What is pet insurance for a pre-existing condition?
Pet insurance for pre-existing conditions refers to policies covering health issues your pet had before the policy was activated or during its waiting period.
A waiting period is a fixed amount of time during which you cannot claim for specific illnesses or injuries.
A pre-existing condition can be any illness, injury or symptom that:
- Was diagnosed by a vet
- Was treated by a vet
- Was visible or documented, even without a formal diagnosis.
Why do pre-existing conditions exist for pet insurance?
Pre-existing conditions help insurers manage financial risk and keep premiums affordable. Like most insurance products, pet insurance is designed to cover unexpected events, not conditions that existed before the policy started.
For instance, if your pet developed an infection months before you took out a policy, your insurer might still classify it as a pre-existing condition. Even if it was treated and fully resolved, it could be excluded from coverage until its waiting period is over. .
However, not all pre-existing conditions are equal. Some may become eligible for coverage if your pet remains symptom-free for a defined period (typically 12-18 months).
Understanding what qualifies as a pre-existing condition and how long-term or short-term issues are treated can help you make an informed decision when choosing pet insurance.
What are the types of pre-existing conditions?
Temporary conditions
Temporary conditions are short-term issues that fully resolve with no lasting effects. For example, your pet ate something and got an upset stomach. If there’s no lasting damage and it doesn’t happen again, it’s usually not considered pre-existing if it returns after your policy starts.
Some insurers will lift the exclusion on temporary conditions if your pet remains symptom-free for 12 to 18 months.
Chronic conditions
Chronic conditions are typically defined as long-term or recurring conditions requiring ongoing treatment. These are often permanently excluded by most insurers. Some common examples include:
- Seasonal skin allergies that return every year
- Diabetes or Cushing’s disease, once diagnosed
- Arthritis, even if diagnosed early before treatment is needed.
Congenital or hereditary conditions
Issues your pet is born with or inherited genetically are often considered pre-existing if signs or a diagnosis exist before your policy commences.
However, such conditions may be covered if the pet is asymptomatic at enrolment and the condition is not specifically excluded from coverage. Some common examples include:
- Hip or elbow dysplasia
- Heart defects present from birth
- Cruciate ligament.
Linked or bilateral conditions
If your pet is diagnosed with a condition that is likely to affect another part of the body or lead to a related illness, the insurer may specifically exclude such conditions from your policy. Some common examples include:
- Ruptured cruciate ligament in one leg, leading to exclusion of the other
- Arthritis in a joint that stems from an earlier injury
- Cataracts in one eye often leading to exclusion of both eyes
However, it’s worth remembering that insurers may treat pre-existing conditions differently. Even though the general categories may be similar, each insurer is likely to have its own approach to assessing and covering pre-existing conditions.
It’s important to read a policy’s Product Disclosure Statement (PDS) and clarify how the insurer defines and applies exclusions, especially if your pet has a known medical history.
Does pet insurance cover pre-existing conditions in Australia?
Most pet insurance policies in Australia exclude cover for pre-existing conditions (except fixed-term period).
However, some insurers let you request a review of a pre-existing condition after a certain time. This is especially helpful if your pet hasn’t shown any signs of the condition since it was treated. Your insurer might reassess and reclassify the exclusion, potentially offering coverage moving forward.
It’s important to know that what’s considered curable or reviewable varies. Always check the PDS carefully so you’re clear on what’s temporarily excluded and what’s not.
How do insurers know about pre-existing conditions?
Insurers typically rely on veterinary records to assess your pet’s health before approving a claim. They may request a full medical history or vet notes from the past few months.
This information helps them determine whether a condition is new or if it existed before the policy started. It also forms the basis of any exclusions listed in your policy.
If you make a claim shortly after your policy begins, insurers will look closely at your pet’s records to check whether the issue was already developing.
That’s why it may be helpful to get pet insurance early, before your pet shows signs of any health issues. Doing so can increase your chances of having more conditions covered and fewer exclusions on file.
What happens if my pet develops a chronic condition once the policy starts?
If your pet develops a chronic condition after you purchase a policy and it is not specifically excluded, the condition will generally be covered for the duration of the policy period, provided you keep renewing the policy without any gaps in coverage.
This means ongoing treatment for chronic illnesses like arthritis or diabetes will be covered, but you may need to maintain continuous insurance with the same provider.
However, if the chronic condition develops during the waiting period, it may not be covered. Waiting periods typically range from a few days to a few months, depending on the insurer and the type of condition.
If you switch to a new insurance provider or start a new policy, any chronic or pre-existing conditions that your pet already has may be excluded again by the new insurer. Many insurers treat these as pre-existing and will not cover ongoing treatment for them under the new policy.
How to find the best pet insurance cover for pre-existing conditions?
If your pet has a medical history and you’re looking for insurance that covers pre-existing conditions, it’s important to understand the nature of your pet’s condition first.
You can provide the insurer with documentation from your vet to check whether any pre-existing conditions may be covered.
Keep in mind that different insurers treat pre-existing conditions differently. Some may allow coverage for certain issues, while others might exclude them entirely. It’s worth comparing what’s on offer to see what suits your pet’s health needs.
However, if your pet is older, you may find that only accident cover is available. Some insurers may even refuse to accept pets beyond a certain age. Getting cover while your pet is young and healthy can help reduce exclusions down the line.
You can compare pet insurance with Canstar, and search various policies on our database based on the kind of pet you have and your particular coverage needs.
