Policy Disclosure Information:
Consumer has 30 day right to review the policy.
Orthopedic does not include cancers or metabolic, hemopoietic, or autoimmune diseases.
Pre-existing condition means any condition for which any of the following are true prior to the effective date of a pet insurance policy or during any waiting period: Any condition with prior medical advice, treatment, or signs/symptoms before the effective date or waiting period of a pet insurance policy. A condition for which coverage is afforded on a policy cannot be considered a pre-existing condition on any renewal of the policy.
Prescription Food does not include treats, general health maintenance diets, weight loss diets, puppy or kitten diets, homemade diets, or raw food diets, even if prescribed or dispensed by a veterinarian.
Supplements excludes herbs, Cannabis products (CBD), general health maintenance vitamins/supplements, or weight loss supplements, even if prescribed or dispensed by a veterinarian.
Treatment is care that your veterinarian administers. This includes but is not limited to anesthesia, consultations, examinations, hospitalization, laboratory tests, nursing, MRI or CT scans, surgery, and X-rays.
Vaccinations must be in accordance with the manufacturer’s recommendations, following a complete clinical examination, for prevention of disease.
Pet Parent’s Responsibilities: A. You must act prudently in the care and protection of Your Pet. You must protect Your Pet from exacerbation and/or recurrence of any injury and/or Illness after its first occurrence and provide proper illness/preventive care. B. We do not pay claims for Illnesses that result from failure to follow the Vaccination guidelines described below, unless Your Veterinarian has advised against the Vaccination for medical reasons: 1. Dogs should be vaccinated for distemper, hepatitis, parainfluenza, parvovirus, rabies, and any other condition for which Vaccination was recommended by Your Veterinarian. 2.Cats should be vaccinated for panleukopenia, rhinotracheitis, calicivirus, rabies, and any other condition for which Vaccination was recommended by Your Veterinarian. C. You must administer appropriate prophylactic Medication as recommended by Your Veterinarian to protect against Illness. We do not pay claims for Illnesses or Injuries that result from Your failure to follow this requirement.
Waiting Periods: A. Illnesses that occur or reoccur within the 14 days following the policy’s first effective date are deemed pre-existing conditions and not eligible for coverage. B. Waiting periods for Illnesses will be waived if either of the following occur: 1. The pet parent makes available at the time of application all medical records for the preceding 24 months or from the pet’s birth, whichever is shorter. Records received must include a physical examination by a licensed Veterinarian occurring within 180 days prior to the effective date of this Policy; or 2. After the purchase of the policy, documentation is provided to Us showing a completed medical examination was performed by a licensed Veterinarian, at the expense of the policyholder, during the first 14 days following the policy’s first effective date.
Cured Condition Eligibility: If your pet’s pre-existing condition is curable and has been cured and free from treatment and symptoms for a period of 180 days, it is a new occurrence.
What is Covered: We will reimburse you for the actual costs for expenses we cover that you incur during the policy period. Accident Benefits Your policy reimburses actual costs for covered expenses related to the diagnosis and treatment of injuries resulting from an accident up to the annual limit.
Prescription food does not include prescription food for general health maintenance, or prevention, even if prescribed or dispensed by a veterinarian.
Supplements does not include supplements for general health maintenance, or prevention even if prescribed or dispensed by a veterinarian.
Illness Benefits Your policy also covers the actual costs for expenses related to the diagnosis and treatment of illnesses, up to the applicable limits, exclusions, and limitations. Please note that dietary supplements for routine or preventive care are not included.
Microchip Implantation is limited to $50.00 and does not include any associated fees for registration, monitoring, or renewal.
Orthopedic Expenses are limited to 50% of the annual limit for each policy period. All other provisions of the policy remain applicable.
What is not Covered-
Exclusions
We will not pay for costs associated with or resulting from the following:
1. Aesthetic, cosmetic, endodontic, or orthodontic dental services such as caps, crowns or crown amputation, fillings, implants and root canals or planing. 2. Anal sac (gland) expression and/or resection when no infection or disease is present. 3. Unless the applicable Boarding, Advertising, and Holiday Cancellation Endorsement is applied to this policy: a. boarding, b. expenses related to the cancelling of travel or holiday plans, or c. the advertising and reward of finding a lost pet. 4.Unless the applicable Breeding Endorsement is applied to this policy: a. breeding, b. pregnancy, c. whelping, or d. nursing. 5. Conditions that occur during a waiting period. 6.Cosmetic, aesthetic and elective procedures, elective surgeries or prostheses, to include but not limited to claw removal, ear cropping, and tail docking, and any complications arising from such procedures or surgeries. 7. Dental cleanings are not covered unless they are necessary to treat a covered illness or covered by a policy endorsement. 8. Experimental or investigational treatments or medications, including clinical trials, which are not widely accepted as effective or proven in the veterinary medical community are not covered. 9. Funeral services, memorial items, urns, caskets, disposal of remains or burial plots/fees. 10.Grooming or grooming supplies (including but not limited to non-prescription baths, ear cleanings, non-prescription shampoos, and nail trims).11. Herbs, natural supplements and non-prescription and preventive vitamins. 12. House call fees, time, and travel expenses including air and ground pet ambulance transportation to and from the veterinarian’s premises or hospital. 13. Illness or injury that results from intentional, malicious, or grossly negligent activities or from failure to perform actions commonly accepted as responsible pet care by you, a member of your household or a caregiver for your pet. 14. Non-medical supplies such as but not limited to: a. toys, b. leashes, c. ramps, d. bedding, or e. other devices intended to prevent injury or illness, but that do not treat a condition. 15. Non-veterinary services, charged by a Veterinary Provider or others including but not limited to: a. administrative fees, b. medical records expenses, c. medical waste, d. chart set-up fees, e. providing information which may be required by Us, f. discount package, or g. membership fees, postage, and tax unrelated to a covered expense. 16. Organ or heart valve transplants. 17. Pre-existing conditions that occurred on or before the first effective date of the applicable coverage or during a waiting period. 18. Prescription food, non-prescription pet food, commercial diets or treats used for prevention or general health maintenance (including weight loss). These expenses are not covered even if prescribed, dispensed, or recommended by a veterinarian. Included are foods such as life stages (puppy, senior, etc.), low calorie, sensitive stomach, or limited ingredients. 19. Unless covered by an applicable endorsement as shown on the Declarations Page, we do not pay for Preventive care without an occurrence. These include but are not limited to: a. general health maintenance diagnostics, b. laboratory procedures, c. medications, d. physical examinations, e. surgery, f. wellness exams or tests, g. preventive treatment, tests, or diagnostic procedures, h. vaccinations, i. flea and other parasite prevention, or j. spaying or Neutering (including preventive sterilization Surgery, such as for Treatment for cryptorchidism, chimerism, or chromosomal abnormalities). 20. Training or training devices. 21. Treatment arising from: a. avian influenza, b. intentional slaughter by, or under, the order of any government or public or local authority, or c. epidemics or pandemics as declared by the U.S. Department of Agriculture. 22. Treatment because of an Injury or Illness due to a Bilateral Condition that has been determined to be a Pre-Existing Condition. 23. Veterinary expenses related to coursing, organized fighting, law enforcement or guarding, personal protection or racing. 24.Dietary supplements for routine or preventive care. 25. Unless the applicable Holistic and Alternative Treatment Endorsement is applied to this policy: a. Holistic Treatment or Alternative Therapy is not covered by the policy. This includes: i. Acupuncture. ii. Chiropractic. iii. Homeopathy. iv. Hydrotherapy. v. Naturopathy. vi. Physical therapy. vii. Rehabilitative therapy. 26. Hunting accidents, or injury to a pet by a wild animal during a hunting trip. 27. Any expense reimbursable under any Wellness Program. 28. Any claim for loss that arises from a nuclear reaction, radiation, radioactive contamination, or the discharge of a nuclear device or a chemical, biological, biochemical, or electromagnetic weapon, device, agent, or material, whether controlled or uncontrolled, accidental, or otherwise; or 29. Any claim for loss that arises from war, invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolution, insurrection, strikes, riots, or civil commotion. 30. Claims for veterinary charges, fees, or other related expenses exceeding eligible benefits or because such expenses are more than the fees usually charged by the provider being used; and experimental Treatments, therapies and Medications including any Treatment for a cloned animal or utilizing a cloned animal. 31. Treatments for any Illness for which a vaccine is available for Your Pet to prevent such Illness and for which Vaccination is both recommended by Your Veterinary Provider and rejected by You. 32. Costs of Treatments arising from Your decision to pursue a course of Treatment other than that which was recommended to You by Your Veterinarian, unless specifically authorized by Us prior to Treatment. Examples include, but are not limited to: a. Cost of Treatments continued after a Veterinarian has recommended a Pet be euthanized for humane reasons; b. Ignoring a Veterinarian’s recommendation to amputate a leg, resulting in extra costs associated with Treatment of necrosis; and c. Ignoring a Veterinarian’s recommendation to remove an eye, resulting in extra costs associated with chronic eye issues.
Claims- You Pay While Pet Parent under this agreement, you are responsible for paying the following: A. Examination fees not associated with a covered condition, B. Deductible (if You choose to have one), C. The balance after the Amount We Pay Percentage is applied, D. Taxes not associated with a covered condition, E. Costs not covered by this policy.
Renewal and nonrenewal- Unless you notify us that you want to cancel or we advise that your policy will not be renewed, we will automatically issue you a new policy at the end of each 12-month policy period. Coverage and rates are subject to change at renewal. Your renewal declarations page will specify the coverage and rates that apply.
Policy Cancellation- We may cancel your insurance policy at any time with 30 days written notice during the term of the policy for the following reasons: (1) Fraud in obtaining coverage; (2) An increase in hazard within your control that would produce a rate increase; or (3) Loss of our reinsurance covering all or part of the risk covered by your policy. Notwithstanding we may cancel your insurance policy at any time during the term of the policy if we as the insurer are placed in supervision, conservatorship, or receivership and the cancellation or nonrenewal is approved or directed by the supervisor, conservator, or receiver.
Failure to pay-If you fail to pay your premium, we may cancel your coverage at any time. A notice will be sent to you providing at least 10 days’ notice of our intent to cancel or such other time as required by the state of your primary address.
Dual Coverage With Us – We will not insure your pet under more than one pet insurance policy during any policy period.
Pet Residence Restriction – Your pet must reside with you at the primary address listed on the policy. It is your responsibility to notify us of any change in address. A change in your primary address may result in a change to coverage availability and rates.
Territory – To be eligible under this policy, covered expenses must be incurred during the policy period within the United States and its territories (Guam, Puerto Rico, and the U.S. Virgin Islands).
POWER UP ENDORSEMENT DISCLOSURES
BOARDING, ADVERTISING, AND HOLIDAY CANCELLATION ENDORSEMENT
We will pay up to $300 per policy period for the cost of boarding your pet at a boarding licensed kennel or cattery to look after your pet if you, the Pet Parent, are hospitalized for five (5) or more days following an accident or illness, which began more than 30 days after the inception date of this policy. We will not pay more than $25.00 per day or more than the maximum benefit in any occurrence.
Exclusions-We will not pay any benefits if You are: 1. Admitted to a hospital: a. For less than ninety-six (96) hours; b. Because of an Injury, sickness or disease which first occurred or manifested before Your Pet was covered under this Policy; or c. For the treatment of alcohol abuse, drug abuse, suicide attempt or self-inflicted Injuries; 2. Treated in a care setting other than a hospital; 3. Giving birth under circumstances other than as a result of a medical emergency; or 4. Receiving any treatment that is not related to an Injury, sickness or disease.
Holiday Vacation Cancellation Costs- If your pet requires urgent, lifesaving medical treatment, we will pay up to $500 per policy period for travel and accommodation expenses you are not able to recover while you are on holiday vacation or up to 7 days before you leave for a vacation holiday. You must, as soon as reasonably possible but no later than ninety (90) days, after the end of the Policy period. Exclusions-We will not pay any benefits for: 1. Any costs relating to a vacation You booked less than twenty-eight (28) days before You were due to leave, or 2. Any cost of cancellation insurance.
Advertising & Reward- If your pet is lost or stolen, we will pay up to $500 per policy period for the cost of local newspaper advertising, including any reward incurred by you in order to recover your pet. We will not pay for: 1. More than the maximum benefit, per occurrence; 2. Any occurrence resulting from Your neglect or deliberate concealment of Your Pet, 3. Any reward that we have not agreed to before you advertise it; 4. Any reward not supported by a signed receipt from the person who found your pet; or 5. Any reward paid to a person living with you, or employed by you, or other member of your family.
BREEDING ENDORSEMENT
What is not covered Exclusion 4 is removed from policy by Breeding endorsement.
EXAM FEE ENDORSEMENT
Exclusion for examination fees not associated with covered condition is removed from policy by Exam Fee endorsement.
HOLISTIC AND ALTERNATIVE TREATMENT ENDORSEMENT
We will pay up to $900 per occurrence, not to exceed $2,000 per policy term, for Holistic and Alternative Treatments that must be prescribed and provided by, or under the direct supervision of, a vet. Nonprescription Holistic and Alternative Treatments must be recommended and provided by, or under the direct supervision of, a vet.
1. ACUPUNCTURE -Acupuncture involves placing needles at special points on the body to help healing.
2.CHIROPRACTIC-Chiropractic care for pets often involves adjusting the spine and hands-on therapy.
3. HOMEOPATHY-A system of health care that is a gentle way to care for the whole animal. It uses special, diluted natural substances to help the body heal itself.
4.HYDROTHERAPY-Hydrotherapy uses water to help pets heal and get stronger. Pets might swim in a pool or use an underwater treadmill for set times. It’s used to help with problems like arthritis, bone issues, nerve conditions, and injuries to muscles or other soft tissues.
5.NATUROPATHY-Naturopathy is a way to treat pets without drugs or surgery. It uses things like air, water, herbs, body touch, and electricity. It thinks that diet, mindset, exercise, and other natural things play a big part in health. Naturopathic doctors use many different methods, like nutrition, behavior change, herbal medicine, homeopathy, and acupuncture.
6.PHYSICAL THERAPY-The goals of physical therapy in animals may include:1.Pain management, 2.Rehabilitation after injury or surgery 3.Enhancing mobility, 4.Conditioning and fitness, 5.Prevention and wellness
7. REHABILITATIVE THERAPY-Pet therapy helps animals get better after they’ve been sick, hurt, or had surgery. It uses special exercises and treatments.
VACCINATION ENDORSEMENT
We will pay up to $100 for the cost of vaccinations per policy period. Eligible vaccinations and frequency limitations are as follows:
Dogs-1. The Rabies vaccination is allowed once every three years. 2. The DHPP vaccination is allowed once every three years. 3. The Canine Bordetella vaccination is allowed once per policy period. 4. The Leptospirosis vaccination is allowed once per policy period.
Cats- 1. The Rabies vaccination is allowed once every three years. 2.The FVRCP vaccination is allowed once every three years. 3.The Bordetella vaccination is allowed once per policy period. 4.The FELV vaccination is allowed once per policy period.
This additional coverage is not subject to the policy’s deductible or Annual Limit.
LOUISIANA RESIDENCE:
What is not Covered section of the policy:
Conditions that occur during a waiting period, and not considered an accident.
Treatment because of an Injury or Illness due to a Bilateral Condition that has been determined to be a Pre-Existing Condition, and not considered an accident.
Televet Services: We cover Veterinary services when provided through a telemedicine visit with a veterinarian if we would cover those services when provided during an in-person visit, as long as telemedicine is medically appropriate way to provide the veterinary services: Telemedicine can be provided over the phone or online has been added to the policy.
NEW HAMPSHIRE RESIDENCE:
What is not Covered section of the policy:
Conditions that occur during a waiting period, and not considered an accident.
Treatment because of an Injury or Illness due to a Bilateral Condition that has been determined to be a Pre-Existing Condition, and not considered an accident.
NORTH DAKOTA RESIDENCE:
Promotional Items and Non-Insurance Services are removed from the policy.
Televet Services: We cover Veterinary services when provided through a telemedicine visit with a veterinarian if we would cover those services when provided during an in-person visit, as long as telemedicine is medically appropriate way to provide the veterinary services: Telemedicine can be provided over the phone or online has been added to the policy.
