Seven Pet Health Insurance Pitfalls 1. What is the limit of cover? It is not unusual for veterinary bills to run into several thousands of pounds, particularly in specialist care where bills of over £4,000 are becoming more and more common. Levels of cover provided by policies can range from just a few hundreds of pounds to many thousands. Be careful to check the limit – it is not uncommon for us to meet clients who have no idea of the limit of cover on their policy and they get a nasty shock when they find that the cover is less than half, even a quarter, of the estimated cost. 2. Is there an aggregate and do you know what one is? If there is an aggregate on the policy, you certainly need to understand it. For example, a policy might offer headline cover of £10,000. The smaller print might, however, point out that this is in the aggregate, with a maximum of £1,000 per condition. When your much loved pet falls sick, you only have cover of £1,000 for all the vets fees that follow. 3. Is there an excess (there almost certainly will be) and how does it work? Like many insurance policies, pet health policies almost always have an excess and there is much variation in how that works. It might be a fixed amount per condition, or a fixed amount per condition per policy year, or it might be a percentage, or it might be a fixed minimum per condition with a percentage on top. Finally, it might change as your pet ages. The impact to you of a 20% excess on a £1,000 bill is £200 out of your wallet. Make sure you know what your excess is and how it will work if you have a claim! 4. Beware of chronic illness! Many people think the word “chronic” means bad, it actually means long-standing. Just like us, our pets sometimes suffer chronic diseases that cannot be “cured” as such but that have to be managed, sometimes year in and year out. Think of the ones your friends and family have long term medication for. Many pet health insurance policies will only provide cover in the policy year, not “for life”. If your pet develops a chronic disease, the costs will climb over time and you might be financially on your own after the first year unless you have a policy that provides cover for life. 5. Your pet health policy is a contract between you and the insurer. The consent form you sign at your vets is a contract between you and the vet. There is no contract between the insurer and your vet. Some insurers will be quick to advise you that they will deal directly with your vet in settling any claims, however, the lack of any contract between the vet and insurer is a major obstacle that puts your vet, and sometimes you, at financial risk. Your vet is certainly not obliged to deal directly with the insurer even if the insurer says it can be done. Each vet’s willingness to take this risk without the security of a contract will depend to a large extent on their previous experience of dealing with a particular insurance company. Northwest Surgeons has had to develop a weighty administration to deal with this particular problem and we pass the cost of that administration on to those clients who ask us to perform direct claims with their insurers, on their behalf. Your vet could be in a difficult position from a regulatory point of view if you ask them about this, but it would be reasonable for them to answer the following question about their own practice “Which insurance companies or underwriters will your practice perform direct claims with?” Perhaps you should ask your vet that question before deciding for yourself which is the best insurer for you? 6. Don’t try to cheat. Almost without doubt, part of the paperwork you will complete in taking out a health insurance policy for your pet will ask you to declare any pre-existing conditions your pet has and will give the insurer right of access to your pet’s clinical records. Equally without doubt an insurance company faced with a significant claim will, quite rightly, want to see the clinical records from any vet that has been involved with the case. Under the terms of his or her professional regulation, your vet has a duty to comply fully and honestly with the insurer. If you have not been scrupulously honest in the first instance, expect the insurer to find out, expect them to reject your claim, expect to be left with a hefty veterinary bill and don’t expect much sympathy from your vet! 7. And finally….Keep the paperwork safe. You should have a schedule and certificate of insurance. These documents provide essential details and proof of your cover that your veterinary surgeon will need to see – they are unlikely to accept that you have pet health insurance at all unless you can produce these documents….and yes, people without any insurance do try that one on, so it is not a reflection on you personally when the vet won’t take your word for it!
Posted on: Thu, 04 Sep 2014 11:35:30 +0000
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