Pet Insurance and What It Covers

Pet insurance is a growing market segment. In a State of the Industry Report study, the North American Association (NAPHIA) found the number of pets insured in most cases in 2020 grew by 20% to 3.1 million over 2.5 million in 2019. The dynamics of companion animals living longer and the rising and significant costs of pet care power the growth curve.

Published on May 28, 2022

furry friends red cat and corgi dog walking in a summer meadow under the drops of warm rain

Most people treat their pets almost as if they are human, and as such most are considered valued family members. So, it’s natural for most pet owners to provide their animals with quality healthcare. But those sentiments only heighten their concerns about the increasing costs of preventive care, dealing with injuries and critical and chronic illnesses, and the staggering emergency medical care expenses. For many of them, pet insurance is the perfect solution.

A Pet Insurance plan is like health insurance for humans, except it reimburses some medical expenses for a pet's health-related problems. Most policies offer coverage for certain illnesses, injuries, and treatments with various deductibles and payment limits. In addition, the types of pet insurance vary by carrier ranging from multiple coverage choice plans to standard one-size-fits-all plans.

NAIC Pet Industry Overview.

The NAIC described the context of where the pet industry is and a discussion about the situation. They developed a white paper at the 2018 Spring National Meeting. Also, they used the white paper to discuss their report's discoveries. Pet insurance delivers accident and illness coverage for pets, particularly dogs and cats.

Types of Pet Insurance Policies.

Pet insurance is usually available in three types of pet health coverage:

  • Accident-only – exclusive coverage limited to injuries due to accidents with a cap per accident.
  • Accident and illness (A&I) cover accident-related injuries and sickness and disease identified by a veterinarian's diagnosis with caps per accident and illness incidents.
  • Wellness plans cover preventative pet care costs such as annual physical checkups and routine vaccines. However, riders sometimes get it as a rider to A&I plans. This type of comprehensive plan is the most expensive because of the wide range of pet healthcare problems it covers and can include the costs of microchipping and end-of-life expenses.

What Does Pet Insurance Cover?

The coverage will differ. Accident-only and wellness policies are more limited and specific, while an A&I policy includes cancer and most specialty medical care. Particular conditions receive coverage, whether chronic (long-term) or inherited illness, congenital disorders, or diseases.

Pet insurance policies usually include these ailments and conditions with the caveat they vary per pet type, carrier, and policy:

  • Cancer and chemotherapy
  • Heart disease
  • Hepatitis
  • Polycystic kidney disease (PKD)
  • Arthritis, skin allergies, conditions, and rashes
  • Obesity-related Type II diabetes
  • Hip and elbow dysplasia
  • Blood and eye disorders
  • Hypothyroidism
  • Inflammatory bowel disease
  • Ear infections
  • Vomiting and diarrhea
  • Diabetes mellitus
  • Injuries such as ACL ruptures and sprains
  • Poisoning
  • Standard diagnostic tests including ultrasound, X-ray, MRI, CT scan, and blood tests
  • Medical procedures involving hospitalization, surgery, endoscopy, and nursing care
  • Alternative care includes acupuncture, chiropractic, laser therapy, and other holistic treatment
  • Wellness care for vaccinations, flea/heartworm treatment, and spay and neutering procedures
  • Behavioral therapy to alleviate or modify aggression, destructive chewing, and extreme barking

What Is Not Covered by Pet Insurance?

There are a few things that pet insurance does not cover. 

Pre-existing conditions

Pre-existing illnesses or conditions are medical issues that existed before purchasing a pet insurance plan or diagnosed during the plan's waiting period. Although pre-existing conditions are nearly always excluded from pet insurance plans, some policies will include coverage for past conditions if they have healed.

Cosmetic and Elective Procedures and Surgeries

Coverage excludes declawing, tail docking, or ear cropping that they cannot complete because they are a medical necessity.

Routine Care and Wellness Programs

While most pet insurance plans generally don't cover annual vaccinations, spaying, neutering, and teeth cleaning, some services are insurable as policy addendums or riders for an additional premium.

Breeding

Pet insurance plans exclude paying for breeding or pregnancy, although some carriers offer a rider to help pay for the services.

Most pet insurance policies do not count pre-existing conditions and experimental treatments, including their diagnoses, when deemed experimental, investigational, and not acceptable therapy as established by a state veterinary medical board.

There are some exclusions. It does not cover grooming, non-veterinary medical service, or dietary expenses. Although, some plans offer prescription food and supplements. Many pet insurance policies decline coverage for pets after a certain age. They enforce a waiting period before the policy begins to pay. Although some comprehensive pet insurance plans expand to include dental illnesses such as gum disease and dental accidents, most do not without the coverage added as a policy rider.

Non-Veterinary Pet Insurance Riders

There are additional coverage options with insurance riders. For instance, some non-veterinary services and problems are:

  • Lost dog advertising and rewards
  • Boarding fees for dogs while the owner is in the hospital.
  • Cemetery and burial fees for pet deaths due to accidents
  • Liability and property damage coverage

Does Pet Insurance Include Liability Coverage?

Many policies only offer limited protection against animal bites and other types of bodily injury. Often benefits apply only to animals owned by the policy owner. Others specifically exclude cats and birds. Still, other policies provide coverage only for animals kept inside the house or yard. Therefore, the policyholder must have purchased the policy within 30 days before the incident.

In addition, many policies exclude certain breeds from coverage, and they vary widely among insurers. For example, one carrier excludes pit bulls, bull terriers, rottweilers, chows, mastiffs, malamutes, wolf hybrids, and coyotes. Other carriers limit exclusions for specific breeds for greater availability.

Pet Insurance Costs

A standard A&I policy can have a premium between $500 - $600 annually. The price will vary due to several factors, including:

  • Pet breed
  • Age
  • Zip Code
  • Coverage type
  • Policy limits for reimbursement
  • Deductible amount

Best Pet Insurance Programs

Independent agents also have possibilities in the luxury and companion animals business, such as marketing equine and canine insurance programs. The ProgramBusiness.com Market Directory is the place to find the best pet insurance programs. It's the quickest way to find and access hard-to-place, unusual risks in the Excess & Surplus Lines and program business space.

Your search of the Program Business Market Directory would return results for Amwins Underwriting. In addition, it offers specialty programs for these unique prospective insureds.

  • Animal Clubs, Associations & Special Events – a non-admitted program designed to protect clubs and associations from third-party claims.
  • Animal Mortality - a dedicated program designed to protect against the loss or theft of horses and domesticated animals.
  • Animal Trainers - an insurance program offering general liability coverage for various types of animal trainers. They can add professional liability on an occurrence form.
  • Equine (General & Professional Liability) - provides comprehensive professional and general liability coverage for horse owners, trainers, and equestrians. A deep understanding of the sport drives them.

 

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