Pet insurance traps
The most dangerous
- Dropped or downgraded after the pet gets sick
Once your pet is sick or you claim a lot, some policies let the insurer cancel, refuse to renew, cut coverage at renewal or take away discounts.
- Cancelled for any reason, or on short notice
Some policies let the insurer cancel in the first 60 days for any reason, or later without giving a reason, and the next insurer will exclude what the pet already has.
- Pre-existing can mean anything a vet 'would have' found
The insurer can refuse a claim for a problem nobody noticed or recorded, by arguing that a routine vet exam would have found it before your cover began.
- Change the plan, or lapse for a day, and start over
Raising your limit, changing the plan or a gap in cover can start a new policy, and everything already in the vet record becomes pre-existing.
- One sign excludes a whole category: lumps, kidneys, skin, allergies
One sign before the waiting period ends can exclude a whole group of diseases: every lump including cancer, all kidney care, all skin conditions and ear infections for at least 12 months, all food and environmental allergies.
- One cancer, and the same type may not be covered again
After a carcinoma, lymphoma, mast cell tumor, melanoma or sarcoma, Pets Best can refuse later cancers of the same type anywhere in the body, with one narrow exception; read literally, this can apply even if it paid for the first one.
- One bad knee can exclude the other, and at Healthy Paws every other leg
One knee problem before cover starts can exclude the other knee, and one spine sign the whole spine, for the life of the policy; Healthy Paws' wording excludes every other leg after a prior cruciate problem.
- Joints and spine: lifetime exclusions from the first 180 days, every disc, never an accident
A limp or back pain in the first months of a policy can exclude a knee, hip or disc condition for the life of the policy, at some insurers together with the other leg or every other disc.
- Cured, but excluded for life
A condition the pet had before enrollment can stay excluded after it heals: the contract has no cure rule, the condition is on a never-curable list, a recurrence makes the exclusion permanent, or the condition is a named exclusion that is hard to remove.
- Missing records or exam: the waiting period moves and the claim fails
If there was no enrollment vet exam, or you do not provide its record when the insurer asks at claim time, the illness waiting period is stretched to a later vet visit, and an illness that began before that date is not paid.
- Renewal: the price can rise, cover can shrink, and renewing can count as agreeing
At renewal the price can rise with your pet's age and many insurers can change the limit, deductible and terms; in several policies renewing, often automatic, counts as agreeing.
- Claims can cost you later: claim-based premiums and deductible resets
A claim can cost you later: in Pennsylvania, Fetch, Pumpkin, Embrace and Nationwide's Modular plan say premiums may rise with claim history, and after a paid claim Figo's reduced deductible goes back to its starting amount at the next renewal.
- Skipped preventive care as grounds to deny
Skip a vet-recommended exam, dental cleaning, vaccine or parasite dose and the insurer can refuse claims; at Fetch and Figo the wording reaches any claim.
- Claim deadlines, a 48-hour vet visit and one year to sue
Miss a claim, records or appeal deadline and the insurer can refuse to pay; Nationwide's one-year suit limit can run out before your claim is decided.
- Claims paid "in error" taken back, policies voided after the fact
If the insurer later decides it paid a claim against the terms, it can ask for the money back, and that payment does not stop it denying later claims for the condition; some policies also let it void coverage and drop open claims.
- A closed block: no new customers, and the price catches up with the limit
Pets Best's older New Jersey policies are closed to new customers: pets age, claim costs rise 17.7% a year, and in the rate manual an 11-year-old dog costs $4,926.58 a year for a $5,000 annual limit.
Dangerous
- Smaller payouts: lifetime and per-incident caps, a copay for each vet, deductible math, fee disputes
Plans with the same headline numbers can pay different amounts: a limit you missed, a copay for each vet, the deductible taken after the percentage, or a fee the insurer disputes.
- Dental cover with strings: tartar before the start, required cleanings, $1,000 caps
Some policies pay for dental illness only if you keep up yearly exams and recommended cleanings they never pay for, and a trace of tartar before the start can exclude dental illness with no end date.
- When the second sock isn't covered: repeat-incident and behavior exclusions
A dog that keeps swallowing things or getting into fights can lose cover for that kind of incident: at Pets Best after two similar incidents in 18 months, at Figo after three similar claims, and at Fetch and Embrace for a second anesthetic removal of a swallowed object in the same policy period.
- Often unpaid: exam fees, prescription food, drugs off the formulary
At a sick visit the exam fee, prescription food and some drugs often stay with you: some brands never pay them, others only with paid options that are hard to add later.
- Policy papers that contradict state law, and states where no one checks them before sale
The sample policy and disclosure you are shown can give fewer rights than state law, such as a 14-day accident wait or 15 days to return the policy instead of 30.
- Disputes decided by a vet the insurer picks
If you dispute a denied claim, the insurer or a vet it picks usually reviews it; Healthy Paws' standard form makes that vet's decision binding on you, and Nationwide's time to sue can run out before the denial.
- A 25% cap does not cancel an increase. It spreads it out
New Jersey's regulator limits increases to 25% a year, but insurers carry the rest into later renewals: Pumpkin, Spot and ASPCA reach the full price by the fifth renewal, and Pets Best 2.0 asks for +49.1% under the same cap.
Annoying
- Claim in the first month, lose the refund
At most insurers one claim in the first 30 days, even a denied one, ends the full money-back refund; at Pets Best the full refund voids the policy and denies open claims.