A pet’s illness or accident is considered pre-existing if the condition was onset before the pet insurance policy coverage effective dates, or during a waiting period. This means if the first signs or symptoms of a condition showed up before coverage started, it would be considered pre-existing to coverage, even if it was not formally diagnosed. The most common reason why an illness or an accident is not covered by any pet insurance provider is if the condition was present before coverage started. For coverage to be available with almost all types of insurance, the problem must be new and unexpected.

For example, if typical symptoms of allergies (itchy skin, ear infections) were present before the coverage was effective or appeared within the waiting period of the policy, the allergies and related conditions, such as itchy paws and pyoderma, would be pre-existing to coverage.

To process a claim, we look at your pet’s condition, the onset and treatment dates, and your closed invoices. Sometimes, we need your pet’s updated medical records to understand the case better. When you help us collect this information, we can get your claim done faster.

Claims are put on hold if we are missing information or need some more details from you – if this happens, we will send you an email to tell you what it is we are looking for! If you need some further assistance on understanding what is missing, please give our team a call during business hours at 1-888-501-7768.

If you already have a policy with us, your policy will tell you how long you have from the date on the invoice to submit a claim to us! You can log in to your Portal Account to view your policy documents. 

Spot Levels 1, 2, 3, and 4 allow 180 days from treatment to submit a claim to us. Please note that if your claim is submitted on your behalf by your veterinary clinic, you are responsible to ensure it is submitted within the eligible time frame.

Every claim goes through a few steps in the assessment process. Here is a helpful guide to explain what your current claim status means.

If you disagree with the outcome of a claim, you can submit a Reassessment Request. Please complete a Reassessment Request form and submitting new or additional information or documentation to support your request.

Examples of additional information or documentation are your pet’s complete medical records if not previously submitted, lab or test results, and a statement from your vet that includes details about the reason for reassessing the claim. Reassessment Request forms must be submitted within 90 days from the date on your claim’s Explanation of Benefits letter.