For the same reasons that we take out medical aid cover for ourselves and our dependents, so we consider the risk of extraordinary veterinary costs arising for our pets. Pet medical insurance assists with the payment of veterinary costs related to illness or accidents affecting your pets. Some pet medical aid products will cover additional smaller items like day-to-day benefits, and vaccinations. Veterinarian, Dr Rosemary Dallas shares her views with us here, as to why she feels pet insurance can be such an important product for pet owners.
An annual claims limit is simply how much your pet medical insurance provider will pay you per year for each pet in aggregate for all claims made. This may be an amount of R30, 000, R40, 000, or even unlimited. Each product will have their own benefit limitations.
Similarly to an annual cover limit, each provider is generally only prepared to pay you up to a specific amount on each individual claim. By way of an example, repairing your dog’s cruciate ligament may cost R25, 000 based on a cost estimate from a vet, however your provider of medical cover may only be prepared to pay a maximum of R20, 000 for any one claim. You would need to pay the shortfall.
The industry standard is a thirty day waiting period for all claims relating to an illness, meaning that you cannot claim any benefits under the policy for illness-related vet expenses until the passing of thirty days. This should NOT however exclude any medical costs arising from an accident or trauma to your pet. There is generally no waiting period for accidents. Some product providers will have additional specific waiting periods for specific procedures.
Very few pet insurers will cover your pet for pre-existing medical conditions. This should come as no surprise. You’re probably more familiar with motor vehicle insurance and know that you can’t insure your car after an accident to try and get the damage repaired. Pet medical insurance is there to protect you from unforeseen veterinary costs, and not those that you are aware of.
In instances where pre-existing conditions are covered, this will generally be qualified to some degree.
Just like short-term insurance on your car, the excess amount is the amount that you must pay, before your provider will pay anything. The purpose of the excess is to prevent claimants from adopting risky behavior, in this case - with their pets, and minimizing the loss that the insurance risk pool faces, by essentially limiting losses from smaller events.
By way of an example, Insurer A has a R200 or 10% Basic excess, while Insurer B has a R500 or 25% basic Excess.
Scruffy the dog suffered a broken leg and internal injuries and requires medical treatment with an estimated cost of R25, 000.
All else being equal, the Excess payable by yourself on Insurer A would be R2, 500 whilst the Excess payable by yourself using Insurer B would be R6, 250.
A co-payment is an amount of money that you need to pay, alongside your insurance provider. It may differ to an excess amount and is applied by some product providers for people who have multiple claims in a relatively short period of time, or who claim for similar type injuries or illness repeatedly.
Underwriting is simply an industry term for the process whereby the insurer fully comes to understand the medical risk that they are insuring. Some providers choose to perform their underwriting at the time you apply for cover. This may include medical questions on the application as well as the underwriter requesting supporting information from your vet. It is important that you disclose all previous conditions as non-disclosure could result in a claim being rejected and even the cancellation of the policy.
Other providers choose to perform the necessary underwriting at the time of claiming. So should you submit a claim for hip dysplasia costs for your German shepherd, your provider will at that time ask your vet to submit a report on the prior medical issues identified for your pet, and whether any of those pre-dated your cover start date.
No product will generally turn a particular breed of pet away, but they may limit the benefits that certain breeds can enjoy. By way of an example, certain dogs are more predisposed to hip-related degenerative conditions, which some providers will not cover. Some will however cover your pet for all conditions, regardless of their breed.
A vaccination benefit is simply a benefit afforded to you as a policyholder at no extra cost, that covers the expenses associated with having your pet vaccinated. These are usually capped to an annual amount.
Routine care and maintenance is used to describe the typical day-to-day costs and preventative care associated with owning a pet. This may include dental polishing, grooming, etc. Theses costs are not normally covered, but many providers do offer this as an extra benefit (with a small fee).
Each provider's 'Routine care' products differ markedly, so if this is something that appeals to you, it would be best to contact the product provider directly. We have indicated those product providers who offer this benefit at an extra cost.
Pet insurance claims generally fall under two types. Those arising from an accident, and those arising from an illness. A comprehensive pet insurance product will cover both, but in instances where you pet is over the age at which a product provider may accept them (generally 8 years old), there does exist the possibility to take out an ;accident only' policy. This will only cover your pet in cases where vet costs were incurred as a result of an accident. Not an illness.
We have listed under each provider as to whether or not they offer an 'accident only' product.