Pre-Existing Conditions and Pet Insurance: What’s Covered

What is a pre-existing condition?

A common question we receive from pet owners when researching our pet insurance is what exactly is a pre-existing condition? A pre-existing condition is any illness, injury or condition that occurs or has symptoms manifest before the insurance policy’s start date. A crucial note to be aware of is that a condition does not need to be diagnosed by a vet to be classified as a pre-existing condition, instead sometimes it can be that your pet showed symptoms that are linked to a disease/condition.

However, if your pet has had a condition, or showed symptoms in the past, that does not mean the pet can never receive coverage. Firstly, whilst that condition may not be covered, it doesn’t affect your eligibility to claim for other, unrelated conditions. Secondly, some insurers, including Lifetime Pet Cover, will offer cover for pre-existing conditions under certain terms. For Lifetime Pet Cover policies, a condition will no longer be treated as pre-existing, and will therefore be eligible for cover, if:

• The condition was treated, and the pet has fully recovered without leaving susceptibility to future problems or underlying weakness and since that point;
• The condition has been treated and the pet has not received any treatment for or in connection with the condition for a continuous period of 24 calendar months;
• There are no symptoms or vet consultations relating to the condition for the previous 24 months.

With this in mind, when you are researching insurance providers, it is integral to speak to them and be honest about what treatment, conditions, and symptoms your pet has had so that you’re clear on whether or not a claim may be paid. This will help you decide on the best pet insurance for your pet and will reduce the risk of you being unexpectedly denied a claim for a veterinary bill.

What may be considered a pre-existing condition?

Essentially, any condition can be considered pre-existing but some of most common include:

• Hip or elbow dysplasia
• Cherry eye
• Allergies
• Cancer
• Diabetes
• Hernia
• Congenital heart disease
• Nervous system issues
• Arthritis
• Epilepsy
• Glaucoma
• Cataracts
• Uveitis
• Kidney Stones

A common issue pet owners run into, however, isn’t a diagnosis. Instead, it’s symptoms. For example, let’s say you take your dog to the vet because of excessive vomiting. You don’t receive a diagnosis and later you decide to get pet insurance. A few months after your policy starts, your dog starts vomiting again and this time you find out the dog has stomach cancer. Though it wasn’t spotted by your vet before, the vomiting your pet experienced a few months ago will be treated as an early sign of the stomach cancer that has now been diagnosed. In this scenario, stomach cancer would then be treated as a pre-existing condition and it is very likely that all claims related to that will be denied.

Another scenario may be a visit to the vet for excessive feet licking. Although this may seem like a relatively normal tick, it can be a sign of allergies. If this symptom appeared before you started your insurance policy, treatment for allergies will likely not included in your cover.

In short, symptoms show an animal is suffering from a condition, and these conditions will rightfully be considered pre-existing and therefore excluded from cover.

Common symptoms that may result in a condition being treated as pre-existing include:

• Vomiting
• Nausea
• Diarrhoea
• Head shaking
• Excessive licking
• Hair loss
• Sores
• Weight gain/loss
• Change in personality
• Change in gait

The main thing to keep in mind when looking at pet insurance is that even a pet with a health condition can receive coverage from an insurance policy, it just won’t provide cover for the pre-existing condition. Remember, symptoms are proof that a condition exists, so it is integral you’re honest about what your pet has exhibited so you’re not hit with a large and unexpected veterinary bill.

What to consider when switching insurance providers

You may be wondering what exactly pet insurance covers. It’s important to realise that, unless the insurers terms say otherwise, a pet insurance policy will only cover conditions, accidents, or illnesses that develop while under the policy. For example, you may purchase a policy for a dog that already has kidney stones and after starting the insurance policy, they develop arthritis. If the arthritis is in no way related to the kidney stones, claims won’t get denied on the basis of a pre-existing condition, though it will still be subject to all other policy terms.

However, we sometimes see existing policy holders who receive a diagnosis, or their pet experiences symptoms, and want to change to a different insurance company. If you are considering this, it’s important you understand that the new insurance company is unlikely to cover costs related to any diagnosis or symptom that occurred prior to the start of a new policy. For this reason, before deciding on switching providers, it is a good idea to determine what a new policy will or won’t cover.

If you want to protect your pet with insurance that covers new conditions year on year, a lifetime policy may be the right choice for you. A lifetime pet insurance policy will offer you continued cover on any condition that comes up while the policy is in place, even after renewal. Switching providers may result in the pet not receiving veterinary care due to pre-existing conditions, therefore leading to large vet bills that the pet owner must find alternative funds for.

How do I know what my policy covers?