At Petplan, we know pets are family, but the insurance world considers pets property (😱).

But pets aren't like a couch or a car, and vet records can be complicated and confusing. Over the last 15 years, our claims adjusters have processed millions of claims, and we’ve combined their pet expertise with best-in-class technology to bring you a simple claims process that gets you paid back faster than ever. 

Here are a few insurance terms that will help explain how claims work:  

  • Reimbursement rate: What percentage of your claim that you’ll be paid back
  • Annual deductible: The fixed dollar amount you're responsible for paying before your insurance kicks in
  • Per-condition deductible: The fixed dollar amount per condition you're responsible for before insurance kicks in
  • Maximum annual payout: The maximum dollar amount you can get paid back each year
  • Waiting period: The amount of time from your enroll date to the date you can start submitting claims—these vary state to state and can be as long as 15 days
  • Pre-existing condition: Any injury or illness that your pet had prior to signing up for coverage or that occurred during your waiting period  
  • Preventive: Routine vet visits such as annual check-ups, teeth cleanings, spay/neutering, flea/tick/heartworm medicine and vaccinations

How do I submit my claim? 

Submitting a claim can be done in as little as 30 seconds. We’ll ask you a few questions about your vet visit and have you submit a copy of your paid invoice along with your pet’s medical records (if we don’t already have them on file). Plus you can easily upload all of your documents with your phone camera—all in the app. 

Your claim will be assigned to a licensed adjuster within 24 hours and claims are typically processed within 15 days. If we’re missing any information or have any questions, we’ll let you know as soon as possible. You can get real-time updates and track your claim status in the Homepage and Claims section of the app.

When should I submit my claim?

Most states require that you submit your claim within 90 days from the day of treatment. If you submit your claim past the 90-day window, we might not be able to approve your claim. For more details, you can find your policy documents in the app under Accounts >> Policy >> Get Details >> All Policy Documents

My claim was approved, now what? 

Once approved, we’ll apply your deductible and reimbursement rate and process your payment the next business day.

For example: If you submit a claim for $1000 and you have a 90% reimbursement rate, and a $250 annual deductible, we will pay you $650 ($1000 x 90%= $900 - $250= $650)

If you have another $1000 claim in the same coverage year, since your deductible has been met we’ll pay you back $900 of that approved claim. Coverage years are based on your annual renewal date—not the calendar year. 

Don’t forget to enroll in direct deposit and get your money back even faster. In the app go to Account, click on Billing, then Preferred Reimbursement Method and add your debit card. 

What if my claim is denied? 

If your claim is denied you can find a detailed explanation as to why in the Claims section of the app. 

Claims submitted for pre-existing conditions and wellness visits are the most common reasons for denied claims. 

Any injury or illness that your pet had before signing up for coverage or that occurred during your waiting period is considered a pre-existing condition, and we will not be able to pay you back for any vet bills related to that condition. In fact, no pet insurance provider covers pre-existing conditions.

At this time Petplan does not cover vet visits related to annual check-ups, teeth cleanings, spaying, neutering or vaccinations. However, this year we will launch the industry’s best preventive care product that will cover these things—and we’ll let you know when it's available in your area.

Jan 18, 2021
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