Pet Insurance Claims Process

Pet insurance allows people with animal companions to make sure their animals get the very best care. But how can policyholders make a pet insurance claim? Here's what pet owners need to know about how the claims process works for this type of coverage.

To make a pet insurance claim, you'll typically need to pay for veterinary care out of your own pocket first. That's because pet insurance operates on a reimbursement model. There are some limited exceptions where the insurer pays the vet directly. However, only a few pet insurers offer this, and not all veterinarians allow this.

In most cases, pet owners need to know that they'll typically pay for medical services, then request the insurer reimburse them by making a pet insurance claim.

If the veterinary care is covered, the insurer will send the owner the funds after the claim is approved. The insurer will subtract the amount of the pet insurance deductible, which is the amount you have to pay before insurance kicks in. If there is a copay, then the copay amount will also be deducted from the reimbursed amount when you make a pet insurance claim.

To make a pet insurance claim, certain documentation is usually required. Typically, pet owners will need to submit the following to request reimbursement for covered veterinary care:

• An itemized bill detailing the services provided at the veterinary visit
• A claim form provided by the pet insurer
• Veterinary records, which will show that the services were not provided to treat an excluded pre-existing condition and were for a covered illness or injury
• Information on how reimbursement should be made, such as a bank routing and account number or an address to send a check

Owners may be eager for reimbursement when making a pet insurance claim. The specific amount of time a claim takes varies depending on many factors. Different insurers promise different reimbursement times. And delays could occur if an insurer needs to investigate whether a pet insurance claim is covered.

In general, however, a claim will usually be paid in around two weeks or less.

Sometimes, problems will arise when you make a pet health insurance claim. But there are some steps you can take to avoid issues with reimbursement for covered veterinary services.

• Make sure the treatment is covered. Read your pet insurance policy carefully before making a claim. Find out if the services are covered or excluded by the policy.
• Consider getting pre-approval: Some pet insurers will review a request for services before the owner pays the vet. The insurer can pre-approve payments for veterinary care. This allows you to avoid paying expensive bills out of pocket and then ending up surprised when your pet insurer doesn't reimburse you.
• Follow instructions for making a claim: Pet insurers will provide a form and instructions. It's important to follow the directions carefully. This includes submitting all required documentation and completing the paperwork in full.
• Provide all requested documentation: Submit medical records and a detailed description of services with the pet insurance claim, along with any other requested information.
• Submit the claim in a timely manner: Don't delay submitting a claim, as some insurers have a time limit and won't reimburse care if you wait too long to submit the pet insurance claim.
• Respond promptly to requests for additional information: If a pet insurer requests more details, don't delay in providing them.

Owners make pet insurance claims for many different kinds of medical issues. Common claims include treatment for the following health problems:

• Urinary tract infections
• Seizures
• Ear infections
• Gastrointestinal problems
• Skin conditions

Owners also make claims for many more serious health issues, including cancers and heart disease.