Cured, but excluded for life

From Pet Insurance Wiki · last updated 19 Oct 2026
One of the most dangerous traps. Every example below comes from an insurer or regulator document, linked next to the quote. All traps

Your dog was ill before you insured it and has been healthy for a long time, yet the insurer may still refuse to pay for that condition for the rest of its life. Some policies have no rule for cured conditions at all, some exclude whole groups of conditions from that rule, and in some the condition coming back can shut it out for good.

How it works

An insurer excludes a condition the pet had before the policy started (a pre-existing condition). The question is what happens once it has healed. The documents we read use four schemes.

  1. The contract has no rule for cured conditions. The policy does not promise to cover a condition again once it has gone away. The promise is only on the insurer’s website, and a website is not a contract. That is the case with Pets Best and Healthy Paws in Texas.
  2. There is a rule, but whole groups of conditions are “not curable” by definition. Chronic, ligament and knee conditions never count as cured, and at some insurers neither do orthopedic, genetic, congenital and hereditary ones. Figo decides for itself what is curable. That is the case with Figo, Spot, Pumpkin and ASPCA.
  3. A “second chance” that can end in a lifetime exclusion. One year with no coverage. If the condition comes back in that year, another year. If it comes back again in the second year, it is never covered. Even if it does not come back, coverage starts only after a vet exam that the policy does not pay for. That is the case with Fetch.
  4. The condition is written into the policy as its own exclusion. You can ask for its removal only in writing, with proof that the condition was cured at least six months before the request. Chronic conditions cannot be removed. That is the case with Nationwide Whole Pet.

The law does not fix this. No state requires an insurer to cover a cured condition again. Pennsylvania’s law says outright that it does not limit the types of exclusions, and Washington’s says the same of its definitions. The 180-day and 365-day cure periods are the insurers’ own rules. Texas has no pet insurance law: under the Texas regulator’s rules pet insurance is a “non-regulated” line (non-regulated inland marine), policy forms are not filed for approval, and the policy text controls.

One more detail makes the exclusion wider. At Spot, Pumpkin and ASPCA, a condition “occurs” when it could have been found at a routine exam, even if nobody noticed it. Healthy Paws excludes abnormalities whose symptoms were apparent before the policy started, and counts among them conditions a routine exam could detect. So a condition nobody saw before enrollment can still be excluded. More on this in the trap pre-existing can mean anything a vet “would have” found and in the guide to pre-existing conditions.

Examples

Pets Best, Texas: no rule in the contract, a promise on the website

The Texas sample policy of Pets Best (form IAIC-PB10001-ILL, insurer Independence American) treats as pre-existing any condition for which, before the policy started or during the waiting period, a vet gave advice, the pet was treated or there were signs of it: “the Pet had signs or symptoms directly related to the Condition”. There is no time limit: the insurer can look at the pet’s whole life. There is no clause on cured (cured, curable) conditions anywhere. The word “cured” appears only in the definition of a chronic condition. The Texas amendatory endorsement (IAIC-PB10001-PO-AE) does not touch the pre-existing section.

On its website Pets Best promises something else: “Once healed or cured, these conditions are no longer considered pre-existing by Pets Best and can be covered by your plan should they reoccur.” That is a website statement, not a right under the contract. We are not saying Pets Best never pays for cured conditions. We are saying the policy does not guarantee it.

Pets Best in Texas gives renewal protection voluntarily: a condition the policy has covered will not become pre-existing at renewal. But that is not a cured-condition rule.

The Pets Best policies for Arizona, California, Florida, Illinois, New Jersey, New York, Pennsylvania, Vermont and Washington have no cured-condition clause either. Only in Vermont is the look-back limited, because there the law limits it: 180 days before the policy starts (8 V.S.A. §7153(c)(6)(A)). The Pets Best Vermont policy repeats this: “within 180 days prior to”.

Sources: Pets Best, Texas sample policy, IAIC-PB10001-ILL, s. 5.A.1 (p. 5) and definition T (p. 14); Pets Best page on pre-existing conditions.

Healthy Paws, Texas: a definition without symptoms, a promise in the FAQ

In Texas, Healthy Paws links to a Westchester Fire policy (form LD-50812). In it a pre-existing condition is an “Illness or condition which developed or redeveloped prior to the pet policy effective date”. No symptom in the record and no vet note is needed for that. There is no time limit. There is no cured-condition clause. The Texas endorsement LD-51409 changes only how fast claims are handled, the deadline for lawsuits, cancellation and governing law.

A separate exclusion, II.4.h, adds abnormalities whose symptoms were apparent before the policy started: “This includes conditions that are detectable by a routine physical exam by your veterinarian”.

The promise is on the website, in the FAQ: “If a pet has fully recovered from a curable illness or injury, meaning they have been free of clinical signs and symptoms and have not received treatment for the condition for a continuous 365 days, the condition may no longer be considered pre-existing.” Note the word “may”. The same FAQ gives examples of conditions that would not count as cured: cruciate ligament tears, orthopedic conditions and conditions that need ongoing medication. The contract does not contain this promise.

Sources: Westchester Fire, Pet Health Insurance Policy LD-50812 (07/18), s. II.2 (p. 2), II.4.h (p. 3), definition 24 (p. 6); Texas amendatory endorsement LD-51409 (11/18); Healthy Paws FAQ, “Curable conditions”.

Figo, Texas: Figo decides what is curable

Figo covers a cured condition again after 365 consecutive days with no symptoms and no treatment. The count runs from the later date: the last treatment or the last symptom. But the insurer itself decides whether a condition is curable: “curable, as determined by Us”. And four groups of conditions are never curable: “Genetic Conditions, Ligament and Knee Conditions, Orthopedic Conditions, and Chronic Conditions are not considered curable.”

Figo’s “orthopedic” includes intervertebral disc disease (IVDD), any condition affecting the intervertebral spaces, and osteosarcoma. So if a dog had an IVDD episode before the policy, it will not be covered however many years the dog lives without symptoms. The same goes for osteosarcoma, a bone cancer.

The same rule is in Figo’s policies for Arizona, Illinois and Indiana. In Pennsylvania the policy says “congenital or hereditary” instead of “genetic”.

Source: Figo Pet Insurance Policy, Texas, file IAIC_FPI_POL_AI_TX_1025_ForIssue_021326 (the document prints no form number): Part I, definition of Orthopedic Condition; Part III, “Cured Pre-Existing Conditions”; Part IV, exclusions.

Spot, Pumpkin and ASPCA, Texas: 180 days, but “would have been detectable”

Spot, Pumpkin and ASPCA use one policy text in Texas (form PET-P-20000-1024, insurer Independence American, endorsement PET-AE-20000-TX-0723). The period here is shorter than Figo’s 365 days: “If your pet’s pre-existing condition is curable and has been cured and free from treatment and symptoms for a period of 180 days it is a new occurrence. This does not apply to chronic conditions or ligament and knee conditions.”

In Texas, Arizona and Florida only those two groups can never count as cured. The same brands’ policies for Pennsylvania and California add congenital, hereditary and orthopedic conditions.

The main catch is in the definition of when a condition “occurs”: “When signs or symptoms related to a condition first were observed by any individual, recorded in your pet’s medical record, or would have been detectable by a routine physical veterinary exam.” A condition can turn out to be pre-existing even if nobody noticed it before enrollment. This wording is in the Spot and ASPCA policies for Arizona, Florida, Pennsylvania and Texas and in Pumpkin’s Texas policy.

The ASPCA Texas sample matches the Spot sample word for word apart from the address. The Pumpkin Texas sample (PET-SAMPLE-COV-TX-V48_03_26) has the same clauses.

Sources: Spot, Texas sample policy, PET-P-20000-1024: definitions (p. 3), Cured Condition Eligibility (p. 4), exclusions (p. 5); ASPCA, the same Texas sample; Pumpkin, Texas sample policy, March 2026.

Fetch, Texas, Pennsylvania, Washington: up to two years excluded, and a recurrence can make it permanent

Fetch has a special rule for curable conditions. The policy defines a curable condition as one that “can be completely resolved without recurrence or any manifestations of clinical signs” and gives no examples. On its page about pre-existing conditions Fetch names as curable, for example, ear infections, urinary tract infections, diarrhea and hot spots.

The rule covers a curable condition that was observed, recorded or identified in the 365 days before the policy started or during the waiting period (15 days). The definition and the Pennsylvania and Washington disclosures also add the pet’s first vet exam. Conditions that first appear after the waiting period are not affected by the rule: they are covered as usual (§V.e.iii in the Pennsylvania policy).

How it works under exclusion V.e.iv:

  • In the first policy year (365 days from the start) the condition is excluded.
  • If it comes back in the first year, the exclusion runs for another 365 days.
  • If it comes back in the second year too, it is excluded for life: “If the same curable medical condition reoccurs during the second curable exclusionary period it will be excluded from coverage for the life of your pet.”
  • If the condition does not come back, it becomes coverable only after an exam: “provided an annual exam is conducted by a veterinarian dated after the curable exclusionary period and before the first reoccurrence”. An exam during the exclusion year does not count. The policy does not define “annual exam”. The policy does not pay for routine exams (exclusion q.iii in the Washington policy), and section VII.6.a.ii requires the owner to “arrange and pay for” an annual exam if the vet recommends one. The same exam condition applies at the end of the second exclusion year. The Washington disclosure describes the two exclusion periods but says nothing about the exam condition.

The policy contradicts itself. The definition of “Curable Exclusionary Period” is harsher than exclusion V.e.iv. It has no second year and no exam condition: “If, however, during that subsequent one (1) year or sometime after, the curable medical condition is treated or shows clinical sign(s), that condition will be excluded for the life of your pet.” Under this text Fetch could argue that a single recurrence at any time is enough for a lifetime exclusion.

Separately, the policy excludes anything observed or recorded at the first exam (exclusion mm in the Texas and Washington policies, ll in the Pennsylvania policy). If the pet has had no first exam in the 12 months before the policy start or in the first 30 days after it, the owner must arrange one at their own expense as early as possible (VII.6.b).

Where it is written:

  • Texas: base form GPTM 050 1125 A with the Texas endorsement GPTM 100-TX 0124 A, sample dated 12.23.25. Definitions on pp. 3–4, exclusion V.e.iv on p. 10 of 17. The endorsement does not change these clauses.
  • Pennsylvania: form GPTM 050 PA 1125 A, sample dated 1.9.26. Definition on p. 3, exclusions e.iii–e.iv on p. 11 of 18. Fetch’s Pennsylvania disclosure (as of February 12, 2026): “If the same curable medical condition reoccurs during the second exclusionary period, then it will be excluded from coverage for the life of your pet.”
  • Washington: form GPTM 050 WA 1125 A with endorsement GPTM 100-WA 0124 A, sample dated 4.2.26. Definition on p. 3, V.e.iv on p. 10, q.iii on p. 11, VII.6.a.ii on p. 14 of 17. The endorsement does not change these clauses.
  • Other states: the same text, including “for the life of your pet” and “or sometime after”, is in Fetch’s forms for Arizona (GPTM 050 1125 A), Florida (GPTM 050 FL 1125 A), California (GPTM 050 CA 0325 A), New Jersey (GPTM 050 PML NJ 0326 A), Michigan (GPTM 050 MI 1125 A) and New York (the base form with an endorsement). In the newer countrywide form GPTM 050 0326 A (Wisconsin, Kentucky, Missouri, Virginia, Vermont, Indiana, Utah, Wyoming and others) and the Illinois form GPTM 050 IL 0326 A the rule is rewritten: the 12 months run from the last treatment or sign in the record, a plain exam replaces the “annual exam”, and the second period runs from the date the condition comes back. The lifetime exclusion after a recurrence in the second period remains. So does “or sometime after” in the definition.

What the law says:

  • Pennsylvania. The law allows pre-existing exclusions (40 Pa.C.S. §4706(a)(1)) and does not limit the types of exclusions (§4703(c)(1)). It has no look-back limit and no cured-condition rule, so Fetch’s “second chance” is more generous than the law requires. But §4706(a)(3) bars treating as pre-existing at renewal a condition the policy has already covered. Our conclusion: once a curable condition has become covered and the policy has renewed, the “or sometime after” clause can probably not be applied. This does not affect the two-year sequence in V.e.iv: there is no coverage during the exclusion periods.
  • Washington. The law allows pre-existing exclusions “with appropriate disclosure” (RCW 48.205.050(1)) and says its definitions do not limit the types of exclusions (RCW 48.205.030(2)). The insurer has to prove the exclusion applies. RCW 48.205.020(6)(b) says: “A condition for which coverage is afforded on a policy cannot be considered a preexisting condition on any renewal of the policy.” Our conclusion, not tested in court: the “or sometime after” clause, which brings back a lifetime exclusion after the condition has already become covered, sits badly with this.
  • Texas. There is no pet insurance law. Our conclusion: under the general rule that unclear policy wording is read in the insured’s favor, the conflict between the definition and V.e.iv can be challenged.

Sources: Fetch, Texas sample policy, GPTM 050 1125 A and GPTM 100-TX 0124 A, definitions (pp. 3–4), V.e.iv (p. 10); Fetch, Pennsylvania policy, GPTM 050 PA 1125 A, definitions (p. 3), V.e.iii–e.iv (p. 11); Fetch, Pennsylvania Insurer Disclosure of Important Policy Provisions; Fetch, Washington policy, GPTM 050 WA 1125 A and GPTM 100-WA 0124 A, definition (p. 3), V.e.iv (p. 10), q.iii (p. 11), VII.6.a.ii (p. 14); Fetch page on pre-existing conditions. More on the state laws on the pages for Pennsylvania, Washington and Texas.

Nationwide Whole Pet, Pennsylvania: a named exclusion that is hard to remove

A Nationwide Whole Pet policy can list “Additional Excluded Conditions” on the Declarations Page: conditions excluded for your pet in particular. The policy never pays for them (§7.C), or for their complications and progression: “Diagnosis or treatment of any complication or progression of any condition or procedure excluded by this policy” (§7.D).

You can ask for such an exclusion to be removed only in a written request for review (§13). You must attach all your vet’s records about the condition and documents showing it was cured: “you must provide us with medical records or other documentation from your veterinarian demonstrating that the condition was cured at least six months before the date of your request. Chronic conditions are not eligible for removal. All review decisions are final.”

“Cured” is read strictly here: “Cured means the condition is eliminated and having no effect on the pet so that the pet is fully restored to normal health without any treatment or management.” A condition kept under control with medication does not qualify. A chronic condition is any condition that “can be treated or managed, but not cured”. Even with the documents, the policy does not promise to remove the exclusion: it only sets the minimum evidence.

“Final” applies to Nationwide’s internal review. A complaint to the Pennsylvania Insurance Department or a lawsuit is still possible. But a lawsuit under the policy must be brought within one year of the pet’s first treatment for the condition (§14).

Pennsylvania law does not help here. It does not limit the types of exclusions (40 Pa.C.S. §4703(c)(1)). Renewal protection (§4706(a)(3)) covers only conditions the policy once covered, and this one was excluded from the start.

The same clause is in the national form VS-G-11 (02-17) and the California form VS-G-11-CA (01-15). In the newer modular forms VS-G-15-PA (9-24) and VS-G-15 (3-26), a similar rule in §20 applies to reconsidering a pre-existing condition: cured at least six months earlier, chronic conditions not reconsidered, a single review (Nationwide may refuse another one without new medical records), final decision.

Caveats: the Pennsylvania sample is dated September 2024, before Act 2024-19 took effect (around December 2024). We did not check whether Whole Pet is sold in Pennsylvania now.

Source: Nationwide, Percent of Invoice Plan A Coverage Form (Whole Pet), VS-G-11-PA (9-24), Pennsylvania sample, National Casualty Company: definitions §2.A and §2.D (p. 2), §7.C–D (p. 5), §13–14 (p. 7).

Step by step: an ear infection with Fetch

An owner in Texas, Pennsylvania or Washington. The only numbers are the periods from the policy; there are no prices.

  1. Three months before enrollment the dog was treated for an ear infection. The record shows it.
  2. The Fetch policy starts on March 1, 2026. The ear infection is excluded for 365 days.
  3. In August 2026 the ear flares up again. The treatment is not covered, and the exclusion runs for another 365 days after the first year.
  4. In December 2027, in the second exclusion year, the infection comes back again. From then on the ear infection is excluded for the rest of the dog’s life.

The other path. In step 3 the ear does not flare up. Then, after the first exclusion year, you need to take the dog to the vet for a routine exam. The policy does not pay for it. If the infection comes back before that exam, it does not become coverable. And even after the exam, Fetch could point to the definition in the policy (“or sometime after”) and exclude the condition for life at any later recurrence.

What to do

  • Read the policy, not the website. Find the section on cured conditions (cured, curable) in the policy. If there is none, as with Pets Best and Healthy Paws in Texas, a promise on the website gives you no right. Ask the insurer to confirm in writing on what terms a cured condition will be covered.
  • Check the “never curable” list. Chronic, ligament and knee, orthopedic, genetic, congenital and hereditary conditions. And read the definition of orthopedic: Figo’s includes IVDD and osteosarcoma.
  • Check who decides and from what date the clock runs. At Figo the insurer decides what is curable, and the 365 days run from the last treatment or symptom, whichever is later. At Spot, Pumpkin and ASPCA the contract period is 180 days.
  • Check what the policy counts as “before the policy”. Wording such as “would have been detectable by a routine physical veterinary exam” (Spot, Pumpkin and ASPCA, in the definition of when a condition occurs) or “detectable by a routine physical exam” (Healthy Paws, exclusion II.4.h) means the exclusion can catch something nobody saw.
  • With Fetch: keep the records; after the exclusion year, before any recurrence, take the dog for an exam and keep the dated record. Ask Fetch in writing which clause applies if the condition comes back after it has become coverable: the definition (“or sometime after”) or exclusion V.e.iv.
  • With Nationwide Whole Pet: check the Declarations Page. If it lists “Additional Excluded Conditions”, collect your vet’s records and, once six months have passed since recovery, submit a written request for removal. If it is refused, complain to your state insurance department (in Pennsylvania, the Pennsylvania Insurance Department). Remember the one-year window for a lawsuit.
  • Insure before the first entry in the vet record and never let the policy lapse. Why that matters most is explained in the guide to the pet insurance trap.

Sources

History

  1. First published