when can i claim on pet insurance?

Pet Insurance: When Can I Claim? | man on computer filing a pet insurance claim with corgi sitting on his lap
Posted by fetch! blog editors on Apr 21 2020

Whether you just enrolled your furry family member in pet insurance or you had your first unexpected vet visit, it’s not uncommon to be confused when it comes to filing a claim. In short, you can submit a claim as long as your policy is active. However, it’s important to understand what waiting periods are and how they work, in order to understand how they impact a submitted claim.

Pet insurance waiting periods

A waiting period is a predetermined timeframe set by the pet insurance provider where no claim is eligible for coverage. Waiting periods often vary from one provider to the next so it’s wise to read the terms and conditions for complete details. You may be tempted to pick a provider based on shorter waiting periods, but it’s best to choose the most comprehensive medical coverage, for the best protection in the long run.

With Petplan, there are two timeframes to be aware of: a 15-day illness and injury waiting period and a 6-month exclusion for conditions relating to the hips and knees.

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  • The waiting period for injuries and illnesses occurs during the first 15 days of the policy beginning on the date of policy inception (the day your policy becomes active).
  • The exclusionary period for knees occurs during the first 6 months of the policy, starting on the inception date. This can be waived if your veterinarian deems your pet’s knees healthy during an examination that must be performed within the first 30 days. Since your policy requires your pet to be seen by a licensed veterinarian anyway, it’s wise to have the knees examined at that time. The exclusionary period for hips occurs during the first 6 months start on the effective date of the policy. This cannot be waived.

How pet insurance waiting periods work

Waiting periods work quite simply as long as you know the duration. Simply count the number of days from your inception (also referred to by some providers as effective date). For example, if you enroll your pet with Petplan on January 1st, your injury and illness waiting period would go through January 15th and the exclusionary period for hips and knees, July 1st.

What happens if I make a claim during the waiting period?

If your pet experiences any injury, illness or behavioral disorder during a policy's waiting period, any related expenses will not be reimbursed and it will be deemed a pre-existing condition.

This is a common reason why claims are denied. Your claim will still be assessed, but the expenses tied to the condition or injury will not be covered in the future. Keep in mind that there may also be a deadline to file a claim (usually 90 days from the date of treatment for an injury or illness).

Now that you know the when, learn the how. Read our how to file a claim blog! It’s also wise to familiarize yourself with how your pet insurance provider handles claims.

As always, don’t hesitate to call Petplan or read through frequently asked questions if you are still unsure.

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