Making an Insurance Claim
Before you make a claim, you need to check that your pet is actually covered! This may sound silly but people often get caught out. It is worth while checking that:
- Your pet has been insured with the current insurance company prior to the illness/injury occurring. Most policies have a period of time after taking out a policy that won’t cover you for illness. (This is to prevent people taking out insurance only when their pet becomes ill!).
- Your policy doesn’t have any specific exclusions.
- If you have changed your insurance provider, they are unlikely to cover the cost of a claim if it can be in any way related to a previous problem that your pet may have suffered from. This often will catch people out as you would be surprised what insurance company will class as “pre-existing”. (For example if you dog had diarrhoea three years ago, and then you try to make a claim for recent diarrhoea on a new policy, they may not cover it!).
Have you kept up with your premium payments?
Is your pet actually covered by your pet insurance policy?
Before you claim
You need to check if it is worth while making a claim – you need to take into account your excess amount and also see if you are required to pay any percentages of the final fee. Smaller amounts often are not worth claiming for as it will be less than the costs involved.
When to make a claim.
If you think you are going to make a claim, then it is worth checking ifyour insurance company has any specific requirements of “time-scale”. Some companies may set time limits – such as “you have to notify us within 6 weeks of an illness/injury occurring”. This can catch people out if a problem escalates over time and turns into a condition that you do want to claim for. Therefore it is worthwhile being very aware of what your policy stipulates, so you can act in good time if necessary.
Sometimes, if you are not sure if you are going to make a claim, it is handy to let the insurance company know that the pet is ill and a claim may be coming so they can record it on their system.
What can I claim for?
For most insurance policies, you can make an individual claim for veterinary treatment for each specific illness or injury. Each cost associated with the specific problem is added together and this is the total claim. You will then get reimbursed with the total claim, less the excess/percentage fee and any exclusions.
Usually you only pay the excess once, per condition per policy year.
What gets excluded?
This varies but it can often involve:
- Illnesses that have already been excluded or that were present before you took out (or changed) policy provider.
- Prescription diets often are not covered unless in certain circumstances.
- Routine treatments such as flea treatments/wormers, etc.
- Problems that are associated with pregnancy such as caesareans, etc.
- Dental treatments such as cleaning or routine extractions (unless caused by trauma) are often not covered.
Dealing with the veterinary practice
Many insurance companies will offer to “pay the vet directly”. As a practice we do not routinely allow direct claims unless by prior agreement with the vet in charge of your case/pet. Please do not assume we will deal directly with the insurance company as this often causes awkward situations.
We will only agree to direct claims with:
- Certain insurance companies.
- Unavoidable large bills.
- Clients who have shown good payment history/trust previously.
Sadly this has come about due to poor claim handling by many insurance companies and a significant amount of insurance fraud that we have to endure.
How do I make a claim?
With certain companies, we are able to the claim electronically. Please check with us if we can claim electronically. If not you will need to either download or get them to send you a claim form.
For all indirect claims, let us have the claim and then we will complete the details and contact you to let you know when it is ready to collect. We are not allowed to send the form off for you, and so you will need to collect it.
Due to the high levels of paperwork involved for insurance claims, we usually suggest a turn-around time of around up to 14 days. We do charge an admin fee for this work. Please enquire at reception what these currently are.
It is better to make the claim at the conclusion of treatment and just do a single final claim, however we do appreciate that with some cases, the financial amounts can add up in the interim, and so please feel free to ask us to do a claim at a suitable point.