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Pet insurance waiting periods
Pet insurance waiting periods
Written by
Tina Sendin
Edited by
Andrew Kemp
Reviewed by
Adrian Bennett
How does pet insurance work?
Long story short
Waiting periods are timeframes during which you can’t make an eligible claim
Waiting periods begin on your policy’s start date and vary based on different conditions and insurers.
Depending on the condition, waiting periods can be up to 6 months or more
Accidents and injuries generally have an up to 2-day waiting period, while complex conditions could mean having to wait for 6 months or more.
Waiting periods could reset when changing insurers, but that’s up to the provider
It’s also possible to waive the waiting periods, especially after proving uninterrupted coverage for a certain period.
How does pet insurance work?
Pet insurance works like health insurance for humans – when you pay a premium, your insurer helps cover a portion of eligible vet bills for accidental injuries and illnesses. Although some plans also include routine care, which is usually an optional add-on. The amount that your insurer pays depends on the level of cover and the details of your policy, such as the annual cover limit and benefit percentage.
While pet ownership is a rewarding experience, sometimes vet bills can put us in a tough position. Taking out a pet insurance policy means your insurer may help cover some of this expense should your pet need vet treatment if they get sick or injured.
What are waiting periods for pet insurance?
Waiting periods dictate the time you must wait between your pet’s policy start date and when you can make an eligible claim for a certain condition. After they elapse, you won’t need to serve these waiting periods again when you renew your policy.
Let’s say your pet becomes sick or gets injured. If their specific condition is subject to a waiting period, and the waiting period has not been served, you won’t be covered for the cost of their veterinary treatment. Your insurer may require you to hold the policy for a specific time before cover for that injury or illness can be provided.
And, while most pet insurance companies in Australia include waiting periods in their policies, the specific conditions and periods can vary. In general, accidents and injuries typically have minimal waiting periods (usually up to 2 days), while orthopaedic, joint and hereditary conditions might have waits of up to 6 months. And you’ll usually have to wait for up to a month for illnesses.
It’s also worth noting that for many insurers, if your four-legged friend develops a condition during the waiting period, it will usually be considered a pre-existing condition and excluded from coverage. And this can mean you won’t receive reimbursements for any costs related to your pet’s treatment.
Helpful tip
It’s a smart idea to insure your pets when they’re still young, as this means they’re less likely to have pre-existing medical conditions that could affect their access to cover. It also means you’re less likely to have waiting periods if your pet gets sick later in life. Not to mention that getting a policy early could help you save on expensive vet bills should anything go wrong in the meantime.
Adrian Bennett
General Manager for General Insurance
Why do waiting periods exist for pet insurance?
Waiting periods are put in place to protect both pet owners and insurers from fraudulent claims that would drive up pet insurance premiums. Without them, it’s possible some pet owners would buy their pet’s cover at the first sign of illness or injury, make large claims and then cancel it shortly after.
Waiting periods also allow insurance underwriters to have some sort of baseline in determining whether a condition developed through time while the policy’s active, or if it’s an underlying issue.
Can I get pet insurance with no waiting periods?
Yes, it’s possible – some insurers have no waiting periods for accident-only cover. Accidental injuries like a snakebite or trauma from a car accident could usually be covered immediately. And for pet insurance with a higher level of cover, such as accident and illness cover or comprehensive, waiting periods can also be dropped by insurers.
You read that right: if switching insurers, you could have some providers waive the waiting period given there’s evidence of uninterrupted coverage for longer than a certain period, say 12 months.
So, whether a policy comes with no waiting periods could all boil down to the pet insurance cover, the insurer and what you’re claiming for.
It’s always a good idea to review a policy’s Product Disclosure Statement to find specific information about conditions and treatments with waiting periods.
What are common pet insurance waiting periods?
Waiting periods for pet insurance typically range from zero to a couple of days for emergencies (like accidents and injuries) to up to 6 months for more complex conditions needing specialised care and treatment – think things like orthopaedic, joint and breed-specific conditions. Illnesses, meanwhile, will usually have a 30-day wait.
While most pet insurance companies in Australia include waiting periods, the specific conditions and periods can vary.
Accidental injuries
It’s common for accidental injuries not to have a waiting time (especially if ‘specified’) or be up to 2 days. Accidental injury cover can reimburse a portion of your vet bills if your pet has been injured as a result of motor vehicle accidents, burns and allergic reactions to insect bites. Although the waiting period for these medical concerns depends on the insurer.
Typical waiting period
None to 2 days
Examples
- Trauma from a car accident
- Burns
- Allergic reactions to insect bites
- Snake bites
Illnesses
An up to 30-day waiting period for illnesses is common, though this can vary depending on the insurer. Most insurers define an illness as any kind of sickness or disease not covered by accidental injury cover, such as cancer, skin conditions, gastrointestinal problems and tick paralysis.
Typical waiting period
Up to 30 days
Examples
- Eye conditions like conjunctivitis, corneal ulcers, cataracts or glaucoma
- Skin conditions like allergies, bacterial infections or fungal infections
- Gastrointestinal tract conditions such as vomiting, diarrhea, gastroenteritis and pancreatitis
- Ear conditions like infections, ear mites or hematomas
Musculoskeletal, hereditary and chronic conditions
Complex and ongoing conditions typically have longer waiting periods because they’re more likely to develop over time rather than from a one-off accident. Insurers may require you to wait several months before you can claim to make sure that the condition isn’t a pre-existing one.
Typical waiting period
6 months (or more)
Examples
Musculoskeletal conditions
- Cruciate ligament conditions
- Hip dysplasia or elbow dysplasia
- Arthritis
- Patella (kneecap) luxation
- Intervertebral disc disease
Hereditary (breed-related)
- Heart conditions (for example, dilated cardiomyopathy)
- Eye conditions (for example, progressive retinal atrophy)
- Brachycephalic obstructive airway syndrome
Chronic conditions (ongoing)
- Diabetes
- Kidney diseases
- Thyroid disorders (e.g. hyperthyroidism)
What if my pet has a pre-existing condition?
Most pet insurers won’t cover your pet’s pre-existing condition – whether they’ve had it before you first purchased your policy, or it showed up during the waiting period. But you can still get protection for possible future illnesses, provided the waiting period for that condition has been served.
In some cases, pre-existing conditions can even be considered temporary if your pet recovers and doesn’t show signs of a relapse within a set amount of time. In that case your insurer may review the situation and provide cover going forward.
What happens if I change pet insurers?
Changing insurers can lead to new waiting periods, limits on pet coverage and new premium amounts. Plus, your pet’s pre-existing conditions may not be covered by the new provider. That said, it’s also possible to have the waiting periods waived, especially after providing uninterrupted coverage for a period (say 12 months).
There are a lot of pet insurance providers to choose from, and switching to a new insurer could mean you find more competitive premiums, attractive optional extras and coverage that’s overall, more suited to your individual needs. Comparing policies could allow you to find insurers that could give you the most bang for buck and even waive the waiting periods for you.
Can I change policies with my insurer?
Yes, you can change pet insurance policies with your insurer. You can upgrade or downgrade your cover with your current provider. However, it’s worth checking if there might be certain conditions to satisfy, especially when done while the current policy is active.
Some pet owners consider upgrading or changing their policy if their pet is getting older or they’re moving to a new location with different risks. And on the flip side, some want to scale back their policy to reduce expenses.
If you’re updating your policy with the same insurer, you might possibly have to re-serve a waiting period depending on what was covered in your previous policy. Again, some insurers allow you to waive waiting periods if you show evidence of uninterrupted coverage, so it’s always worth checking this with your current one.
What are other things to consider when comparing pet insurance?
Policy limits (such as annual and sub-limits), benefit percentages, excess, waiting periods, pre-existing conditions and the claims process are some of the things to consider when comparing pet insurance. Apart from waiting periods and premiums, they could inform your decision and strike a good balance between costs and coverage. These details could be found in the Product Disclosure Statement of a policy.
Annual and sub-limits
Annual limits and sub-limits determine how much you can claim and get reimbursed for vet bills, and some insurers may have higher limits than others. Understanding these maximum caps protects you from unforeseen out-of-pocket costs if your pet suddenly needs expensive or long-term treatments.
The annual limit depends on the policy or insurer, say whether the policy has basic (with lower limits) or comprehensive coverage (with higher limits). The annual benefit limit is the total amount an insurer will pay in a year.
Also, policies usually have sub-limits – or caps that apply to certain conditions. So, it’s also worth looking at what each policy’s sub-limits might look like.
Benefit percentage
The pet insurance benefit percentage is the amount that an insurer will reimburse you for eligible vet services and treatment costs. Some insurers may offer higher benefit percentages for the same types of cover than others. The benefit percentage determines your out-of-pocket costs depending on the insurer’s policy and level of cover. They are typically around 60% to 90% – sometimes even 100%! Comprehensive levels of cover may have higher benefit percentages than basic ones.
If the benefit percentage is less than 100%, then you’ll need to pay the balance of your vet’s bill, which is the gap, as well as paying any policy excess that applies.
Claims process
While most insurers would require you to pay the vet directly before making a pet insurance claim, others might be able to offer the option for claiming on the spot. But you need to let them know you’d prefer them to submit a GapOnly claim for you, and you’ll only need to pay the gap after your claim’s been assessed (often in a matter of minutes).
If paying up-front, you’ll usually have to submit the claim first. Then, if your claim is approved, you can be reimbursed for a portion of the expenses, helping to cover the costs of your pet’s treatment. It’s important to know that insurers have their own processes, so this is another factor to consider when comparing.
Excess
Insurers may differ on whether you’ll need to pay an excess, how much it is and when it needs to be paid. Excess is the amount you need to pay if you make a claim for your pet. You might need to pay an excess for each condition, but it’s always worth checking the Product Disclosure Statement to see how excess works for the policy you’re considering.
iSelect does not offer a comparison service for Pet insurance policies at this time.
Any advice provided by iSelect on this website is of a general nature and does not take into account your objectives, financial situation or needs. You need to consider the appropriateness of any information or general advice we give you, having regard to your personal situation, before acting on our advice or purchasing any policy. You should consider iSelect’s Financial Services Guide which provides information about our services and your rights as a client of iSelect.