'My pet insurance won't pay out - what should I do?' Everything you need to know (2024)

The UK has changed dramatically in recent years but we still have national obsessions that are quintessentially British.

Over lockdown, an astonishing 3.2 million households purchased or adopted a pet – and a huge and evolving industry has grown up around them, from daycare to specialist food providers.

According to the latest research that almost two thirds of the population have a pet. That’s 13 million dogs, 12 million cats, 1 million rabbits, 600,000 guinea pigs and 200,000 ferrets!

This demand has led to spiralling prices and a worry trend of pet theft – to such a degree that the Government is considering much tougher penalties for pet thieves.

And from the complaints I see, the additional costs that pet owners incur are clearly causing concern.

Which brings us to the most important pet expenses you’ll encounter - pet insurance and vet bills.

Though many more policies have come on to the market in recent years, lots of people are put off by high prices or confusing contracts.

Pet insurance varies considerably like all insurance products but it makes sense to buy the best one you can afford – but that doesn’t always mean the most expensive.

Pet insurance – what you need to know

There are four main types of pet insurance:

  • Lifetime cover
  • Maximum benefit cover
  • Time limited cover
  • Accident only cover

Lifetime policies: The best policy you can buy is a lifetime policy which covers your pet for treatment for life (in most circ*mstances), though usually for a set amount each year.

These are the priciest policies but make the most sense for pet lovers.

The policies cover you for new illnesses and accidents, not pre-existing conditions. But lifetime policies will pay for ongoing treatment as long as the agreement stays in force (if you renew them each year).

The amount paid out is capped each year, so bear in mind that the policies don’t cover limitless expenses for veterinary treatment.

The insurance covers various ailments, so your cat could be treated for two separate illnesses in a year, though each illness will have a maximum policy limit.

Maximum benefit policies: If lifetime policies are a little too pricy then the next best policy is the maximum benefit or ‘money limited’ policy.

Just as with lifetime policies, pre-existing conditions are generally not covered.

Maximum benefit policies will pay out a capped or fixed amount for each potential medical condition your pet might have. You’ll be able to make claims up to the policy limit for each condition.

The big difference here is once you’ve hit that limit, that’s the maximum amount that will be paid out even if the condition is ongoing, though there tends not to be a time limit if you’re under the limit.

You’ll still get payouts for new illnesses or conditions but only if they are unrelated to the previous claims.

Time limited policies: Though time limited policies look similar to maximum benefit policies, there is one key difference.

The insurance works by setting a fixed limit for each medical treatment.

However, as the name suggests, the policy will only cover you for a set time frame from the start of treatment (usually a year).

So unlike a maximum benefit policy, once you hit the maximum payout or cross the time deadline, the claim ends.

Accident only policies: The cheapest policy you can buy only covers accidents, not conditions that might be diagnosed by a vet. The policy should set out fixed limits for each type of injury and treatment.

Some policies also have a time limit for ongoing treatments. Look for policies that offer emergency treatment for some illnesses too.

With the last three policies, if you find that you’ve maxed out your limit for a medical condition, you may still be able to get a good policy elsewhere, however, this will exclude the treatment that you’ve already claimed for.

What should be covered?

It’s not just medical treatments that are covered by pet insurance. Here are some other things to look for in your pet insurance policy.

Death payments: No-one wants to think about this eventuality, but it’s worth pointing out that most pet insurance pays a sum in the event of your pet’s death to cover the amount you paid when you purchased it (or what your pet might be worth if it was sold).

After a certain age, these policies will not pay out.

Traveling abroad: Surprisingly, your policy might cover you for illness or injury that happens to your pet while abroad.

You’ll need to have followed the rules of entry to that country though, so no sneaking your cat abroad in your purse on the Eurostar.

Pet accommodation: Some policies cover the cost of your pet going into kennels, a cattery or other shelter if you fall ill or are hospitalised, leaving the pet alone.

Third party cover: As with other forms of insurance, third party cover is there should your pet injure someone or damage something. This covers legal costs, the other person’s bills and other expenses.

Euthanasia and other death costs: Cremation and euthanasia can be surprisingly expensive, so look for this in your insurance contract.

Problems and things to think about

Much like human illnesses, most complaints about pet insurance involve ongoing medical treatments, disputes over whether a "new" condition is related to an older one and "non-disclosure" – where the insurer feels you haven’t disclosed a previous medical condition.

As with all general insurance products, terms and conditions are very much open to interpretation.

If your insurer is relying on unclear or ambiguous terms to reject a claim, you should complain. In addition, if the insurer is giving more weight to their veterinary experts than your vet, you should push back.

In recent years, I’ve seen some quite unusual treatments recommended by vets. Again, as with humans, treatments for pets need to be generally accepted as effective and practical.

Check with your insurer to find out if the treatment is approved before you pay for it up front.

Other things you might assume are covered may not be, like "preventative" treatments. This can be anything from spaying, anti-flea treatments and grooming.

Some policies will cover dental treatment though expect limitations on when the policy will pay out. The whole process of your pet giving birth may also be excluded.

What if you are unhappy with a claim

If you need to make a claim, speak to the insurer and tell them about the vet’s costs that you’ve been quoted ASAP. Some vets may recommend "experimental" treatments that aren’t recognised and might not be covered.

We’ve seen dogs sent for hydrotherapy treatments that turned out to be frolicking in a paddling pool in a shed – for hundreds of pounds.

So make sure you look into what every treatment involves and how it helps the underlying medical condition.

The business must write to you with their decision on the claim. Set out what you don’t think is fair in your own words and ask the firm to reconsider its decision.

You can ask your vet to get involved too if the insurer is ignoring their advice.

Ultimately, you can take your complaint to the free Financial Ombudsman Service.

  • Martyn James is a leading consumer rights campaigner, TV and radio broadcaster and journalist

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'My pet insurance won't pay out - what should I do?' Everything you need to know (2024)
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