pocket expenses for further treatment. Many policies also have annual limits for specific conditions, so be aware of the limits that apply to your policy.

Check the terms and conditions

Remember, whichever policy you opt for, and however comprehensive it may seem, always be sure to carefully read the terms and conditions. You don’t want to sign up for a policy, only to find out that common health problems for your breed or other potential issues are excluded, and see yourself shelling out vast sums of money in the future.

You can read about the different types of pet insurance policies here.

Compare Pet Insurance with CANSTAR

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