Dropped or downgraded after the pet gets sick

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 pet gets sick, you file claims, and some policies let the insurer drop you or cut your cover: cancel it, refuse to renew it, or renew it on worse terms. There is nowhere to go without losing something: a new insurer will count the pet’s existing conditions as pre-existing.

How it works

A pet policy runs for a year and renews every year. In the policies we have read, the insurer keeps four ways to make things worse for a sick pet:

  1. Cancel or refuse to renew because of the pet’s health. Nationwide’s ground is a health risk that existed before the policy and that the insurer did not know about. The owner does not have to be at fault.
  2. Refuse to renew over “loss experience”, which can include your claims. Fetch’s ground is a “material change” in “loss experience”. The policy does not define the term. The insurer decides when a change is material.
  3. Renew on worse terms. At renewal Fetch can change the price, the annual limit, the deductible, the share you pay, and the terms themselves. Once it has paid 50 claims, Fetch may offer “lower” coverage.
  4. Take away discounts. After Fetch has paid more than 50 claims, you may lose a promotional discount. Figo can change or end a discount at any time with 30 days’ notice (in Washington, only at renewal).

It usually starts with a claim. To handle it, the insurer may request the pet’s records from every vet. If it finds an illness from before the policy that it did not know about, or sees a run of claims, it may have a ground.

It hits at the worst moment. The policy ends while the pet is sick and needs cover most. A new insurer will count the conditions already in the record as pre-existing. Why this happens is explained in the pet insurance trap and pre-existing conditions.

Examples

Nationwide: cancellation for a risk the insurer did not know about

Nationwide’s Modular policy lets the insurer cancel partway through the year, or refuse to renew, if it finds a health risk that existed before the policy started:

“We may cancel or non-renew this policy for any of the following reasons: … b. An increased risk associated with your pet’s health that existed before the original policy inception date, of which we were unaware at the original policy inception date.”

  • The owner does not have to be at fault. Misstatements on the application are a separate ground in the same list (item c). Item b applies even if the owner hid nothing.
  • No claim is required. In practice, though, the risk usually comes to light after a claim. Nationwide can ask for the records, and the owner must hand over “all medical records” relating “or even possibly relating” to the pet’s health (section 14.C).
  • Cancellation comes with 10 days’ notice: “ten (10) days before we cancel this policy, or at the time required by the law of your state of residence”. For a non-renewal the policy promises no notice period at all. The 30 days in section 19.D are for changes to the policy, not for non-renewal.
  • After the policy ends, treatment is not paid, including conditions that started under the policy and are still being treated. The policy covers only expenses incurred “during the policy term” (section 11). If the policy is cancelled, unearned premium is refunded pro rata (section 17.B).

Source: Nationwide / National Casualty Company, Modular Pet Insurance Coverage Form VS-G-15 (9-24), section 17 “Termination of Insurance”, pp. 9–10; section 11 “Policy Term”, p. 6; section 14.C, p. 9.

Where it applies. The same ground, word for word, is in every edition of VS-G-15 linked from petinsurance.com/forms. In most it is item 17.C.b; in California it is 17.D.b, in Massachusetts 17.C(2):

The same ground is in another Nationwide form linked for Arizona, My Pet Protection Plus VS-G-16 (6-24), item 12.D.ii. The Whole Pet form (VS-G-11-0818, 01-21) does not have the “unaware” ground. But its section 10.B lets Nationwide cancel with 10 days’ notice and lists no reasons at all.

Arizona law does not limit this clause. Arizona has no pet insurance law. No state law sets a notice period or limits the grounds for cancelling or not renewing a personal pet policy, so the policy terms decide. The regulator’s 2013 Order 13A-071-INS (Exhibit B, item 10) exempts pet insurance from Article 14 (A.R.S. 20-1671 et seq., which includes 45 days’ notice of non-renewal). But Article 14 only ever covered commercial policies (A.R.S. 20-1671), so owners had no such protection before the order either. Article 8 (A.R.S. 20-1651 et seq.) covers homes, the belongings in them and personal liability. In our reading, a policy that pays vet bills does not fall under it. In other states the proviso “or at the time required by the law of your state of residence” may lengthen the notice. We have not checked this in every state. How state law can limit cancellation, for example in Washington, Illinois and Pennsylvania, is covered in cancelled for any reason, or on short notice.

Fetch, Arizona: non-renewal for “loss experience”

Fetch’s Arizona sample policy lets it refuse to renew at the end of the year:

“we may elect not to renew this policy on the expiration date due to a material change in the condition, factor, or loss experience material to insurability.”

  • The policy does not define “loss experience”. The wording is broad enough to cover the pet’s own claims or a change in its health. Fetch decides whether a change is material. That claims are included is our reading. Fetch’s Washington endorsement supports it: it expressly forbids non-renewal based on “claims activity”, which suggests the base text would otherwise allow it.
  • Apart from the ground itself, the only requirement is a letter 60 days ahead: “with a written notice at least sixty (60) days prior to the expiration date”. The Arizona form does not require the notice to give a reason.
  • Terms can change at every renewal: “We may change the premium, maximum annual policy coverage, co-pay amounts, deductible(s) and policy terms and conditions at renewal. You will be notified of changes in writing.” No minimum notice period is set for these changes.

Fetch links the same file for Colorado and North Carolina.

Source: Fetch Pet Health Insurance Policy, sample GPTM 050 1125 A (12.23.25), section VIII.6 “Cancellation and Nonrenewal”, items (d) and (e), p. 17.

Arizona law does not limit this clause. Order 13A-071-INS also exempts pet insurance rates and forms from filing with the regulator (Exhibit A, I.A). No law controls the grounds for non-renewal, a duty to give a reason, or the notice period. The only protection is in the policy itself: the listed grounds and the 60 days’ notice.

Fetch, New Jersey: non-renewal for “adverse loss experience”

In New Jersey, a Fetch policy that has been in force for 60 days or more, and any renewal, can be cancelled or not renewed only for the reasons on a list (items a–n). But the list is open-ended: item n allows “any other reason that conforms with our written underwriting guidelines”. And on top of the list:

“In addition to the above reasons, we may nonrenew this policy for adverse loss experience. We will specifically identify the loss experience that supports this action.”

  • There is no threshold. The policy does not define “adverse loss experience” and does not say how many claims, or how large, count as “adverse”. That it means the claims on your policy is our reading; the promise to identify the loss experience supports it. Heavy or expensive claims can end with the pet not being renewed.
  • There are protections. Fetch must state the reason, name the specific losses, and give written notice “at least thirty (30) days but not more than one hundred-twenty (120) days” before the end. Changes to terms at renewal also come with 30–120 days’ notice.
  • The first 60 days of a new policy: any reason. “If this policy has been in effect less than sixty (60) days, we may cancel for any reason.” This does not apply to renewals.

Source: Fetch, GPTM 050 PML NJ 0326 A (sample 9.21.26), section VII.11 “Renewal”, p. 16; section VIII.6 “Cancellation and Nonrenewal”, pp. 18–19.

New Jersey law does not forbid non-renewal. The pet insurance act (P.L. 2025 c.224, N.J.S.A. 17:46D-3 to -11, in force from 1 January 2027) does not limit cancellation or non-renewal. It only bars requiring a vet exam to renew (17:46D-8c) and stops a condition the policy covered from becoming pre-existing at renewal. Fetch’s New Jersey rules mirror N.J.A.C. 11:1-20: state the reason and the losses, give 30–120 days’ notice. Formally those rules are written for commercial and homeowners policies. Our reading is that Fetch applies them to pet cover voluntarily.

Fetch, Washington: claims can make the policy cost more and cover less, but are not a ground for non-renewal

In its mandatory Washington disclosure, Fetch writes:

“Premiums may be increased and coverage may be reduced based on your pet’s individual claim history.”

Five other Washington disclosures we read say the opposite:

  • Figo: “We do not reduce coverage or increase premiums based on the policyholder’s claim history”.
  • Pumpkin and Hartville: “We will not reduce coverage or increase premium due to claims history”.
  • Healthy Paws: “Premiums are not based on your own pet’s individual claims experience”.
  • Pets Best: “Your cost will not change based on your Pet’s individual claims experience”.

Trupanion’s disclosure does not say whether claims affect the premium or the coverage. We could not get the Washington disclosures of Embrace, Nationwide, Spot, Lemonade, MetLife or ASPCA.

Fetch’s Washington sample policy adds three rules:

  1. After 50 claims: a lost discount and “lower” coverage. Once Fetch has paid “more than fifty (50) claims”, you may lose a promotional discount or credit. Fetch also reserves the right to offer “alternative, lower coverage”. Notice comes at least 20 days before renewal.
  2. Coverage can be raised only if you have never claimed. You can apply to raise the annual limit or lower the deductible or co-pay once a year at renewal, “provided that you have not previously filed a claim with us”. Even without a claim, Fetch has to approve. After any claim, the policy gives you no way to increase coverage.
  3. Terms can change at every renewal: premium, limit, co-pay, deductible and the terms themselves (VIII.6.e). The endorsement does not change this item.

Protection: no non-renewal because of claims. Fetch’s Washington endorsement: “A decision to not renew a policy will not be made based on a pet’s medical history or claims activity.” A non-renewal notice must come at least 60 days ahead and include the reason. The endorsement also keeps conditions diagnosed after the policy started covered for as long as Fetch coverage is continuous. The upshot: claims can make the policy cost more or cover less, but they should not get it dropped.

Sources: Fetch, Washington Insurer Disclosure of Important Policy Provisions (updated 20 December 2024), “Summary of Important Policy Provisions”; Fetch, sample GPTM 050 WA 1125 A with endorsement GPTM 100-WA 0124 A: VII.10, p. 15; VIII.6.e and VIII.9, p. 17; endorsement items I and II.

Washington law only requires the insurer to say so. RCW 48.205.040(1)(d) requires the insurer to disclose whether it changes coverage or premiums based on claims history. It does not forbid it. Any claims surcharge has to be in the rates Fetch files with the regulator (the OIC). But Washington filings cannot be viewed online right now, so we could not check its size. An open question (our reading, not settled law): the law protects against pre-existing exclusions at renewal, and defines a renewal as coverage “substantially similar” to the old policy (RCW 48.205.020). An offer of “lower coverage” might fall outside that definition.

Fetch uses the same claims-history sentence in its disclosures for Pennsylvania, Delaware, Louisiana, Maryland, Mississippi, Nebraska, New Hampshire, Rhode Island and Vermont.

Fetch, Texas: after 50 claims

Fetch’s Texas sample policy:

“If we pay more than fifty (50) claims in total to you for your pet, you may lose your promotional discount or credit received. We also reserve the right in these circumstances in which fifty (50) claims have been paid to offer alternative, lower coverage to you.”

  • The 50 claims are counted over the whole life of the policy, not per year. A chronic condition claimed about once a month would pass 50 in roughly four to five years.
  • Claims that only count toward the deductible may not count as “paid”.
  • The policy does not define “promotional discount”. It is unclear whether Fetch’s military discount counts, and we do not say it is at risk.
  • No notice period is given: “The proper notice will be sent”.
  • The Texas endorsement (V.e): “Your policy will not automatically renew if any changes eliminate or reduce coverage.” Reduced coverage cannot switch on silently. But the policy will not renew by itself either, so do not miss Fetch’s letter.
  • Non-renewal in Texas works differently. The endorsement rewrites the rule (V.d): it lists no grounds, and only bars non-renewal solely because the policyholder is an elected official. But the 60-day notice must state the reason.

Source: Fetch, sample GPTM 050 1125 A with Texas endorsement GPTM 100-TX 0124 A (12.23.25), section VIII, item 9 “Claims In Excess of 50”, p. 17; endorsement item V, PDF pp. 19–20.

Texas law does not limit this clause. Texas has no pet insurance law. The Department of Insurance (TDI) treats pet insurance as non-regulated inland marine, so policy forms are not filed or approved. The only limit is item V.e of the endorsement, which is a contract term, not a law.

The same item 9, word for word, is in Fetch’s forms for Arizona, California, Illinois, New Jersey and the countrywide GPTM 050 0326 A.

Figo: discounts can be withdrawn at any time

Figo’s Texas policy (underwritten by Independence American Insurance Company):

“These discounts may be altered, changed, modified, revised, discontinued, or terminated at any time by the Company at its discretion, upon thirty (30) days written notice to You.”

This is tied neither to renewal nor to claims. The same wording is in Figo’s policies for Arizona, Illinois and Pennsylvania. Washington’s is softer: discounts change only “at Policy Renewal”, with 20 days’ notice.

Source: Figo Pet Insurance Policy IAIC FPI POL AI TX 1025, Part VI “General Provisions”, “Premium Discounts”, p. 10.

Fetch by state

Fetch’s terms differ from state to state. What we found in the sample policies on fetchpet.com/terms-conditions:

State, form Non-renewal Non-renewal notice After 50 claims Raise coverage after a claim
Arizona, GPTM 050 1125 A for “loss experience” 60 days, no reason required discount, “lower” coverage never
California, GPTM 050 CA 0325 A for “loss experience” 60 days discount, “lower” coverage no
Florida, GPTM 050 FL 1125 A for “loss experience” 60 days discount, “lower” coverage; 50 counted per policy term; changes only at renewal no
Illinois, GPTM 050 IL 0326 A for “loss experience” 60 days discount, “lower” coverage never
New Jersey, GPTM 050 PML NJ 0326 A for “adverse loss experience”, losses must be named 30–120 days, with reason discount, “lower” coverage no
Pennsylvania, GPTM 050 PA 1125 A for “loss experience” 30 days no such clause no
Texas, GPTM 050 1125 A + GPTM 100-TX 0124 A no grounds listed 60 days, with reason discount, “lower” coverage; a reduced policy does not renew by itself never
Washington, GPTM 050 WA 1125 A + GPTM 100-WA 0124 A for “loss experience”, but not because of the pet’s medical history or claims 60 days, with reason discount, “lower” coverage; 20 days’ notice no

“No” means the policy lets you apply to raise coverage only if you have never filed a claim with Fetch. The Arizona, Texas and Illinois forms say it outright: “If you have submitted a claim with us, your coverage is not eligible to be increased at any time.”

What it looks like for an owner

Fetch, a chronic condition. The dog has allergies, with a claim every month.

  1. After the first claim you can no longer raise the limit or lower the deductible. This is so in every Fetch form in the table.
  2. At every renewal Fetch can raise the premium, lower the limit, or raise the deductible or co-pay.
  3. In roughly four to five years paid claims pass 50. You may lose a promotional discount, and Fetch may offer lower coverage. Pennsylvania’s form has no such clause. In Florida the 50 are counted per policy term, so a claim a month never reaches them.
  4. In Arizona Fetch can refuse to renew at the end of any year over a material change in “loss experience”. The letter comes 60 days ahead and does not have to give a reason. In New Jersey it can refuse over “adverse loss experience”, but must name the losses and the reason and give 30–120 days’ notice. In Texas the endorsement lists no grounds, but the notice must give the reason. In Washington claims are not a ground for non-renewal.
  5. A new insurer will exclude the allergies as pre-existing.

Nationwide, an old entry in the record. An owner buys a Modular policy. A year later comes a large claim. Nationwide requests records from every vet and finds an entry at the previous vet that it did not see at enrollment. It can cancel with 10 days’ notice, or refuse to renew with no promised notice period. Treatment after the end date is not paid, even if it is already under way.

What to do

  • Before you buy, find the cancellation and non-renewal section in the sample policy for your state (“Cancellation and Nonrenewal”, “Termination of Insurance”). Check three things: the grounds (the pet’s health, “loss experience”, “unaware”), how many days’ notice you get of a non-renewal, and whether the insurer must give a reason. Read the state amendatory endorsement too: Fetch’s change the rules in Washington and Texas.
  • Ask in writing and keep the answer: “Can you cancel or refuse to renew my policy because of my pet’s claims or health? How much notice will you give? Will you state the reason?”
  • In Washington, read the insurer’s disclosure. The law requires it to say whether claims change the price or the coverage. Figo, Pumpkin, Hartville, Healthy Paws and Pets Best say claims do not raise the premium. Fetch says claims may raise the premium and cut the coverage.
  • When you enroll with Nationwide, attach the full records from every vet and keep proof you sent them. Ground 17.C.b applies only to a risk the insurer was “unaware” of. This is our reading of the clause, not a guarantee.
  • With Fetch, pick the coverage you need from the start. In every Fetch form we read, you cannot raise it after a claim.
  • Do not count on discounts. At Fetch you may lose a promotional discount once it has paid more than 50 claims. Figo may change a discount at any time with 30 days’ notice (in Washington, only at renewal).
  • Read every letter from the insurer before renewal. In Texas a Fetch policy whose new terms reduce coverage does not renew automatically.
  • If a non-renewal notice arrives: check the notice period against the policy; ask in writing for the reason (Fetch must give one in Texas, Washington and New Jersey); in New Jersey, ask which losses it relies on. Complain to the state regulator: DIFI in Arizona, TDI in Texas, the OIC in Washington, the Department of Banking and Insurance in New Jersey.
  • If the pet is dropped anyway, a new insurer will count its existing conditions as pre-existing. An accident-only policy does not cover illness at all, so illness entries in the record matter less there. More in the pet insurance trap.

We cannot yet say which brands are free of this: we have not checked the other insurers’ policies for these particular grounds. Their cancellation rules in general are covered in cancelled for any reason, or on short notice. From what we have read: Fetch’s Pennsylvania form has no 50-claims clause, and Fetch’s Washington endorsement bars non-renewal for claims. Nationwide’s Whole Pet form lacks the “unaware” ground but lets Nationwide cancel with 10 days’ notice without listing reasons, so it is not a safe alternative.

Sources

History

  1. First published