notice to policyholders

2019 Pet Health Insurance Policy Terms and Conditions Update

This is a summary of some key changes in your pet health insurance policy from Petplan. No coverage is provided by this summary nor can it be construed to replace any provision of your policy. This notice does not reference every editorial change made in your policy. Refer to your policy terms and conditions and Declarations page for complete details on the coverages provided. If there is any conflict between the policy and this summary, THE PROVISIONS OF THE POLICY SHALL PREVAIL.

BROADENING OF COVERAGE:

I. Definitions Used Throughout This Policy

Telehealth Treatment, any treatment administered by a veterinarian to treat any injury or illness by means of remote telecommunications technology including phone, email, Internet, text and video, has been added as a covered treatment with no copay or deductible applied at a maximum $1,000 annual limit.

First Exam has been changed:

If your pet has not been examined by a veterinarian within the twelve (12) months prior to the effective date of the policy (thirty (30) days if your pet is age six (6) years or older), has been changed to (6) months prior to the effective date of the policy for pets of any age. This broadens coverage for pets age six (6) years or older.

2. SPECIAL COVERAGES AND LIMITS have been added to your policy. These coverages are limited to a $1,000 annual limit with no copay or deductible applied:

a) BEHAVIOURAL FEES AND TELEHEALTH

b) ADVERTISING AND REWARD

c) BOARDING FEES

d) LOSS DUE TO THEFT OR STRAYING

e) DEATH FROM INJURY OR ILLNESS

f) VACATION CANCELLATION

VII. General Conditions 6. CARE FOR YOUR PET has been changed:

If your pet does not receive an annual examination within each policy period following the first 12-month policy period of coverage with us, any illness, clinical sign(s) or behavioural disorder observed or recorded at the next examination will be excluded from coverage. Expanded to include injuries if your pet missed an annual exam. 

REDUCTIONS IN COVERAGE:

I. Definitions Used Throughout This Policy

First Exam has been changed:

If your pet has not been examined by a veterinarian within the twelve (12) months prior to the effective date of the policy (thirty (30) days if your pet is age six (6) years or older), has been changed to (6) months prior to the effective date of the policy for pets of any age. This is a reduction in coverage for pets under age (6) six.

Waiting Period is changed

The five (5) day waiting period for accidents and injuries has been changed to (15) days. The waiting period for illnesses remains at (15) days.

III. Insured Coverages

The medically necessary reasonable cost of pharmaceuticals that can only be obtained by means of a veterinarian prescription to treat an illness, injury or behavioural disorder is now limited to a quantity of ninety (90) days or less for each claim submitted.

V. General Exclusions General Exclusion h. has been changed:

If your pet has shown clinical signs of a cruciate or soft tissue injury to one knee before the effective date of this policy or in the first 6 months of this policy (with no knee certification) then both knees are excluded from coverage.  Previously, if one cruciate or soft tissue problem was repaired during the (6) six month exclusionary period the other knee was automatically excluded from coverage for the longer period of twelve (12) months from the date of last treatment to the affected knee or the first six (6) months that the policy is in effect.

General Exclusion i. has been added:

The costs arising out of or related to any treatment associated with hip dysplasia where clinical sign(s) occur during the first six (6) months that the policy is in effect are not covered. Previously, the standard fifteen day waiting period applied.

General Exclusion q.v weight loss, and nn. have been added:

Coverage is not provided for routine and preventive care, including but not limited to treatment(s) and therapies for weight loss or costs and payments arising out of or related to physical therapy and/or holistic therapy to treat weight loss.

VII. General Conditions 2. YOUR DUTIES AFTER LOSS has been changed:

If your pet suffers a loss that may be covered by this policy, you must complete and send to us a completed claim form describing the illness or injury as soon as practicable but no later than ninety (90) days after the end of the policy period has been changed to ninety (90) days after the date of treatment.

7. CARE FOR YOUR PET has been changed:

If your pet has not been examined by a veterinarian within the twelve (12) months prior to the effective date of the policy (thirty (30) days if your pet is age six (6) years or older), has been changed to (6) months for pets of any age. 

VIII. Other Terms and Conditions, 6. Cancellation and Nonrenewal

The method to cancel this policy has been clarified to: You may cancel this policy at any time by calling us toll-free at 1-800- 240-1875 or by mailing or delivering to us advance written notice of cancellation at customeradvocate@gopetplan.com or to Petplan Pet Insurance 3805 West Chester Pike, Suite 240, Newtown Square, PA 19073. If you notify us within the first thirty (30) days from the effective date shown on the declarations page, and you have not submitted any claim against this policy, we will refund the entire premium. After thirty (30) days, we will return the pro rata premium based upon the date of termination of this policy.

The following clause was added:

We may elect not to renew this policy on the expiration date (for any of the reasons stated in Section VIII.6.c above). We may do so by writing to you at your last known address shown on the declarations page, with a written notice at least sixty (60) days prior to the expiration date.

OTHER CHANGES

I. Definitions Used Throughout This Policy

The following definitions have been added:

Curable Medical Condition

Any medical condition or injury that can be completely resolved without recurrence or any manifestations of clinical signs.

Curable Exclusionary Period

There is a three hundred sixty-five (365) day exclusionary period for any curable medical condition that is observed, recorded, or identified up to three hundred sixty- five (365) days prior to the original inception date of the policy or during the waiting period. A second three hundred sixty-five (365) day exclusionary period will apply if the curable medical condition reoccurs within the first three hundred sixty-five (365) days after the original inception date of the policy. If the same curable medical condition reoccurs during the second exclusionary period, then it will be excluded from coverage for the life of your pet.

Excess Insurance

If any claim under this policy is eligible for coverage or reimbursement by any other insurance, this policy shall be deemed excess insurance.

Experimental Treatment

Drugs, therapies, or treatments that are unproven, have been confined largely to laboratory use, or have progressed to limited pet application and trials, and lack wide recognition from the scientific community as a proven and effective measure of treatment. Holistic Therapy Acupuncture, aromatherapy, chiropractic, homeopathic and other alternative therapies administered by a veterinarian to treat an injury or illness.

Maximum Annual Policy Coverage

The most we reimburse during the policy period for each type of insured coverage covered by this policy as shown on the declarations page.

Original Inception Date

The first policy period effective date with us for your pet where continuous coverage has been provided without interruption. Any lapse or gap in coverage will reset the date to the next policy period effective date after the lapse or gap in coverage.

Physical Therapy

Hydrotherapy, laser, underwater treadmill, kinesiotherapy, land-based exercise, massage, stretching, electrical stimulation and other rehabilitative therapies administered by a veterinarian to treat an injury or illness.

Sick Visit Fee

The veterinarian examination cost for treating your pet’s injury or illness.

Supplements

Any medicinal substance including but not limited to nutraceuticals, vitamins, and herbal medicines not requiring a prescription that a veterinarian recommends for the treatment of an injury or illness.

The following definition has been deleted:

Select Breed

Certain breeds of dog for which special policy conditions apply. If a dog is a select breed, it is noted on the declarations page under “Breed Classification.”

Administered by Fetch Insurance Services, LLC. For questions concerning your policy, call 1.866.467.3875.