Pet insurance in Pennsylvania

What the law guarantees

Pennsylvania passed its pet insurance law in 2024: Act 2024-19, which added chapter 47 to title 40 of the Consolidated Statutes (40 Pa.C.S. §§4701–4711). It took effect on 7 December 2024. It follows the NAIC Pet Insurance Model Act, a template law that state regulators wrote for states to copy.

What matters to a buyer:

• No waiting period for accidents. The law prohibits one outright (§4706(b)(1)).
• At most 30 days for illness and orthopedic conditions. The policy must also let you waive the wait with a vet exam. You pay for the exam unless the policy says the insurer will (§4706(b)(2)).
• A narrow definition of pre-existing condition (an illness the pet had before the policy). It is a condition for which, before the policy or during a waiting period, a vet gave advice, the pet was treated, or “verifiable sources” show signs or symptoms “directly related” to it (§4702). An insurer that uses the term must use this definition (§4703(a)).
• The insurer carries the burden of proof. If it denies a claim as pre-existing, it must prove the exclusion applies (§4706(a)(2)).
• Renewal resets nothing. A condition the policy already covered does not become pre-existing at renewal, and renewal cannot require a vet exam (§4706(a)(3) and (c)).
• 30 days to return the policy. If you have made no claim, you can return it within 30 days for a full refund (§4704). The model act gives 15 days.
• A disclosure document. The insurer must publish an Insurer Disclosure of Important Policy Provisions and link to it from its home page (§4705(b)). It says whether the premium rises with claims, the pet’s age or a move, and which company is the insurer if a brand sells the policy.
• Breed in advertising. Ads must say whether the price or cover changes with claims, species or breed, age or a move (§4707(2)). The model act has no such rule for ads, and its disclosure list does not mention breed.

The law does not limit exclusions: an insurer may exclude anything it discloses (§4703(c)). Nor does it cap rate increases. For a violation, the Insurance Commissioner can fine up to $5,000 per violation and order restitution (§4710).

The law takes “renewal” from the Unfair Insurance Practices Act. Insurers quote that definition in their disclosures (Fetch, Pumpkin, Spot, ASPCA, Figo): a new policy from the same or an affiliated insurer with types and limits of coverage at least equal to the old one. A policy with no fixed end date counts as a series of 12-month terms.

Where the rate filings are

The Pennsylvania Insurance Department sends the public to SERFF Filing Access (serff-sfa.naic.org/serff/sfa/home/PA) for filings. That address did not load on 17 October 2026 and has worked again since 19 October. We have not collected the state’s filings yet. We have read one old filing, described below. Everything else on this page comes from the law and from documents the brands publish for Pennsylvania.

The one filing we have read is old. It is Nationwide’s 2020 filing SCTT-132489734 (insurer: National Casualty) for two employer plans, VBW-I and VB-II, covering 10,677 policies. It was submitted on 12 August 2020, approved on 31 August and took effect on 21 January and 1 April 2021. The company’s calculation showed a need of +76.9%; +6.4% was requested and approved: VBW-I +10%, VB-II 0%. The department wrote: “We are very concerned about your rate need.” The company replied that with other factors the need was about 30%. In these plans the price depends on species, deductible and reimbursement share; the filed formula has no age, breed, area, tenure or claims factor. These are not the retail Whole Pet and Modular plans, and this is not today’s rate.

What we found in the brands’ Pennsylvania documents

We read the disclosures and sample policies that brands post for Pennsylvania. The law sets a floor; the documents contain terms that are easy to miss.

The price can rise because of your claims. The law allows this as long as the insurer discloses it.

• Nationwide (Modular Pet Insurance): at each renewal the premium may be affected by the number and amounts of claims paid in the previous 18 months (disclosure IDIP-MPI-PA (9-24), item 5).
• Fetch: premiums may go up and cover may be reduced based on your pet’s claim history.
• Pumpkin: premiums “may increase or decrease due to claims history”. Spot and ASPCA, written by the same insurer (Independence American), say they do not raise prices for claims.
• Embrace: its general disclosure (not a Pennsylvania one) says the premium may rise with claim history.
• No claims surcharge: MetLife, Spot, ASPCA, Figo, Lemonade, Pets Best. Healthy Paws does not look at your own pet’s claims, but changes prices with the claims of the whole program in your region, and with breed and age.

Nationwide’s documents conflict with the law. Its Pennsylvania sample Modular Pet Insurance policy (VS-G-15-PA (9-24)) says every coverage starts after a 14-day waiting period, counted from underwriting approval and a successful payment. There is no exception for accidents, although the law bans an accident waiting period. It defines a pre-existing condition as anything that “began” before the policy, “whether or not the condition was discovered”. That is wider than the law’s definition. The disclosure for the same policy uses the law’s definition. The sample is dated September 2024, before the law took effect. If you buy Nationwide, ask which version your policy will use.

More in Nationwide’s policies:

• Modular: cruciate ligament problems are excluded if signs appear in the first policy term. Cruciate cover can be added only after 12 months, at renewal. A claim filed more than 12 months after treatment is not paid.
• Modular: the insurer may cancel or not renew if it finds a health risk that existed before the policy and that it did not know about (section 17.C).
• Whole Pet (VS-G-11-PA (9-24)): a pre-existing condition is anything that began in the 12 months before the policy. A chronic condition is pre-existing unless it began after the policy started. Ligaments are not covered in the first 12 months, and a gap in cover starts that count again.

Changing your plan restarts the clock.

• Embrace: if you raise your cover (a lower deductible, a higher limit, adding exam or medication cover), the illness waiting period and the pre-existing check start again from the date of the change.
• Figo: cover can be raised only at renewal, and the waiting period then runs from the date of the change. Any other mid-term change issues a new policy with a new waiting period and a new pre-existing check.
• ASPCA: some changes count as a new enrollment. The old policy ends, cover is not continuous, and anything that happened before is pre-existing.

Narrow windows to waive the wait. The law requires an exam waiver, but the insurer sets the terms.

• Figo: the exam within 7 days of the start date, and the vet’s form within 7 days too.
• MetLife: a full waiver needs an exam in the 7 days before the start, a partial one an exam in the 5 days after. Anything found at the exam becomes pre-existing.
• Pumpkin, Spot, ASPCA: an exam from 3 days before to 7 days after the start, and the form within 30 days.
• Lemonade: its Pennsylvania disclosure gives 14 days for illness and 30 days for orthopedic conditions and does not mention an exam waiver.
• Pets Best: one of its two Pennsylvania disclosures lets the wait be reduced only for cover bought through “pre-approved channels”.

Orthopedic conditions and knees.

• Embrace (the national V6 policy that its site shows for Pennsylvania): cruciate ligament disease, disc disease (IVDD), kneecap luxation and hip dysplasia that show signs in the first 180 days are never covered. If one side was affected, the other side is excluded too. Embrace’s California policy has the same 180-day rule.
• Figo: a problem with either knee before the policy or during the wait excludes both knees for good. A type of cancer diagnosed before the policy is excluded too.
• Healthy Paws: hip dysplasia is not covered if the pet was 6 or older at enrollment.
• Fetch: the orthopedic waiting period in Pennsylvania is 30 days. Fetch’s California form instead excludes orthopedic conditions of the first 180 days for life.

Curable conditions take a long time to come back into cover.

• Fetch: a curable condition seen in the 365 days before the policy, during the wait or at the first exam is excluded for 365 days. If it recurs, for another 365. If it recurs again, for life.
• Figo: a curable pre-existing condition is covered after 365 days without symptoms or treatment. ASPCA: after 180 days, but not for orthopedic, knee, congenital, hereditary or chronic conditions.

Required vet exams.

• Healthy Paws: its Pennsylvania endorsement says a pet under 6 “should” have had an exam in the 12 months before or the 15 days after the start, and a pet 6 or older in the 30 days before or the 15 days after, so that claims are processed faster. It replaces the base policy’s rule that a missing exam may void the policy. The policy does not pay for exam fees.
• Embrace: without an exam in the 12 months before or the 14 days after the start, the policy becomes accident-only.
• Fetch: without a first exam, cover may be reduced.
• Trupanion: dental illness is covered only if a vet examines the teeth at least once every 365 days.

Claim deadlines. ASPCA: 270 days from the date of service. Fetch: 90 days. Embrace: within 60 days after the end of the policy term (general disclosure). Nationwide Modular: notice within 90 days, and nothing is paid after 12 months.

Who the insurer is. In Pennsylvania, Lemonade’s policies are written by Metromile Insurance Company, not Lemonade Insurance Company as in Florida and California. Healthy Paws’s Pennsylvania endorsement and sample policy are issued by Westchester Fire Insurance Company, though its disclosure also allows ACE American or Indemnity Insurance Company of North America; in Florida it is ACE Property and Casualty. Pets Best posts two Pennsylvania disclosures, one from American Pet Insurance Company (Trupanion’s insurer) and one from Independence American. Your declarations page shows which applies to you.

Embrace: 15 or 30 days to return the policy. The national V6 policy that Embrace’s site shows for Pennsylvania gives 15 days to return it. Pennsylvania law requires 30. We did not find a Pennsylvania endorsement from Embrace.

How Pennsylvania differs from Florida and California

• Its rate filings are in SERFF Filing Access. We have read only one Nationwide filing from 2020. Florida’s filings are in IRFS, California’s in WARFF.
• The free look is 30 days, as in Florida; the model act gives 15.
• Ads must say whether claims, breed, age or a move change the price or cover; the model act has no such rule for ads.
• Lemonade and Healthy Paws use different insurers in Pennsylvania than in Florida.