Pet Insurance: The General Consensus

[Guest Labradork]

It is worth looking again the policy fineprint, the companies I researched all sounded pretty similiar (in fact their websites all looked pretty darn similiar too, I think they all own a peice of each other lol).

PIA has the following statement :

The maximum We will pay for a single Condition, a Recurring Condition

or a Chronic Condition suffered by Your Pet is the maximum amount

that was current in the Policy Period when the Condition first manifested.

Once this maximum amount has been paid, We will not pay for any

further Treatment of that Condition during the remainder of the Policy

Period or any future Policy Period.

My maximum amount is $15,000 from memory. In theory for a recurring or chronic condition I pay one excess (for that particular condition) per calendar year and insurance will reimburse the rest up to a maximum of my policy limit. There is no time limit as such.

Now just hoping my doofus boy doesnt develop one really nasty immune problem or something!

Hey lucknow - I did read about this in one of the reviews. I'm not really sure what to make of it. I guess asking an Insurance Company to pay out thousands of dollars year on year for a dog with a chronic condition might be a bit much. But on the flip side... if your dog is only 1 year old, and by some horrible stroke of misfortune, develops a recurring/chronic/ongoing condition, EVEN IF you continue to insure your pet with PIA for the rest of it's life, they will still only pay the maximum stated amount (let's say $8K) to assist you in treatment of that condition, EVER. Not just for the first year, but for the rest of it's life. I guess you would just hope for a pretty generous policy limit........

[Guest Labradork]

That said, $15K is a pretty good policy limit, especially when you are paying a per-condition (rather than per-claim) excess.

Hmmmmmm. Interesting. I'll add PIA to the list!

[Danois]

I also read one review where the owner said the Insurance Company continued to debit their account monthly, after their pet had died!

Why wouldn't they?

A pet insurance policy is an annual policy which you can choose to pay monthly. Even if your dog dies during the policy year you have to pay the annual premium in full. When I rung my insurer to tell them Angs had passed away so I needed to cancel the policy I opted to pay out the rest of the premiums in one go.

[KJ]

Just a couple of things.........

- Exclusions on bilateral conditions (e.g. if dog does a cruciate on his left leg, the right automatically won't be covered)

This would be in relation to a pre existing condition eg..if the dog already has a cruciate problem in one leg, they will not pay for that condition in another leg. If you dog is insured before any problems have developed all legs will be covered.

Requiring the pet owner to pay for treatment upfront, then waiting for reimbursement

With PetPlan they have an option where the vet can be paid directly from the company athough the vet must approve of this. Is is pretty standard to expect to pay for treatment upfront.

Having to provide very extensive Vet histories

I provide vet histories with every claim and would not expect any claim to be paid without providing a history.

I also read one review where the owner said the Insurance Company continued to debit their account monthly, after their pet had died!

I think with most companines the full policy period must be paid for even if the dog dies.

Edited February 27, 2011 by KJ

[Danois]

I have never had to provide a vet history with a claim - there is space on the form for the vet to note the diagnosis or treatment comments but that's it.

[lucknow]

It is worth looking again the policy fineprint, the companies I researched all sounded pretty similiar (in fact their websites all looked pretty darn similiar too, I think they all own a peice of each other lol).

PIA has the following statement :

The maximum We will pay for a single Condition, a Recurring Condition

or a Chronic Condition suffered by Your Pet is the maximum amount

that was current in the Policy Period when the Condition first manifested.

Once this maximum amount has been paid, We will not pay for any

further Treatment of that Condition during the remainder of the Policy

Period or any future Policy Period.

My maximum amount is $15,000 from memory. In theory for a recurring or chronic condition I pay one excess (for that particular condition) per calendar year and insurance will reimburse the rest up to a maximum of my policy limit. There is no time limit as such.

Now just hoping my doofus boy doesnt develop one really nasty immune problem or something!

Hey lucknow - I did read about this in one of the reviews. I'm not really sure what to make of it. I guess asking an Insurance Company to pay out thousands of dollars year on year for a dog with a chronic condition might be a bit much. But on the flip side... if your dog is only 1 year old, and by some horrible stroke of misfortune, develops a recurring/chronic/ongoing condition, EVEN IF you continue to insure your pet with PIA for the rest of it's life, they will still only pay the maximum stated amount (let's say $8K) to assist you in treatment of that condition, EVER. Not just for the first year, but for the rest of it's life. I guess you would just hope for a pretty generous policy limit........

That said, $15K is a pretty good policy limit, especially when you are paying a per-condition (rather than per-claim) excess.

Hmmmmmm. Interesting. I'll add PIA to the list!

I specifically wanted a company that had a decent policy threshold. I remember looking at some brochures a few years back that had attractively low premiums but payment thresholds were scarily low. $300 for a broken limb or some such ridiculous amount. At the time it would probably cover xrays and splints but not much else, nowadays you'd be lucky to even diagnose the break for that!

Having said that this thread has made me look much closer at the fineprint, I knew my annual limit but didnt realise it was a limit per condition until I looked closer after reading some of the other posts. Heres hoping none of us ever have to worry about reaching per condition limits!

[Danois]

Don't forget to look at the other sublimits - most policies will also have an annual sublimit for medications.

[Guest Labradork]

A pet insurance policy is an annual policy which you can choose to pay monthly. Even if your dog dies during the policy year you have to pay the annual premium in full. When I rung my insurer to tell them Angs had passed away so I needed to cancel the policy I opted to pay out the rest of the premiums in one go.

I guess that makes sense Danois. I haven't really had too much experience with health insurance previously (I have a family member in medicine who has helped me!) so it didn't click. Although I might be an 'idealist' to say this, I do think it'd be nice if they calculated your pet's "last" year on a pro-rata basis... seems a little more socially conscious to me.

I specifically wanted a company that had a decent policy threshold. I remember looking at some brochures a few years back that had attractively low premiums but payment thresholds were scarily low. $300 for a broken limb or some such ridiculous amount. At the time it would probably cover xrays and splints but not much else, nowadays you'd be lucky to even diagnose the break for that!

Having said that this thread has made me look much closer at the fineprint, I knew my annual limit but didnt realise it was a limit per condition until I looked closer after reading some of the other posts. Heres hoping none of us ever have to worry about reaching per condition limits!

Lucknow - after reading the fineprint about PIA, are you happy with it? I didn't even think about per condition payment thresholds - I thought they'd just pay as much as necessary for any condition, until you reached the annual limit (e.g. $15K). It didn't occur to me that they'd put limits on claiming for certain things, like broken bones as you said, etc.

@KJ, thanks for clarifying those points for me, particularly on the bilateral conditions. I was under the impression that cover exclusions on bilateral conditions came into play even AFTER the policy was taken out!

[Tilly]

I looked into pet insurance for our boys but at the time because they are working dogs (security) the regular "pet" insurance wouldn't cover them if they were injured at work.

So we set up an ING Direct account and transferred a set amount into the account each pay (eg $50 per dog). This has worked well for us because the other issue is most emergency places require payment up front or before you leave with the dog - so you need to have the money on hand first because you can claim it back.

[Guest Labradork]

I looked into pet insurance for our boys but at the time because they are working dogs (security) the regular "pet" insurance wouldn't cover them if they were injured at work.

So we set up an ING Direct account and transferred a set amount into the account each pay (eg $50 per dog). This has worked well for us because the other issue is most emergency places require payment up front or before you leave with the dog - so you need to have the money on hand first because you can claim it back.

Hey Tilly,

Thanks for your advice- my only concern with doing this would be accumulating enough money to cover expenses- for example, if in 6 months time, my dog was in an accident and required $5K worth of surgery/vet stays/meds etc., I would've only saved up $300. It'd take over 8 years to save up that amount of money by putting away $50 in a separate account each month. However, the very clear benefit you experience in putting money aside is that if your dog remains illness/accident free, you still have all that money at the end of the day!

[lucknow]

Lucknow - after reading the fineprint about PIA, are you happy with it? I didn't even think about per condition payment thresholds - I thought they'd just pay as much as necessary for any condition, until you reached the annual limit (e.g. $15K). It didn't occur to me that they'd put limits on claiming for certain things, like broken bones as you said, etc.

So far so good, our first claim was hassle free and looks as though they will continue that way. I am still happy with them as comparing premiums vs thresholds at the time they looked pretty good, although when a friend looked a few weeks ago these have gone up (suppose I will get hit with that rise in a few months). It would be interesting to know how they compare to the other popular companies now

[Guest Labradork]

Just reading the PDS for PIA now, Lucknow... everything seems pretty much as expected.

The only thing that surprised me was around bilateral conditions; in that they classify them as the one condition. For example, if your pup does two cruciate ligaments, this is classified as one condition only, and you will be subject to any sublimit/threshold applied under the "cruciate ligament" umbrella. It also means that if your dog has a number of tumors for example, I believe they may be classified under the "cancer" umbrella and you will be subject to any sublimits/thresholds applied to "cancer". I am sure this isn't unique to PIA.

I don't like the parts of the policy (again, this would not be unique to PIA), that say things like... "We will only pay for whatever We deem reasonable". The word "reasonable" is completely subjective. It creates such a grey area, and effectively gives them carte blanche to turn around and reject any claim as they see fit. I suppose "reasonable" is based on the "average" - i.e. what most vets in surrounding areas would recommend/charge for treatment.

[Guest Labradork]

By the way Lucknow, where did you find out about the sublimits? I can't find this in the PDS.

Many thanks

[Danois]

A pet insurance policy is an annual policy which you can choose to pay monthly. Even if your dog dies during the policy year you have to pay the annual premium in full. When I rung my insurer to tell them Angs had passed away so I needed to cancel the policy I opted to pay out the rest of the premiums in one go.

I guess that makes sense Danois. I haven't really had too much experience with health insurance previously (I have a family member in medicine who has helped me!) so it didn't click. Although I might be an 'idealist' to say this, I do think it'd be nice if they calculated your pet's "last" year on a pro-rata basis... seems a little more socially conscious to me.

Why should they be more socially conscious? Insurance is a business. It is reasonable they get a full year premium especially if you have claimed.

Pet insurance is not alone in the requirement to pay the full premium year.

[lucknow]

Just reading the PDS for PIA now, Lucknow... everything seems pretty much as expected.

The only thing that surprised me was around bilateral conditions; in that they classify them as the one condition. For example, if your pup does two cruciate ligaments, this is classified as one condition only, and you will be subject to any sublimit/threshold applied under the "cruciate ligament" umbrella. It also means that if your dog has a number of tumors for example, I believe they may be classified under the "cancer" umbrella and you will be subject to any sublimits/thresholds applied to "cancer". I am sure this isn't unique to PIA.

that is how I interpreted the bilateral conditions also. I did ring to try to clarify after my boy was diagnosed with partial cruciate ligament rupture as initially there was some doubt regarding the stability of the opposite leg. Person I spoke to was unsure and even after speaking to a supervisor could not confirm how they would view a claim for a second leg (as in would my initial excess for cruciate mean I didnt have to pay a second excess). Her explanation was that they have the 'bilateral' more as an exclusion of pre-existing conditions, so a dog that has had an ear infection pre coverage may never be covered for ANY ear problem in the future.

By the way Lucknow, where did you find out about the sublimits? I can't find this in the PDS.

Many thanks

Section 1 Definitions - benefit limits, on page 6. It is pretty hidden away there!

[Golden Rules]

A pet insurance policy is an annual policy which you can choose to pay monthly. Even if your dog dies during the policy year you have to pay the annual premium in full. When I rung my insurer to tell them Angs had passed away so I needed to cancel the policy I opted to pay out the rest of the premiums in one go.

I guess that makes sense Danois. I haven't really had too much experience with health insurance previously (I have a family member in medicine who has helped me!) so it didn't click. Although I might be an 'idealist' to say this, I do think it'd be nice if they calculated your pet's "last" year on a pro-rata basis... seems a little more socially conscious to me.

Why should they be more socially conscious? Insurance is a business. It is reasonable they get a full year premium especially if you have claimed.

Pet insurance is not alone in the requirement to pay the full premium year.

I had a different experience a couple of years ago when I lost a dog. I had already paid the full premium in advance, and I got a refund when I called to tell them to cancel the policy.

eta - the refund was for the remainder of the policy, and I had not made any claims that year.

Edited February 27, 2011 by Golden Rules

[Keira&Phoenix]

I would recommend it highly.

I have a 3 yo female who had demodex at 4 months, luxatting patella at 10 months and has been diagnosed with hip displaxia and arthritis. She wasnr insured so not only have these conditions cost me thousands they will continue to cost me thousands throughout her life. Not much point in insurance now as she isnt covered for much so Its a case of having spare money in case of anything that comes up.

For this reason i had Phoenix insured the day she came home. I am with Medicare on their top insurance which is $48 a month. Thats $100 excess a year per condition (so only $100 for the whole 12 months for each condition or resulting issues from a condition) then 100% of vet bills repaid. I also get back a certaim amount for desex or vaccinations, worming etc each year. About to claim on allergies and desexing but have been told they pay out in 5 days. I have also spoken to them and no increase in premium or exclusion for the small claim i am making for an allergic reaction she had.

[coogie]

We have both our dogs insured with Petplan and are very happy with their service,Issy has just had surgery for luxating patella and they paid promptly and with no discussion. The premiums for the platinum policy are slightly higher than other companies but both of our dogs seem to be a bit accident prone so I feel it is well worth it. The only thing I don't like is that as a "select" breed (Shar Pei) they will not continue to cover them fully as they get older (over 7 years) so we may need to re-think at that point. We have just got the renewal for Issy and no significant increase despite the claims,in fact I was pleasantly surprised as I thought it would have gone up more just in terms of an annual increase.

A family member had a bad experience with Medi bank private where they refused to pay a claim over a technicality and some ambiguous wording in the policy, I had considered them but was put off by the way they handled (and then rejected) the claim.

[OSoSwift]

I have Petplan and while I haven't made any huge claims I have made a few smaller ones.

I get a letter to say they have recieved my claim and that it is being looked at. Once I had a letetr saying they had recieved my claim and they were experienceing delays.

They send me a cheque fairly quickly and I have never had any issues that way.

My policies did go up aroud $20 one year but have been teh same for the last two despite having some claims submitted and paid.

One of the things I really liked was you get paid out uo to your yearly cover in each poilcy period regardless of the condition. They are covered for any re-occuring conditions for life up to your amount each year. That is what swayed me to useing them, even though they were a little more expensive thatn some others.

I mainly have it to cover big things so I prefer the $100 excess per condition rather than 80% of say $5000 is more appealing to me. Having Whippets I worry about major stitch ups and broken bones as they go so fast and have been known to run into things!

Also we have LOTS of snakes so treatment for snake bite is a real possiblity.

[poochiemama]

Just a note on medibank private - i used to be with them but ceased the contract based on some very bad customer service. The thing is that they are underwriten by Hollard insurance , and the staff at medibank couldn't draw up my pet insurance contract quickly, they had to go through hollard and kept me waiting there for 20-30 minutes whilst they were attempting to get through to hollard (they were on hold). They couldn't tell me anything about my insurance policy, it was all 'We don't deal with that, we need to ask hollard'; this happened time and time again and it was just too frustrating. I couldn't get a simple question answered, so I was quite doubtful that claims etc would be paid on time. And you can't call hollard directly, you have to go through medibank and pay medibank.