Pet insurance - what counts as pre existing condition?

pamrleader

Hi all, can any one confirm what insurance companies consider a pre existing condition? Reason I ask is that I have just claimed for my cat who was poorly a couple of weeks ago. It was a stomach infection which caused sickness, diarrhoea etc and she was in the animal hospital for a couple of days. Anyway, all better now but vet bill was approx. £1500. I'm insured with Animal Friends but they paid out today. So all in all, I am happy.

However I have got an annual time limit policy. They said in the letter received today that they will now place an exclusion on the policy with respect to the digestive system and therefore cover for this condition will end April 2016.

My question is, why would a stomach infection, so a one-off illness so to speak, be considered a pre existing condition? Unless I am reading their letter wrong. If I was to change insurers at renewal, would I have to disclose this claim/illness? And would all insurers choose to exclude any stomach illnesses forever more or would they reinstate it after a set period of time (like 2 years)?

Thanks for any advice.

stator

Yes you definitely have to tell any new insurer about this claim. I don't know your insurer, but some are more sensible than others. If you send off an appeal they might amend the exclusion to be more specific. They might ask to see the complete medical notes from your vet, so get a copy of them from your vet ready to send off.
You might be better to go to another insurer, specifically a 'for life' policy. They will likely add an exclusion for the preexisting condition, but some insurers will review the medical notes and might be more specific, ie just an exclusion for stomach infection. Or they might say, we will remove the exclusion if your pet doesn't have a recurrence for 12 / 24 months etc.
I have had one exclusion removed by PetPlan after I sent them the full medical history of the pet. Might be worth giving them a call.

pamrleader

Thanks for the advice. The only issue I have is that she had a similar occurrence about 6 years ago. An infection, so the vet believed, from something she ate outside. Now, the vet bills after this first infection were around £350. I was insured with Tesco at the time, but they paid out fine and didn't add any exclusion. This time, the vet bills were £1500 so now we have an exclusion. Thing is, the first infection was so long ago, I wouldn't have thought it would be considered pre-existing, I.e. The insurers would view it as curable, because, well, she was cured. So I'm just wondering why it is different this time. Is it something that the vet may have written on her notes. I should add that we only joined our current vet 6 months ago as we recently moved.

stator

It's probably just the lazyiness of your current (cheap?) insurer. Whenever something happens they add a large exclusion on to keep claims down in the future.

dacouch

Well done on getting Animal Friends to pay a claim, if you have a read of their reviews and the fairly numerous posts on MSE you'll see why I say that.

As Stator says whether it's regarded as an existing condition will be upto any new Insurers. However transferring between Pet Insurers is not something to be taken lightly due to new Insurers tending to exclude existing medical conditions. So if you do change Insurers make sure you read any policy conditions regarding existing conditions and if they agree to accept stomach problems that you get it in writing.

Insurance is a product where buying on price alone is rarely the best bet, this is especially so with Pet Insurance where the cover and policy wordings vary so greatly and you have the addition of your pet being a part of your family so there is an emotional bond.

If you insure a pet in the future from a young animal, the best bet is to buy a Pet Plan Policy, it won't be the cheapest but will offer the best cover and in most cases will more than pay for itself

pamrleader

Yes Stator, they are cheap, around £7 a month.

Dacouch, yep I have now read bad reviews so I'm extremely grateful they paid out! I think I will just wait for renewal and then give Pet Plan a call and see what they can do. It's funny, I grew up with a cat and my mum never had insurance for him, he went to the vet like twice in his life. My current cat has had all the yearly jabs etc. and she has been in the vets more than most! She's a rescue from Battersea and they had her as a domestic short hair. I personally think she is some type of breed as she has tortoise fur but I have no idea what breed she is. She is such a loving little thing but has a sensitive belly and can be quite nervous. Who knows.

My day job is building insurance, but this pet insurance is so much more of a mine field!

dacouch

pamrleader wrote: »

Yes Stator, they are cheap, around £7 a month.

Dacouch, yep I have now read bad reviews so I'm extremely grateful they paid out! I think I will just wait for renewal and then give Pet Plan a call and see what they can do. It's funny, I grew up with a cat and my mum never had insurance for him, he went to the vet like twice in his life. My current cat has had all the yearly jabs etc. and she has been in the vets more than most! She's a rescue from Battersea and they had her as a domestic short hair. I personally think she is some type of breed as she has tortoise fur but I have no idea what breed she is. She is such a loving little thing but has a sensitive belly and can be quite nervous. Who knows.

My day job is building insurance, but this pet insurance is so much more of a mine field!

Home Insurance tends to have the same core covers throughout the market due to the requirements of mortgage lenders and it traditionally being sold through mortgage providers and brokers.

Pet Insurance is not subject to the above and has separated between "Lifetime" policies and policies that only pay out for a condition for the current period (year) of the policy.

The lower end of the market is entirely price driven which means to compete the lower end of the market strip out cover and service.

If your familiar with property insurance, a good explanation would be would you risk covering your home with an insurer who if you made a claim for subsidence, flood or even something so relatively common as fire or an escape of water. If your Insurer would exclude future claims for such an occurrence if you make a claim. Especially as you're no doubt aware that a subsidence or flood claim would in effect preclude you from taking out cover with a different insurer

sallyj17

The term "pre-existing" condition is widely misunderstood as many people think it only refers to "ongoing" rather than "cured conditions". The definition found in Petplan's policy is pretty typical...

"An injury or illness that first happened or showed clinical signs before you took out the policy".
or
"An injury or illness that has the same diagnosis or clinical signs as an injury, illness or clinical sign your pet had before you took out the policy"
or
"An injury or illness which is caused by, relates to, or results from an injury, illness or clinical sign your pet had before you took out the policy".


But would totally agree it is always worth asking when you take out a new policy what they will exclude and for how long. But do be aware that as you say your cat "has been to the vet more than most" then anything that you have consulted the vet about is potentially a pre-existing condition and as such could be excluded from future policies.

pamrleader

Thanks for the comparison dacouch, I just never thought of lifetime for my cat cos, as I said, my previous cat never went to the vet much. I suppose pet is like medical insurance. If you've had cancer but are in remission for 5 years and decide to take out medical cover, cancer would still be excluded for your policy even though you are medically cured.

Thanks sallyj17. I'll just have to phone insurers when the time comes and have a chat. i would hope they would just exclude it for two years and then reinstate it. Maybe my cat is a bit stoopid and eats things she shouldn't in the garden!!!