Frequently asked questions

For policies first issued prior to 10 December 2019 and subsequent renewals:

For policies first issued on or after 10 December 2019 and subsequent renewals:

• What percentage of my vet expenses am I covered for?

  If you are covered under:
  Core Cover and Core Plus Cover: the Benefit Percentage for Pets aged eight weeks and younger than eight years is 90%, up to the applicable policy limits. Once your Pet reaches his/her eighth birthday, the Benefit Percentage will reduce to 65% up to the applicable policy limits on the next policy renewal.
  Total Cover: the Benefit Percentage for Pets aged eight weeks and younger than eight years is 100% up to the applicable policy limits.
  Once your Pet reaches his/her eighth birthday, the Benefit Percentage will reduce to 65% up to the applicable policy limits on the next policy renewal.

• What are annual condition limits?

  The Annual Condition Limits are the maximum benefit amounts paid per illness, injury or other items covered under your policy (such as emergency boarding) that you are claiming for. For example, Core Cover has an Annual Condition Limit of $500 for each covered condition and item, and Core Plus Cover has an Annual Condition Limit of $1,000 for each covered condition and item.
  The Total Policy has different limits per condition or other covered item, ie $750 for Hernia or $6,000 for Bone Fractures, which are all set out in the Benefits Schedule. If you would like more information about the applicable benefit limits for the Total Policy, please refer to the Policy Schedule in your ‘Total’ Product Disclosure Statement.
  As each condition and item covered under your policy has a per condition limit, there may be times where you will need to pay an additional amount of the eligible vet bill above what is covered by your insurance policy. Depending on the condition and the amount of the vet bill, this may be a significant amount.

• Why does my cover drop to a 65% benefit rate when my pet is 8 years old?

  As our Pets age, their health starts to suffer and they are likely to visit the Vet more frequently. The increases in the likely frequency and therefore the cost of Treatments impacts on the cost of pet insurance for all ageing pets. In order to continue providing cover and keep your premiums manageable, your benefit percentage will step down to 65% on the first renewal period once your pet reaches 8 years of age.

• Is my premium calculated the same way as my private health insurance?

  No. Pet insurance does not work like health insurance. Health insurance is ‘community rated’, which means that everyone pays the same premium for their health insurance regardless of their individual health status, age or claims history. This is not the case for pet insurance. Health insurance providers are able to community rate health insurance because there are many other factors at play in the human health care system, such as Medicare and government rebates and subsidies, which is not the case with veterinary care and pet insurance. Pet insurance claim reimbursements are paid for purely by the premiums received by those who insure their pets. In order for each person to pay a fair price for their pet insurance, premiums vary depending on you and your pet’s risk factors.

• What waiting periods apply?

  The Waiting Periods that apply for conditions covered under each policy are:
  Core Cover: 30 days - for Conditions covered under the Illness and tick paralysis sections.
  Core Plus Cover: 30 days - for Conditions covered under the Illness and tick paralysis sections 6 months – for cruciate ligament Conditions (may be waived on application, refer to the ‘Waiting Period’ definition in PDS).
  Total Cover: 20 days - for Conditions covered under Illness, prescription diets, and alternative & complementary therapies, behavioural conditions 6 months – for cruciate ligament conditions (may be waived on application, refer to the ‘Waiting Period’ definition in PDS) 6 months – for treatment covered under the Dental Illness Conditions section

• What is a pre-existing condition?

  - A condition that existed or occurred prior to the commencement date of your first policy period or within any applicable waiting period.
  - A condition that you or your vet were aware of, or a reasonable person in your circumstances would have been aware of.
  This is irrespective of whether the underlying or causative condition was diagnosed at the time.
  Whether it is a pre-existing condition will depend on its nature and experience. If your pet has a temporary condition that has not existed, occurred or shown noticeable signs, symptoms or an abnormality in the 18-month period immediately prior to your claim treatment date, it will no longer be excluded from cover as a pre-existing condition. Chronic Conditions and several other specified Conditions cannot fall within this category.
  You can apply to have Pre-existing Conditions Reviewed.
  For more information about Pre-existing Conditions, click here.

• What is an example of a bilateral condition?

  A Bilateral Condition is a Condition affecting body parts of which the Pet has at least two. However, when applying a Benefit Limit or exclusion, a Bilateral Condition will be considered a single Condition.
  For example: if your Pet displays signs or symptoms of an ear Condition in the left ear prior to taking out your policy or during the Waiting Period (a Pre-existing Condition), Vet Expenses for a subsequent ear Condition in the right ear will not be covered. Refer to the ‘Bilateral Condition’ definition in ‘Section 1 – Definitions’ of the Product Disclosure Statement, Policy Terms and Condition and Financial Services Guide.

• Will I have a lifelong cover for my pet?

  Once your pet is accepted and as long as you continue to renew your policy, your pet will be covered for eligible Vet Expenses for life (subject to the terms of policy that apply on renewal).

• What exclusions apply?

  As with most insurance policies, there are certain situations where you will not be covered. It is important that you read all of your policy documentation for full details of what is covered under each policy. For a list of General Exclusions refer to the Product Disclosure Statement, Policy Terms and Conditions and Financial Services Guide.

• How do you calculate my premium

  New policies; Your premium is calculated using a combination of factors about you and your pet. These factors can affect the premium amount up or down depending upon whether we believe it increases or decreases the risk to us, such as the cover you have chosen, the excess selected, the benefit percentage applicable to the cover you have chosen, where you and your pet permanently live, your age and the species, breed, gender of your pet, the current age of your pet, the age you first insured your pet, and other factors related to our cost of doing business.
  Renewing policies:
  Factors that are taken into consideration for renewal premium calculation include your pet’s age, breed, location, duration for which your pet has been insured, claims history, as well as data relating to the health of pets that are a similar age and breed. Each year we review premiums based on these factors to ensure we can accommodate the costs of possible treatment up to your annual benefit limit, in the event that your pet becomes injured or ill.

• Will my premium increase every year?

  Yes, your premium will increase each year.
  This is for two main reasons:
  Reason #1: Just like humans, the older our pets get, the more likely they are to have health hiccups. Cats and dogs age faster than we do, which means that their likely veterinary treatment costs go up rapidly each year too. As a result, the cost of insuring your pet will also increase as they get older.
  Reason #2:
  Advancements in Veterinary Treatments. The overall cost of medical treatment for pets has increased in recent years due to the increased availability of medical treatments and technology-enabled services and ongoing demand for these services. The treatment options and advancements in technology are providing us with great opportunities to give our pets a great quality of life for longer. While this is great news for the care of our pets, these treatments come at a significant cost. Year on year treatment costs increase, and this is factored into the cost of pet insurance. Please see ‘How do you calculate my premium’ for more information about calculation of premiums.

• Will my premium increase every year even if I don’t submit claims?

  Every year, we review the cost of everyone’s insurance with regards to a combination of factors as well as claims inflation across all our insured pets. Increases in our claims costs due to increases in the range of available veterinary procedures, or due to an increased take-up of those services, impacts everyone’s premiums. Your premium takes into account the average cost of care for pets like yours. To provide an example of this, a pet parent with a three-year-old French Bulldog will be affected by the trends we see in our data from hundreds of three-year-old French Bulldogs that we insure, as well as the specific claims history of their own pet.

• How do I apply to have a pre-existing condition reviewed?

  If your pet has had a temporary condition that was subject to the pre-existing exclusions, you can apply to have it reviewed.
  Your vet will need to certify and provide veterinary records verifying that the condition remains a temporary condition and has not existed, occurred or shown noticeable signs, symptoms or an abnormality in 18 months. The pre-existing condition exclusion(s) will not be deemed to have been lifted unless agreed to by us in writing.
  You can download a copy of the pre-existing condition review form here
  Where your pet requires treatment you can also request a pre – approval for treatment under your policy and we will respond to you advising whether the treatment is covered by your policy.

• How long do I have to submit a claim after my pet had treatment?

  We have recently made a change to our claims procedure. You no longer need to submit your claims within 90 days of treatment. There is no time limit to submitting a claim for your pet.

• Can I visit any Vet?

  Yes, you can visit any vet (other than yourself) that is licensed to legally practice as a veterinarian in Australia. Please note, although it is rare, if expenses incurred by you with respect to the Treatment significantly exceed what is reasonable and expected, having regard to the circumstances in which the Treatment was provided, then claim payments may be adjusted to the amount of reasonable and expected expenses.
  
  If your Pet requires treatment, you can seek a claim pre-approval, whereby we can provide you with the details of your claim reimbursement. To request a pre-approval, simply call us on 1300 618 412

• Can I cancel my pet’s policy?

  You may cancel your policy at any time. We understand circumstances can change and would like to see if we can help keep your cover active. Please call our customer service team on 1300 618 412 or send us an email at petbarn@petsure.com.au so we can discuss your options.
  
  If you do decide to cancel, we will issue a pro-rata refund for the uninsured period where premiums are paid annually, less any applicable government or statutory charges. If you pay by instalments, we will not deduct any further premiums after the date of cancellation.