Pet insurance for pre-existing conditions
If your pet has a pre-existing condition, you can still get pet insurance - but generally not for that condition.
There are lots of good reasons to get a pet insurance policy as early as possible - and one of the biggest is that you’re less likely to have a claim refused because the condition you’re getting treatment for was classified as “pre-existing”. However, even if you only decide to purchase cover for your furry friend after they've suffered from health problems, it's still a good idea to get pet insurance before other pre-existing conditions develop.
Get pet insurance before it's too late
What is a pre-existing condition?
The general definition of this category is any health complaint your pet has suffered from before your policy waiting period has ended (normally 30 days for most conditions, but this can be up to 6 months for conditions like cruciate ligament). If your pet develops any signs of being unwell during this time, the condition is classified as being pre-existing.
It doesn’t matter whether the condition has been treated or diagnosed by a vet or not. If there are any noticeable signs at all that your four-legged friend is unwell prior to being insured (as well as during the waiting period) - if it's limping, for instance - then its health problem is defined as pre-existing. In such cases, your claim might be refused even if the condition doesn’t worsen to the point your pet needs treatment until after you are eligible for reimbursement.
As always, read the fine print carefully and familiarise yourself with the product disclosure statement (PDS), as each insurer's definition of a pre-existing condition may vary. It's also a good idea to check with your vet if there are any details you are uncertain about.
How do pet insurers deal with pre-existing conditions?
An insurer’s specific approach to pre-existing conditions varies from company to company, but generally, exclusions are treated as either temporary or permanent. The first major consideration is whether the ailment can be fully cured, or whether it is likely to have permanent consequences. If your pet recovers completely from an acute health problem and remains clear of any related symptoms for a designated time, many insurers will agree to reinstate cover for that condition.
By contrast, if your furry friend is treated for a health problem in a specific part of its body but your vet is unable to figure out the precise cause, then a later diagnosis in the same area will tend to be treated as pre-existing. Let’s say your pet is treated for diarrhoea, but the disease that caused it is not identified. If the animal develops gastro several months later then the condition is likely to be deemed pre-existing on account of the previous case of diarrhoea.
Similarly, all instances of certain conditions may be considered as a group, regardless of what part of your pet’s body they might affect. So if your pet develops arthritis of the knee after suffering from an arthritic shoulder, this will still be considered pre-existing.
Some insurers classify cancer as a pre-existing condition even if your pet does not show any symptoms at all before you are eligible to claim. This is because the illness can develop very slowly over time, and might have been undetectable while your pet was still uninsured.
In some cases, if your pet hasn't shown any signs or symptoms of a curable condition (such as a broken bone) for a specific period of time (usually 18 months) you may be able to apply for a pre-existing condition waiver that will no longer exclude that condition.
Can you get pet insurance after diagnosis?
Generally, pet insurance companies won't cover pre-existing conditions at all. This isn't terribly surprising - it's equivalent to trying to get car insurance after your car has already been in an accident. While you can still generally get pet insurance, your policy will exclude the particular condition that your pet was diagnosed for.
Are chronic conditions covered by pet insurance?
Some insurers offer a lifetime cover guarantee that covers your pet’s chronic and/or recurring conditions as long as you continue your policy without a gap in cover. So as long as you get insurance before your pet has developed any clinical conditions, and continue paying premiums, your pet should be covered.
However, make sure that you read the fine print to ensure that the insurance company doesn’t reset pre-existing conditions, which means they can exclude any conditions that have been diagnosed or treated in the last 12 months. When shopping around, it’s a good idea to ask the insurer if there is a limit on the period in which you can claim for a particular condition, or a maximum amount you can claim for recurring or chronic conditions.
What are bilateral conditions?
In the realm of pet insurance, bilateral conditions typically fall under the umbrella of pre-existing health problems. The term “bilateral” refers to parts of your pet’s body that have a “left” and “right” version, such as its ears or limbs. Bilateral conditions can affect either the left side of your pet’s body, or the right side, or both.
As an example, this means that if your pet suffers from dysplasia in its left hip, then dysplasia in its right hip will not be covered because it is considered to be pre-existing. This is despite the fact that only the left hip was previously affected.
What are my options if my pet has a pre-existing condition?
You have a couple of options:
- You can get pet insurance and know that your pet won't be covered for that particular illness and any related and/or bilateral conditions; or
- You can open a high-interest savings account
Option 1: If your pet won't be covered for the recurrence of a specific illness (e.g. arthritis) it will still most likely be insured for an unrelated problem – for example, an ear infection, that develops after your insurance is in full swing. However if your pet has several pre-existing conditions, one way of minimising your likelihood of being hit with even more horrendous vet bills is to purchase accident-only insurance which covers a wide variety of health emergencies, ranging from snakebite to fractured bones.
In addition, some pre-existing conditions are classified as curable, meaning your furry friend’s cover may resume if your pet has fully healed and any applicable exclusion period has elapsed. For example, Fluffy the cat might develop a respiratory illness for which she requires expensive antibiotic treatment. Once Fluffy is back to perfect health and the disease does not recur within the specified time frame, her cover for respiratory infection will be reinstated. The duration of temporary exclusions like these is related to the type and severity of the illness involved, but the range is typically between three months and two years.
Option 2: If you don't want pet insurance because of the exclusion of pre-existing conditions, a high-interest savings account is always an option. This is ideal if you religiously contribute to it; say a certain amount every month.
What about insurance for older pets?
Most insurers won’t let you commence cover after your furry friend reaches a certain age (usually nine years old), and by that time, there is a strong probability it will already have some pre-existing conditions in its veterinary history. (There are a few exceptions, so it pays to compare!) Usually the only option on offer for older pets is a lower-value accident only policy. A good way to avoid potential pitfalls is to buy insurance that offers guaranteed lifetime cover while your pet is young. As long as you renew your policy every year, and there are no interruptions to your cover, some insurers will continue to honour claims for chronic illnesses such as arthritis, unless it was diagnosed before the policy commenced.
Even if you do have guaranteed lifetime cover, there will still be limits on how much you can claim for chronic conditions each year. It’s also crucial to fully understand exactly what the so-called “lifetime guarantee” encompasses. In some cases, all it means is that the animal will be insured for the duration of its lifetime, even after its ninth birthday, not that it is permanently covered for ongoing health complaints which would normally be defined as pre-existing.
Are congenital conditions covered?
Hereditary and congenital conditions are those that your furry friend is pre-disposed to since birth, rather than developing as a result of illness or injury. By definition, such conditions already exist at the time you purchase an insurance policy and may not affect your pet’s health until later in life. Fortunately, most insurers agree to cover both congenital and hereditary disorders, as long as there is no clinical indication of these affecting your pet’s health until after the waiting period has elapsed.
Remember that you will not be covered for specific health problems mentioned in the list of exclusions on your insurance certificate, no matter how comprehensive the policy may seem on the surface. Some of these exclusions may have a genetic basis, so if in doubt, ask your vet to explain any details in the PDS that seem contradictory or confusing.
What conditions are normally excluded?
There is no single list of conditions that all insurers place in the “pre-existing” category, but the problems below generally make the grade.
- Bilateral conditions
- Bladder crystals and urinary blockages
- Cruciate ligament problems
- Heart disease
- Hip or elbow dysplasia
- Skin lumps
- Thyroid problems
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