Pet insurance in Texas

No law and no filings

Texas has no pet insurance law. It has not adopted the NAIC Pet Insurance Model Act. The NAIC lists Texas only under related activity: rule 28 TAC §5.5008, which says what kind of insurance pet insurance is.

Since 2021, pet insurance in Texas has been “non-regulated” inland marine insurance (the line that covers movable property). The Texas Department of Insurance (TDI) decided this in an order of 7 April 2021 (28 TAC §5.5002(QQ)). Since 2023 it is §5.5008(25): “Pet insurance (non-filed)”. Non-filed means that rules, rates and policy forms are not filed with TDI.

Before 2021, insurers had to file their rates with TDI, and TDI had to approve the policy forms before they were used. TDI explained the change by fairness: Lloyd’s plans and reciprocal exchanges do not have to file inland marine rates or forms, so making pet insurance non-filed puts all insurers on the same footing. The same order allowed pet insurance to be sold as group policies, for example through an employer.

What this means for you

• No rate filings. An insurer can raise its price without explaining why, and TDI does not review the increase. You cannot look up how much rates went up or what the calculation assumes. That is why the Texas page has no prices or ratings: we have nothing to compute them from.
• No model act. Insurers do not have to give you an Insurer Disclosure of Important Policy Provisions. No law caps waiting periods (the time after you buy before coverage starts) or makes the insurer waive them after a vet exam. No law protects covered conditions at renewal. The policy wording decides everything. In the table above, “unknown” for the waiting-period caps means that Texas law sets no cap.
• General insurance law still applies. If a claim ends up in court, the insurer must prove that an exclusion applies (Texas Insurance Code §554.002). This rule covers all insurance contracts, not only pet insurance.
• Claim deadlines in the Texas endorsements. The Texas amendatory endorsements (state add-ons to the policy) of Independence American (PET-AE-20000-TX-0723) and Westchester Fire (LD-51409) promise to acknowledge a claim within 15 days, accept or reject it within 15 business days after receiving all the documents, and pay within 5 business days after that. If the insurer needs more time, it must say why and decide within 45 days.
• Cancellation and renewal. The Texas forms let the insurer cancel only for listed reasons, such as fraud or unpaid premium: Independence American’s endorsement for Spot, Pumpkin and ASPCA from the first day, Westchester Fire, Fetch and Figo once the policy has run for more than 60 days. In the Independence American, Fetch and Figo forms a notice of non-renewal comes at least 60 days ahead and gives the reason. Independence American’s endorsement also promises 60 days’ notice of changes at renewal.
• Complaints go to TDI: 1-800-252-3439, [email protected]. The TDI notice in the Pets Best policy says to complain or appeal to the insurer as well, or you may lose your right to appeal.

Texas policies are stricter than Florida’s

We read the sample policies that brands post for Texas. In Florida the model act bans waiting periods for accidents and caps the others at 30 days; California also bans accident waiting periods. Texas has no such rule, and it shows.

• Spot, Pumpkin, ASPCA (Independence American, form PET-P-20000-1024): a 14-day wait for everything, including accidents, illnesses and ligament and knee conditions. The same program dropped the accident wait in Florida and California. The Texas sample has no exam waiver either. ASPCA offers its Waiting Period Health Assessment form (a vet exam from 3 days before to 7 days after the start date) in Florida and California, but its documents page does not offer it for Texas dogs and cats.
• Pets Best (Independence American, form IAIC-PB10001-ILL): 3 days for injuries, 14 days for illness, 6 months for cruciate ligaments. The Florida version has 0, 14 and 30 days.
• Figo (Independence American, Texas form IAIC FPI POL AI TX 1025): 1 day for injuries, 14 days for illness, and 6 months for orthopedic conditions in dogs, including fractures from an accident. An Orthopedic Waiver Form after a vet exam in the first 30 days removes the orthopedic wait.
• Fetch (AXIS, form GPTM 050 1125 A with Texas endorsement GPTM 100-TX 0124 A): no wait for accidents; 15 days for illness and for injuries “resulting from normal activity”. Orthopedic conditions that appear in the first 180 days are excluded for life, except knees cleared by a vet exam within those 180 days and conditions caused by an accident.
• Embrace (American Modern Home, V6 terms for Texas): no wait for accidents, 14 days for illness. In dogs, cruciate ligament disease, IVDD (spinal disc disease), patellar luxation and hip dysplasia that show signs in the first 180 days are excluded for life. Without a vet exam in the 12 months before or the 14 days after the start date, the policy becomes accident-only.
• Healthy Paws (Westchester Fire, form LD-50812 (07/18) with Texas endorsement LD-51409 (11/18)): 15 days for injuries and illness, 12 months for hip dysplasia. Pets enrolled at 6 or older get no hip dysplasia cover at all. Missing the required vet exam may void the policy. Exam fees are not covered.
• Trupanion links Texas to its general 2019 sample, TRU (D) 00001 (V10.201902): 5 days for injuries, 30 days for illness, and anything with signs in the 18 months before enrollment counts as pre-existing. We do not know if this text is current: Trupanion’s 2023 Florida disclosure describes a different scheme.

Lemonade, Nationwide and MetLife also sell in Texas. We have not found their Texas policy forms.

Traps in the Texas forms

• More coverage means starting over. At Pets Best, raising the limit or adding an option cancels your policy and issues a new one: new waiting periods, and anything that has shown signs becomes pre-existing. Embrace and Figo also restart the waiting period and the pre-existing check when you increase coverage. Fetch does not let you increase coverage at all once you have made a claim. Spot and Pumpkin say “certain changes” count as a new enrollment.
• Renewal can change everything. Spot, Pumpkin, ASPCA: “Coverage and rates are subject to change at renewal.” Embrace and Fetch can change the price, reimbursement percentage, deductible and terms at renewal. Figo says the premium may rise with age and with “veterinary cost inflation”. Under Fetch’s Texas endorsement, a policy does not renew automatically if the changes reduce coverage.
• Trupanion can reprice at any time. The policy is month to month. The premium can change with 30 days’ notice, at most once in 12 months.
• Repeat incidents are excluded. Pets Best does not pay for treatment after a behavior that already happened twice in the 18 months before, even if that was before the policy started: a dog that swallows a sock for the third time, for example. Figo stops paying after three similar incidents in the pet’s lifetime. Fetch pays for only the first removal of a swallowed object under anesthesia in a policy year.
• Cured conditions come back slowly. Spot, Pumpkin, ASPCA: after 180 days without symptoms or treatment. Figo: 365 days. Fetch: one year. Figo never treats chronic, orthopedic or genetic conditions as curable.
• Cancer. Pets Best does not cover another occurrence of the same type of cancer. Figo does not cover a type of cancer diagnosed before the policy, even if the new case is unrelated.
• Your duties. Figo requires an annual health check and dental exam, and the senior tests your vet recommends for dogs from 8 and cats from 10. Pets Best and Figo can deny claims for illnesses that a recommended vaccine or parasite prevention would have prevented.
• A deductible that punishes claims. Figo lowers the deductible by $50 for each claim-free year and resets it after any paid claim.
• Price depends on where you live. On Embrace’s Texas page the same 8-week-old Chihuahua costs $17.51 a month in Dallas and Austin and $13.04 in San Antonio, about a quarter less. A move within the state can change your price.

Where to find the documents

TDI holds no pet rates or forms, because pet insurance is not filed. Filings made before 2021 are in SERFF Filing Access (serff-sfa.naic.org), which holds Texas filings received after 13 April 2014. Current rates are not there. So before you buy, ask the insurer for its Texas sample policy and the Texas amendatory endorsement. Most brands post them on a “sample policy” page where you pick your state.