petplan terms & conditions explained
Our fine print, in plain view
At Petplan, we strongly believe that nobody benefits by being surprised about what your pet insurance policy does and does not cover.
That’s why we recommend all of our new policyholders read through your policy terms & conditions* during the first 30 days of your policy. In encouraging transparency, we have included a sample policy terms and conditions for your review. Click on the sample policy below to read more:
*Please note: Policy terms and conditions can vary by state. In the event of an annual deductible purchase, policyholders will receive an endorsement to the policy outlining that the deductible is annual, not per condition. Policyholders should refer to their specific terms and conditions located in the Account Portal for more details.
To help explain some areas of the Petplan policy terms & conditions asked about most frequently, we break down our "fine print" below:
One of the most frequently asked questions by pet parents is about pre-existing conditions. Specifically: what are they and how are they determined?
At Petplan, we define a pre-existing condition as a medical condition which first occurred or showed clinical sign(s) or symptoms before the effective date of your policy or which occurred or showed clinical sign(s) or symptoms during the policy waiting period. Simply put, if your pet has or had any condition, whether diagnosed by your veterinarian or not, before enrolling in a Petplan pet insurance policy, it is considered pre-existing.
However, at Petplan we recognize there are two types of pre-existing conditions: those which can be cured, and those which cannot be cured. If your pet has experienced a curable condition previous to enrolling in a Petplan pet insurance policy, the condition, while pre-existing, may be eligible for coverage after an exclusionary period. Provided your pet’s medical history shows no further episodes of the condition subsequent to the initial episode, coverage for the condition may be restored. For further information, visit our FAQs.
As is standard in the industry, there is a waiting period on Petplan policies before accidents and illnesses can be considered coverable. The waiting period will not apply to any renewal of this policy if continuous coverage is maintained.
For most policies underwritten by XL Specialty Insurance Company, accident and injury coverage begins five (5) days after the policy becomes effective. There is a fifteen (15) day waiting period after the effective date of the policy during which we will not cover any illness of your pet. There is a (6) month exclusion on cruciates and patellas. Waiting periods vary by state. Check your policy terms and conditions for full details.
Pet’s last visit to vet
If your pet has not been examined by a veterinarian within sixty (60) days prior to the effective date of the policy, you must arrange to have your pet examined at your own expense within thirty (30) days of the effective date of this policy. Any medical condition(s) or clinical sign(s) observed or recorded during the first exam, and all costs associated therewith, are automatically excluded from coverage.
Your failure to have a first exam of your pet may void the policy. If voided, the policy premium will be refunded. Additionally, any conditions that are related to, caused by, or resulting from medical condition(s) or clinical sign(s) observed or recorded at the first exam performed after the effective date of the policy are also excluded from coverage. This section applies to both new policies and policy years where your pet has not received the care described in Section VII.6.a of the terms and conditions.
For the avoidance of doubt, if your pet does not receive its annual health check during a policy period of renewal coverage, the next examination will be used as the basis for determining any conditions which will be excluded from coverage.
Annual wellness visits
We believe strongly that your pet’s annual wellness check-ups are the best time to catch diseases early to achieve the best possible outcome. As a condition of this insurance, you must take care of your pet and arrange and pay for your pet to have an annual health check; an annual dental exam; any treatment normally suggested by a veterinarian to prevent illness or injury
Cruciate and patellas (knees)
Petplan policies do not cover costs arising out of or related to any treatment associated with damage or rupture of cruciate ligaments, luxation of the patellas or other soft tissue disorders of the knee where clinical sign(s) occur during the first six (6) months that the policy is in effect. However, coverage will be afforded if your pet is examined by a veterinarian within the first thirty (30) days of the policy and the medical record specifically notes your pet does not have any pre-existing conditions relating to the knees, subject to the waiting period.
Please note that if your pet has received treatment for a cruciate or soft tissue injury to one knee during the first six (6) months of the policy (where no certification of knee health has been provided) then the other knee is automatically excluded from coverage for a period of twelve (12) months from the date of last treatment to the affected knee.
If your pet has received treatment for a cruciate or soft tissue injury to one knee prior to policy inception then the other knee is automatically excluded.
If your pet has shown clinical signs of a cruciate or soft tissue injury to one knee prior to the effective date of this policy or during the first six (6) months of the policy (where no certification of knee health has been provided), then the other knee is automatically excluded from coverage
Petplan pet insurance policies do not cover routine care. Instead, our policies are designed to give you the most comprehensive protection against your unexpected vet bills for the best possible value.