Policy papers that contradict state law, and states where no one checks them before sale

From Pet Insurance Wiki · last updated 29 Oct 2026
A dangerous trap. Every example below comes from an insurer or regulator document, linked next to the quote. All traps

Before you buy, the insurer shows you a sample policy and a disclosure of its terms. These papers can give you fewer rights than state law: 14 days without accident cover where the law bans accident waiting periods, or 15 days to return the policy where the law gives 30. If you believe the paper, you may not use a right you actually have.

How it works

Large brands write one national policy form. For states with a pet insurance law they add a state amendatory endorsement or issue a separate form. The version posted on the website may still be an old or national one. Sometimes the state selector on the website opens another state’s document by default.

Where there is a law, the law beats the paper. In Pennsylvania the law 40 Pa.C.S. ch. 47 (Act 2024-19) has been in force since 7 December 2024. It bans waiting periods for accidents, requires a vet exam waiver of the illness waiting period, and gives 30 days to return the policy. Washington has RCW 48.205. The law beats a clause that conflicts with it, and Embrace’s policy even says so itself. But you have to know your right and assert it yourself. Which version an insurer filed with the Pennsylvania regulator can be looked up in SERFF Filing Access; we have not checked it yet.

Where there is no law, nobody checks the paper before sale. In Arizona pet insurance policy forms have been exempt from filing with the Department of Insurance since 2013 (Order 13A-071-INS). In Texas pet insurance has been “non-filed” since 2021: forms are neither filed nor approved. Illinois has no pet insurance law either. Forms there are filed with the regulator no later than the day they are first used; you can look them up in SERFF Filing Access. In all three states no pet insurance law sets minimum terms, so what the policy says is what you get. An overview of the laws is in pet insurance laws by state.

Examples

Nationwide, Pennsylvania: 14 days without cover, accidents included

Nationwide’s Pennsylvania sample Modular Pet Insurance policy (form VS-G-15-PA, 9-24) says every coverage, accident coverage included, becomes available after a 14-day waiting period. The count starts only after underwriting approval and on the day after the payment goes through. So the wait can run longer than two weeks from purchase.

“All coverages are subject to underwriting review and will be available after a 14-day waiting period. The waiting period begins a) after underwriting approval, and b) the next day after successful processing of your payment”

As written, an injury in those days is not covered. And the harm can outlast the 14 days. The policy counts any condition that began during a waiting period as pre-existing, and exclusion 13.A keeps it uncovered after the wait ends:

“Pre-existing condition means any condition that began or was contracted, manifested, or incurred before the effective date of this policy or during any waiting period, whether or not the condition was discovered, diagnosed, or treated.”

Pennsylvania law: “A waiting period under a pet insurance policy for an accident is prohibited.” That is 40 Pa.C.S. §4706(b)(1). The clause conflicts with the law, and a denial based on it can be challenged.

The same documents conflict with the law in two more ways:

  • the form has no vet exam waiver of the waiting period, although §4706(b)(2)(iii) requires one in every policy;
  • Nationwide’s Pennsylvania disclosure (IDIP-MPI-PA, 9-24) does not mention the 14-day wait, although §4705(a)(3) and (a)(12) require waiting periods to be clearly disclosed.

A violation of this law counts as an unfair or deceptive act under Pennsylvania’s Unfair Insurance Practices Act (§4710(b)(2)).

For a fair picture:

  • the sample is dated September 2024, before the law took effect;
  • on 17 October 2026 Nationwide’s forms page still listed exactly this document as the Modular form for Pennsylvania;
  • we do not know whether policies issued in Pennsylvania today carry this wording;
  • the newer edition, VS-G-15 (3-26), has no accident waiting period: “Accident coverage is not subject to a waiting period”. The 14 days remain only for illness, with a waiver. Nationwide lists this edition for Delaware, Florida, Hawaii, Maine, Mississippi, Nebraska, Ohio and Rhode Island;
  • Nationwide’s Pennsylvania Whole Pet form (VS-G-11-PA, 9-24) has no general waiting period, only a 12-month cruciate exclusion.

Where else the clause appears. It is word for word in the national form VS-G-15 (9-24). Nationwide’s forms page lists that form for Arizona, Alabama, Colorado, Connecticut, Georgia, Kentucky, Montana, New Jersey, New Mexico, North Carolina, DC and Vermont’s MPP Choice plan, among others.

  • Arizona: no law, and forms are not filed. There a 14-day accident wait is simply a term of the contract.
  • New Jersey: the law takes effect on 1 January 2027 and bans accident waiting periods. If the form has not changed by then, it will conflict with the law.
  • Montana and Vermont have pet insurance laws, but we did not check their waiting-period rules.
  • The same clause is in the California form VS-G-15-CA (11-20).

Source: Nationwide / National Casualty Company, Modular Pet Insurance Coverage Form, VS-G-15-PA (9-24), SAMPLE, §15.A on p.10; definition §2.S on p.3; exclusion §13.A on p.8. Insurer page: Nationwide.

Embrace, Pennsylvania: 15 days to return the policy instead of 30

For Pennsylvania, Embrace’s website shows two documents: the national V6 sample policy (its state selector maps “PA - Pennsylvania” to it) and the national disclosure INDPP (01/23) linked in the site footer. Both give 15 days to return the policy for your money back.

“You have 15 days from the day you receive this policy to review it and return it to the company if you decide not to keep it. … You must return it within 15 days of the day you first received it.”

Pennsylvania law gives 30 days: an applicant “may return the pet insurance policy to the company that produced the pet insurance policy, or an agent or insurance producer of the company, within 30 days of receipt of the pet insurance policy.” That is 40 Pa.C.S. §4704(a). The one condition: you have not filed a claim yet (§4704(b)). The law requires the 30-day notice to be printed in at least 12-point type on the first page of the policy or attached to it (§4704(c)). And §4705(b)(1) requires it in the disclosure document. Embrace’s document with that title says 15 days.

The law wins. And the V6 policy itself bends to the law: “When this policy’s provisions conflict with the statutes of the state in which this policy is issued, the terms and conditions are amended to conform to such statutes.” So a Pennsylvania owner who has not filed a claim can return the policy for a full refund on day 16 and on day 30 alike. An owner who believes the documents may think the deadline has passed.

Don’t confuse two deadlines. Both documents also say the refund is paid “within 30 days after it receives the returned policy”. That is the deadline for the refund, not for the return.

What we have not seen: a policy actually issued in Pennsylvania. It may carry a Pennsylvania endorsement. We found no Pennsylvania edition or endorsement from Embrace. Embrace does have a separate California notice that gives 30 days, so the company does publish state-specific return terms.

Embrace’s selector serves the same V6 sample with 15 days for 48 jurisdictions (states and DC). They include states whose laws also give 30 days: Delaware, Florida, Hawaii, New Hampshire, Ohio and Vermont, and from 2027 New Jersey (30 business days). We did not check whether Embrace has separate notices for those states, so a conflict there is not confirmed.

Sources: Embrace Pet Health Insurance V6, sample policy, cover sheet before the Insuring Agreement; Part VI “Conformity to State Statutes”; Embrace, Insurer Disclosure of Important Policy Provisions, INDPP (01/23), p.2, “Right to Examine and Return the Policy”. Insurer page: Embrace.

Pennsylvania: the law requires an exam waiver, and most brands narrow it

Pennsylvania law requires every policy to let a vet exam waive the waiting period for illness and orthopedic conditions (§4706(b)(2)(iii)). The insurer may set requirements for the exam, with a proviso: “provided that the specifications do not unreasonably restrict the waiver” (§4706(b)(2)(iii)(C)). What the brands do:

Embrace. New illnesses are covered during the 14-day wait only if the exam took place after the policy start date and the vet’s record says the pet has nothing at all: “Coverage for new Illnesses will be afforded during the fourteen (14) day Illness Waiting Period if your Pet is examined by a Veterinarian after the Pet Original Start Date and the medical record specifically indicates that your Pet does not have any Hereditary Disorders, Congenital Anomalies or Disorders, Orthopedic conditions, Pre-existing Conditions, Illnesses, Injuries or disorders and/or Clinical Signs.” Any finding at all defeats it. An exam before the start date does not count. Source: Embrace V6, Part VI “Other Terms and Conditions”, “Opting out of Illness Waiting Period”. Embrace’s selector serves this text for every state except Kansas, New Mexico and South Carolina.

Figo. Two 7-day deadlines: “A Veterinarian must conduct a full and complete veterinary examination within 7 days of the Pet’s Original Start Date”, and the form must be “submitted to Us within 7 days of the Policy effective date in order to be considered by Us for waiver”. Then, within 30 days of receiving the form, Figo decides: “We will advise You of Our decision to either waive one or both of the Waiting Periods for the Pet, or not to waive either”. The disclosure says “We may waive” if the exam meets Figo’s review criteria. The criteria are in a separate form we have not seen for Pennsylvania. It also says “any conditions identified during the veterinarian examination may be considered Pre-Existing Conditions”. Sources: Figo Pet Insurance Policy IAIC FPI POL PA 0424, Part IV “Waiting Period Waiver”, pp.7-8; Figo, PA Insurer Disclosure of Important Policy Provisions, “Waiver of Waiting Periods”. Insurer page: Figo.

MetLife. An exam in the 7 days before the start gives a full waiver; one in the 5 days after gives a partial waiver. What the exam finds becomes an exclusion: “if the Waiver Exam identifies an Illness that began on or before the date of the Waiver Exam, that Illness will be considered a Pre-Existing Condition for which there is no coverage under the Policy.” The same goes for injuries from before the start date. Source: MetLife (Metropolitan General Insurance Co.), Insurer Disclosure of Important Policy Provisions for Residents of Pennsylvania. Insurer page: MetLife.

Pumpkin, Spot, ASPCA (insurer: Independence American). “The qualifying exam may occur within 3 days prior to or 7 days after your initial policy effective date”. The form is due within 30 days of the exam. “This waiver does not alter the pre-existing conditions exclusion.” Sources: Pumpkin, Notice to Pennsylvania Residents (PET-PA-Notice-1125-PUMPKIN); Spot, Pennsylvania policy provisions; ASPCA, PA Insurer Disclosure (PET-PA-Notice-0424-APHI), p.4. Insurer pages: Pumpkin, Spot, ASPCA.

Fetch. A wider window: a full exam within the first 15 days, the whole length of its illness waiting period. “we will allow for waiver of the waiting period with a comprehensive exam … within the first fifteen (15) days after the original inception date of the policy”. Source: Fetch, Terms and Conditions, Pennsylvania residents. Insurer page: Fetch.

What the law says. On our reading, Embrace’s demand for a record that finds nothing, and Figo’s two 7-day deadlines followed by a decision on criteria that are not in the policy, are arguably in tension with §4706(b)(2)(iii)(C). We found no regulator ruling. That an exam finding can become an exclusion, though, the law itself allows. §4702 counts as pre-existing a condition on which a vet gave advice, or which showed signs, during a waiting period. And §4705(a)(11) only requires a warning that “the examination documentation may result in a preexisting condition exclusion”.

Trupanion: the sample-policy page opens a 2019 form by default

Trupanion posts no Washington-specific policy form. Its Washington page links the disclosure and the general “View sample policy” page, which has a state selector.

  • Choose “Washington” and you get a generic 2023 sample, TRU (D) 00001.1 (V01.202309). Eleven other states get the same file: Florida, Maine, Louisiana, Nebraska, Mississippi, Delaware, Maryland, Vermont, Montana, Rhode Island and Hawaii. This form matches the Washington disclosure: it uses the statutory pre-existing definition, sets no fixed waiting periods, has no 18-month look-back, and allows claims within 365 days.
  • Change nothing, and the dropdown shows “Alabama” and the button opens the 2019 form, TRU (D) 00001 (V10.201902). It has a 30-day illness wait, a 5-day injury wait, an 18-month look-back and a 90-day claim deadline: “Injuries that occur through to and including the 5 days following the Policy Enrollment Date are deemed pre-existing Conditions”.

In Washington the 2019 form would break the law: RCW 48.205.050(2)(a) bans accident waiting periods, and RCW 48.205.020(6) and .030(1) require the statutory definition. A careless click can show a Washington buyer outdated terms that conflict with the law. But it is not true that no other terms are available to them.

The page’s script also sends every state it does not list to the 2019 form, Arizona, Texas and New Jersey among them. Arizona and Texas have no pet insurance law, so nothing there forbids the 2019 form’s waits. In New Jersey, from 1 January 2027 the law bans accident waiting periods, while the 2019 form waits 5 days for injuries.

Terms in both forms worth knowing:

  • the premium can change “at any time” on 30 days’ notice. The 2023 form dropped the 2019 limit of one change per 12 months: “We may change Your monthly premium at any time by providing a written notice to You at least 30 days prior to the effective date of the change.”;
  • “Failure or refusal to disclose a complete medical history for Your Pet when requested may result in the denial of Your claim(s) and/or cancellation of Your policy.”;
  • prescription food is paid at 50%, and only for two months.

The Washington disclosure itself raises questions. It says: “For new policyholders, there are no waiting periods, but unless you enroll through the Veterinary Examination Program, there will be a 12 day delay between when you enroll and when your policy becomes effective.” Neither sample mentions this delay. On our reading, 12 days without accident cover sit badly with the ban on accident waiting periods in RCW 48.205.050(2)(a). We found no regulator ruling on it. On price, the disclosure says only “If you move, the cost of your policy may change”. RCW 48.205.040(1)(d) also asks the insurer to say whether premiums rise with the pet’s age or with claims. On our reading, the disclosure falls short of that.

Sources: Trupanion, View sample policy (state selector); 2023 sample, TRU (D) 00001.1 (V01.202309): 3.C on p.8, 5.B on p.11, Def. T on p.20; 2019 sample, TRU (D) 00001 (V10.201902): 3.C on p.8, 9.A on p.14; Insurer Disclosure of Important Policy Provisions, TRU (D) 00012 WA (V01.202309), p.1. Insurer page: Trupanion.

ASPCA and Pumpkin, Washington: a different insurer, already fined by the regulator for incorrect forms

In Washington, ASPCA and Pumpkin policies are written not by Independence American, which our pages list as these brands’ default insurer, but by United States Fire Insurance Company. That is the same insurer as Spot’s in Washington. “Insurance is underwritten by United States Fire Insurance Company (NAIC #21113. Morristown, NJ).”

This is what happens when a regulator does check. In July 2016 Washington’s Office of the Insurance Commissioner (OIC) fined US Fire, as ASPCA’s insurer, $50,000. Half of the fine was suspended as long as the company followed a compliance plan. The violations included incorrect policy forms: “In July 2016, Kreidler fined the company $50,000 for several law violations, including charging customers the wrong rate, selling policies through unlicensed producers, issuing incorrect policy forms”. In 2019 the OIC found that the company had broken that plan: as recently as November 2018, unlicensed producers were still selling its policies. The OIC imposed the remaining $25,000.

ASPCA’s current Washington sample and Pumpkin’s (March 2026) use one US Fire form, PET-P-20030-0124-USFWA-(3), with the state endorsement PET-AE-20060-WA-0918. ASPCA’s text is identical to Spot’s. The form has a 14-day wait for any illness, orthopedic included; knee and ligament conditions count as affecting both sides; and the insurer can cancel for any reason it states, on at least 45 days’ notice.

Both brands’ disclosures say: “Insurance plan premiums will increase as the covered pet gets older. Insurance plan premiums may increase or decrease due to the policyholder’s geographic location. We will not reduce coverage or increase premium due to claims history.” That is not a violation. Washington law requires the insurer to say whether premiums rise with age (RCW 48.205.040(1)(d)) but does not ban the increases. Compare Trupanion above: its Washington disclosure is silent on age and claims.

Sources: ASPCA, Washington Insurer Disclosure of Important Policy Provisions, PET-USFWA-Notice-0124-APHI, p.1 and p.3 of 4; Pumpkin, Notice to Washington Residents, PET-USFWA-Notice-0124-PUMPKIN; Pumpkin, Washington sample policy, March 2026 (PET-SAMPLE-COV-WA-V48_03_26); WA OIC, “Kreidler fines pet insurer $25,000 for failing to fix law violations” (2019, archived copy).

What it looks like for an owner

Nationwide, Pennsylvania. You buy a Modular policy on the 1st. Underwriting approves it and the payment goes through on the 3rd. The wait starts on the 4th and runs 14 days. On the 10th your dog cuts its paw.

  1. As the policy is written, the cut is not covered: the wait is still running.
  2. By the same text, the cut began during the waiting period and became pre-existing. Treatment of it would stay excluded after the wait ends too.
  3. Under Pennsylvania law there can be no waiting period for an accident (§4706(b)(1)). You can challenge the denial by citing the law.

Embrace, Pennsylvania. The policy arrives on the 1st. On the 20th you decide it is not for you, and you have filed no claims. The documents say 15 days, so the deadline seems to have passed. By law you have 30 days from receipt (§4704). Return it within that time and the insurer must refund the full premium.

What to do

  • Ask which form applies in your state and check its edition date. If the edition is older than your state’s law, ask whether the policy you will get has been updated. In Pennsylvania the law has applied since 7 December 2024, and Nationwide’s posted VS-G-15-PA is dated 9-24.
  • Pick your state on the sample-policy page yourself. Trupanion’s selector defaults to “Alabama”, and the button opens the 2019 form.
  • Check the documents against your state’s law. Where there is a law, check three things: is there a waiting period for accidents (in Pennsylvania and Washington there cannot be; in New Jersey, from 2027), how many days you have to return the policy (30 in Pennsylvania), and is there an exam waiver of the waiting period (required in Pennsylvania). The laws are in pet insurance laws by state.
  • Ask in writing before you buy: “Which form and which state endorsement will my policy be issued on? Is there a waiting period for accidents? How many days do I have to return the policy?”
  • If the paper gives less than the law, act on the law. In Pennsylvania, return the policy within 30 days if you have filed no claims. If a claim is denied under a clause that conflicts with the law, cite the section of the law. If that does not help, complain to the regulator: the Pennsylvania Insurance Department, or Washington’s Office of the Insurance Commissioner.
  • In Pennsylvania, plan the waiver exam in advance. The windows differ: MetLife, 7 days before the start (full waiver) or 5 days after (partial); Pumpkin, Spot, ASPCA, from 3 days before the start to 7 days after, with the form within 30 days of the exam; Figo, exam and form within 7 days; Embrace, after the start date, and the record must show no findings at all; Fetch, within the first 15 days. Remember that what the exam finds can become an exclusion.
  • Where there is no law (Arizona, Texas, Illinois), read the whole sample policy. No pet insurance law sets minimums there, and in Arizona and Texas forms are not even filed with the regulator. Exactly what the policy says applies. Find the waiting-period section and check whether it covers accidents. For example, Nationwide’s VS-G-15 (3-26) form has no accident wait, and VS-G-15 (9-24) has one.
  • Find out who the insurer is in your state. For ASPCA and Pumpkin in Washington it is US Fire, not Independence American. The insurer determines the policy form and the record of violations.
  • Why it is hard to leave an insurer once the vet record has an entry is in the pet insurance trap. How to read rate filings where they are public is in how to read a rate filing.

Sources

History

  1. Pennsylvania and Illinois: policy forms can be looked up in SERFF Filing Access again
  2. First published