Pet insurance and pre-existing conditions 

What is a pre-existing condition?

A pre-existing condition is an illness or ailment that existed prior to the date you took out a pet insurance policy.

Pre-existing conditions are typically split into two different categories.

1. Chronic pre-existing conditions: These are conditions that are pre-existing and permanent. They're typically recurring and require constant care. For example, diabetes. If your pet has a permanent condition prior to taking out a pet insurance policy, it will be excluded from your cover.

It is vital to understand that insurers often apply a "reasonable person" test here. For instance, Bupa policies specify that if a reasonable person in your circumstances would have been aware of a condition before the policy started (irrespective of a formal diagnosis), it is considered pre-existing.

Insurers exclude cover for chronic pre-existing conditions because otherwise, it'd be too easy for pet owners to take advantage of the policy by taking out cover only when they know their pet is sick or injured, and cancelling once they've made a claim.

2. Temporary pre-existing conditions: These are conditions that are pre-existing that have been healed with treatment. They typically no longer affect your pet and haven't done so for an extended period of time. For example, a broken bone that's since been healed is an example of a temporary pre-existing condition. If your pet has a temporary pre-existing condition, you will likely be covered. You may need a signed health check from your vet to confirm the condition is no longer relevant to your pet's health before your insurer agrees to cover you though.

Insurers like RACQ offer a structured path for these cases. If your pet has been free of clinical signs, symptoms, or recurrence for at least 18 months and the condition is not considered lifelong, you can request a waiver. Similarly, Bupa provides a specific "Pre-existing Condition exclusion review form" that requires a vet to certify the pet has been symptom free for the same 18 month duration.

For curable pre-existing conditions, most Australian insurers offer a path to future coverage through a formal review process. If your pet remains completely free of symptoms, clinical signs and treatment for a set period (typically 12 to 18 months), you can apply to have the exclusion lifted. It is important to note that specific "waiting periods" apply here: the asymptomatic period must occur while the policy is active or immediately prior to a claim.

Related conditions

Related conditions are problems that occur later as the result of an earlier injury or illness. For example if your pet has diabetes and then develops cataracts as a result of the diabetes, the cataracts will not be covered.

A more technical exclusion often found in a Product Disclosure Statement (PDS) is the concept of a bilateral condition. A bilateral condition affects body parts that occur in pairs (such as ears, eyes, knees, or hips). Most insurers treat these as a single condition for the purpose of exclusions. For example, if your dog showed signs of a cruciate ligament tear in the left leg before you joined RACQ or Fetch, a subsequent tear in the right leg would also be excluded as a pre-existing bilateral condition. This is because clinical data suggests that when a condition affects one side, there is a high probability the other side will eventually be affected.

If your pet has had any pre-existing conditions, it can be good to review what other conditions can arise as a result of it. From there, you can see what your list of exclusions might look like and decide if it's worth having pet insurance at all.

What conditions are normally excluded?

This will vary by provider and it's often assessed on a case by case basis. Some common exclusions are:

Note that some providers have very specific carve-outs. Fetch Pet Insurance offers a unique approach for shelter pets. While they generally exclude pre-existing conditions, they encourage owners to provide vet history immediately through their app. They may skip waiting periods if the pet is proven healthy, which is a significant advantage for those adopting older shelter animals with unknown histories.

Can I get pet insurance after a diagnosis?

Yes, you can still get pet insurance after your pet has been diagnosed with a health condition, but that specific condition (and any related issues) will most likely be excluded from your new policy. While the insurer will not cover the cost of treating the existing diagnosis, your pet remains eligible for cover for any new, unrelated accidents or illnesses that occur after your policy starts and the waiting periods have passed.

How different pet insurers treat temporary pre-existing conditions

Brand	Condition	Apply
Medibank	You can apply to have pre-existing conditions reviewed if your pet's pre-existing condition hasn't shown any signs or symptoms in 18 months prior to your claim. Your vet will need to certify and provide veterinary records verifying that the condition is a temporary condition and hasn't shown noticeable signs for 18 months. Medibank will let you know in writing whether or not the exclusion still applies.	Get quote
Knose	You may request a Pre-existing Symptoms and Conditions assessment before Your first claim (for example during the cooling off period). Where Pre-existing Symptoms or Conditions have been identified during an assessment, We may issue You an updated Certificate of Insurance or other report including online, which will list them.	Get quote
Pet Insurance Australia	Your vet will need to certify and provide veterinary records verifying that the condition is a temporary condition and hasn't shown noticeable signs for 18 months. PIA will let you know in writing whether or not the exclusion still applies.	Get quote

Table last updated October 2024

Underwriter assessments and vet record evaluations

When you apply for a policy after a diagnosis, the insurer’s underwriter will conduct a detailed assessment of your pet's medical history. Unlike other forms of insurance, many pet insurers do not perform this deep dive until you make your first claim, which can lead to unexpected denials. However, brands like Petsy offer a "Pre-existing Condition Assessment" (PECA) during the application phase or cooling-off period to provide immediate clarity on what will be excluded (Petsy Australia).

During this evaluation, underwriters will request full clinical notes from every vet clinic your pet has visited. They look for:

• Specific dates of first symptoms (not just the date of formal diagnosis).
• Pathology, laboratory results and diagnostic imaging reports.
• A "reasonable person" evaluation to determine if symptoms were visible during waiting periods (Medibank; Petcover).

How to have a pre-existing condition reviewed

If you've noted down that your pet has been sick or injured before but want to ensure it's noted as a temporary pre-existing condition that no longer affects your pet, you may be required to get a vet health check. Your insurer will likely have their own form for this check so contact them to get a hold of it. Alternatively, your vet might have a form they use for this that may suffice. It's best to check with your insurer though.

When interpreting your PDS, look for the specific definition of "Temporary Condition". Most modern policies (like those from Bupa or RACQ) explicitly state that certain issues (such as cruciate ligament conditions or hip dysplasia) can never be classified as temporary, regardless of how long they have been symptom free (Bupa PDS; RACQ PDS).

For the vet to fill in the form, you'll likely need to take your pet in for a health check so the vet can verify they're healthy and provide their signature. From there, you can submit the form to the insurer.

What to do if you can't get cover for pre-existing conditions

If your pet is suffering from a chronic pre-existing condition that remains ongoing or recurrent then it's likely you won't find cover with a pet insurer. If your pet needs care and you can't afford it upfront, you could ask your vet about a payment plan. They may have various options available to make treatment more affordable in the short term.

If your pet is currently healthy but you'd like to future-proof yourself, it can be a good idea to regularly put money aside so that you have an emergency fund for your pet's medical needs, should they require it further down the line.

Unfortunately, neither of these options provide the same support that insurance can, but if no one will cover you then it can be your next best option.

FAQs

• How can I get around pre-existing conditions for pet insurance?

  The short answer is: you can't. If your pet has a chronic pre-existing condition then they're not eligible for cover. If they've had a temporary pre-existing condition then they can likely be covered.
  If pet insurance can't cover you then it's worth getting in touch with your vet to see if they can help you by setting up a payment plan.

  Always check the "General Exclusions" and "Definitions" sections of your PDS. Brands like Fetch allow you to view confirmed pre-existing conditions directly in their app once they have reviewed your pet's history, providing clarity before you even make a claim (Fetch App Guidelines).

• Is anxiety a pre-existing condition for pet insurance?

  It can be; you'd have to check with your pet insurer about whether or not this condition is something you need to note down on your policy.

Written by

Peta Taylor

Publisher of Insurance

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Peta Taylor is a publisher at Finder, working across all of insurance. She's been analysing product disclosure statements and publishing articles for over 2 years. Peta is passionate about demystifying complex insurance products to help users make well educated decisions with confidence. Peta is part of Finder's insurance awards team and works alongside editorial and insights experts to bring users the best insurance products every year. See full bio

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Gary Ross Hunter

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Gary Ross Hunter has over 6 years of expertise writing about insurance, including life, health, home, and car insurance. Having reviewed hundreds of product disclosure statements and published over 800 articles, he loves simplifying complex insurance topics for everyday readers. Gary has contributed to major outlets like Yahoo Finance, The Sydney Morning Herald, and news.com.au, and holds a Bachelor of Arts (Honours) in English Literature from the University of Glasgow, along with a Tier 2 General Advice certification, ensuring his work adheres to ASIC’s RG146 standards. See full bio

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