Pet insurance for pre-existing conditions
Does pet insurance cover pre-existing conditions in Australia?
Pet insurance is a valuable tool for pet owners to manage the costs of veterinary care. However, a pet’s pre-existing conditions can make finding a suitable insurance product more confusing.
Understanding how insurers handle pre-existing conditions in Australia can help pet owners make informed decisions.
Most pet insurance policies in Australia exclude cover for pre-existing conditions, which refer to any illness, injury or condition before the policy starts or during the waiting period. However, some insurers may offer partial cover for certain pre-existing conditions if they’re deemed cured.
For example, vet expenses for conditions such as ear infections or urinary tract infections could be covered even if the condition occurred in the past as long as the condition was successfully treated, has not recurred for a set period (usually 12–18 months), and the insurer has approved coverage. Chronic or incurable conditions like diabetes, arthritis or allergies are typically excluded permanently.
Always compare different providers to ensure you have the most suitable cover for your pet and to deliver the most peace of mind.
What is considered a pre-existing condition?
A pre-existing condition is a specified condition that includes any medical issue your pet showed symptoms of, was diagnosed with or received treatment for before your policy started. This can include:
- Chronic illnesses like kidney disease, diabetes or arthritis
- Previous injuries such as broken bones or ligament tears
- Symptoms noted by a veterinarian, even if no formal diagnosis was made (e.g. limping, vomiting or persistent coughing).
When applying for cover, it’s essential to provide your insurer with your pet’s complete medical history. Always read the Product Disclosure Statement (PDS) to know what is and isn’t covered in your policy and the Target Market Determination (TMD) to understand if the policy fits your needs.
Types of pre-existing conditions
Pet insurers categorise pre-existing conditions into different types, which influence how they are covered:
- Curable conditions: Temporary pre-existing conditions, such as ear infections, skin rashes or urinary tract infections. Some insurers allow these conditions to be re-assessed for cover if they have been successfully treated and have not recurred for 12–18 months.
- Chronic conditions: Long-term conditions like arthritis, diabetes or heart disease are usually excluded permanently from cover.
- Congenital and hereditary conditions: Issues like hip dysplasia, elbow dysplasia, cruciate ligament, luxating patella, heart murmurs or brachycephalic syndrome are often considered pre-existing if they were diagnosed or symptomatic before cover begins.
How do pet insurance companies know about pre-existing conditions?
Pet insurance providers typically require a copy of your pet’s health records when you claim or apply for cover. These records include:
- Medical history from birth or the adoption date
- Notes on past illnesses, injuries or symptoms observed during vet visits.
If a condition is documented before the policy begins, it will likely be classified as pre-existing. Some insurers, mainly if your pet is older, may request a vet consultation to ensure your pet is in good health before a policy can be issued.
What is the waiting period for pet insurance?
The waiting period is the duration pet parents must wait after purchasing a policy before they can make a claim. Waiting periods protect insurers from fraudulent claims and ensure that policies cover unforeseen events rather than pre-existing conditions.
The applicable waiting periods vary depending on the insurer and the type of cover and are usually specified in the certificate of insurance as follows:
- Accidental injuries cover: Often has the shortest waiting period (usually 24-48 hours)
- Illness cover: Typically requires 14-30 days
- Orthopaedic or hereditary conditions: May require a 6-month waiting period or longer.
More about pet insurance for pre-existing conditions
Importance of regular check-ups
Regular veterinary visits and preventive care can reduce the likelihood of conditions becoming pre-existing issues. Early detection allows for treatment before symptoms escalate, potentially preventing the condition from being excluded under future policies.
Can I switch pet insurers if my pet has a pre-existing condition?
Yes, but the new policy will likely exclude any pre-existing conditions. Compare policies to see which provides better cover for other health concerns.
While most Australian pet insurance providers exclude pre-existing conditions, understanding the nuances of cover, waiting periods and how conditions are assessed can help pet owners make the best choice for their furry friends. Some insurers may offer partial cover or help with other unrelated health issues if your pet has a pre-existing condition. Thorough research, comparison, early action and open communication with your insurer are essential for finding suitable protection for your pet.
What happens if my pet develops a chronic condition while covered?
If your pet develops a condition after the policy starts, it will be covered for the policy period, provided you keep renewing it. If you switch to a new insurance policy or provider, the pre-existing conditions may or may not be covered.
Appeal processes for pre-existing conditions
Policyholders can always apply to their pet’s insurer for cover of pre-existing conditions by providing additional documentation from a veterinarian. Steps in the process include:
- Submitting a detailed condition history, including vet reports and treatment records
- Demonstrating that the condition has been resolved and symptom-free for the required period (typically 12-18 months)
- Awaiting the insurer’s review decision, which could result in the condition being reclassified and covered.
Alternative options for pets with pre-existing conditions
If your pet has significant pre-existing conditions, you might consider the following alternatives:
- Savings accounts: Set aside funds for potential veterinary expenses
- Wellness plans: Many veterinary clinics offer plans that cover routine care and minor illnesses at discounted rates
- Specialised policies: A few insurers offer tailored cover or wellness plans for pets with pre-existing conditions, though these are rare.
Are there exceptions to exclusions for older pets?
Some insurers offer specialised plans for senior pets, but these usually have a higher premium and cover for pre-existing conditions remains unlikely. It’s important to start insuring your pet when it’s young to cover it for any conditions that develop as it ages.
Meet our pet insurance expert, Adrian Taylor
As Executive General Manager of General Insurance, Adrian Taylor knows that dogs and cats get themselves into all sorts of mischief. One part of Adrian’s work is to help empower consumers to understand how pet insurance can help save them from exorbitant vet bills when their pet gets injured or falls ill.