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How do you assess a claim?
How do you assess a claim?
John Connor avatar
Written by John Connor
Updated over a week ago

Most claims are assessed within five (5) working days from receiving all necessary information.

We can ask to review and examine your Pet’s past and current records and any other information from any Vet who has treated your Pet.

If the Vet Costs You are charged are higher than the fees usually charged by a general or referral practice, We reserve the right to request a second opinion from a Vet that We choose. If the Vet We choose does not agree with the Vet Costs charged We may decide to pay only the Vet Costs usually charged by a general or referral practice in a similar area for the Treatment.

How do you calculate the Benefit?

We deduct any outstanding Annual Excess from approved Vet Costs and pay the agreed Benefit Percentage of the remainder, up to the Annual Limit. The Annual Limit of Your Policy is the maximum We will pay for each Pet in each Period of Insurance.

For example, let’s say Your approved Vet Costs come to $1,000, You have $250 Annual Excess and have a Benefit Percentage of 80%. This means a benefit of $720 ($1,000 – $250= $750 then $750 x 80% = $600) will be payable to you, and You will still have $24,280 of Your Annual Limit available for any future claims for Vet Costs related to Treatment in the same Period of Insurance (if you have chosen the Annual Limit of $25k).

Future claims during the same Period of Insurance will not have the Annual Excess deducted because you’ve already met this for that Period of Insurance.

Each time Your Policy is renewed, the Annual Excess and the Annual Limit for Vet Costs will be reset.

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