One cancer, and the same type may not be covered again

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

If your pet has had one of five types of cancer, in most states we checked Pets Best can refuse to pay for the next cancer of the same type anywhere in the body, with one narrow exception. Read literally, the clause can also apply when the first cancer was found and paid for under the policy. Figo’s rule looks only at the time before cover began, but it also has no time limit: a cancer type diagnosed before the policy started or before the waiting period ended is excluded for good, even if the new tumor is unrelated to the old one.

How it works

The usual pre-existing condition exclusion looks at what happened before the policy started or during the waiting period. This is a separate cancer clause. It looks not at a particular tumor but at the type of cancer.

Pets Best. The clause names five types: carcinoma, lymphoma, mast cell tumor, melanoma and sarcoma. After one occurrence, later occurrences of the same type and “related Conditions” are not covered anywhere in the body.

  • The clause has no time limit and is not tied to the policy start date. Its heading is “Prior instances of cancer”, but the policy does not define “prior”. Read literally, the clause can also apply to a cancer first diagnosed and paid for while the pet was insured. The documents do not show how Pets Best applies it in practice.
  • There is one narrow exception. If histopathology shows the first tumor was fully removed, with clean margins and at a stage early enough to rule out spread, a new cancer of the same type in a different location of the body “may be covered”. That is the insurer’s call, not a promise. A recurrence at the same site gets no exception.
  • The clause is not in the policy’s list of exclusions (“What isn’t covered”, 5.A). It sits in the next part, “Factors that could impact coverage” (5.B). If you read only the exclusions, you can miss it.
  • The policy has a renewal protection: a condition the policy covered cannot become pre-existing at renewal. But that sentence is in the definition of a pre-existing condition. The cancer clause is separate, and the protection does not expressly reach it.

Figo. It excludes a cancer type diagnosed at any time before the pet’s Original Start Date or before the end of a waiting period. Unlike Pets Best’s clause, it is not limited to five types. Whether the new cancer is related to the old one does not matter. There is no time limit. Figo’s rule on cured conditions (365 days without symptoms or treatment) lifts only the pre-existing exclusion, not this clause. On the other hand, a cancer type first diagnosed after the waiting period has ended is not excluded by this clause.

Examples

Pets Best, Illinois

Clause 5.B.4 is in Pets Best’s Illinois sample policy (insurer: Independence American, IAIC):

“For any form of carcinoma, lymphoma, mast cell tumor, melanoma, or sarcoma, further occurrences of the same type of cancer, or any related Conditions anywhere on or in the body, are not covered.”

The exception in the same clause:

“If prior incidents of carcinoma, lymphoma, mast cell tumor, melanoma, or sarcoma can be shown via histopathology to be fully removed with clean margins and at a stage early enough to preclude metastasis, subsequent occurrences of the same type of cancer in a different location of the body may be covered.”

The renewal protection is only in the definition of a pre-existing condition (definition T): “A Condition for which coverage is afforded on a policy cannot be considered a Pre-existing Condition on any renewal of the policy.”

The Illinois amendatory endorsement (IAIC-PB10001-AE-IL) changes several provisions, but not 5.B.4. Illinois has no pet insurance law, and we found no other state rule that limits the clause. More on the Illinois page.

Source: Pets Best, Accident and Illness sample policy, IAIC-PB10001-ILL, Illinois, section 5.B.4, p. 7; definition T, p. 14.

Pets Best, New Jersey

The same clause 5.B.4, word for word, on p. 7. The New Jersey sample matches the Arizona one: it is the general IAIC form, not a New Jersey edition.

New Jersey’s pet insurance law (P.L. 2025 c.224) takes effect on 1 January 2027. It says outright that it does not limit exclusions: “Nothing in this act shall in any way prohibit or limit the types of exclusions pet insurers may use in their policies” (C.17:46D-6b). One argument remains. The law bars treating a condition the policy already covered as pre-existing at renewal (the definition in C.17:46D-5), and the policy repeats that rule. If Pets Best denied, at renewal, a recurrence of a cancer it had paid for, an owner could argue that clause 5.B.4 is working as a pre-existing exclusion. That is our inference, not a regulator’s or court’s position: the clause is not labeled that way, and we found no ruling on it. If the clause were treated as a pre-existing exclusion, the insurer would have to prove it applies (C.17:46D-8a). More on the New Jersey page.

Sources: Pets Best, Accident and Illness sample policy, IAIC-PB10001-ILL, New Jersey, section 5.B.4, p. 7; New Jersey P.L. 2025 c.224.

Pets Best, other states

The same clause 5.B.4 is in the Pets Best samples on the insurer’s site for these states. None of the state endorsements changes it.

Where the clause is absent: Pets Best’s California form, IAIC-PBI0001-ILL (02/2023), and the older-format Pets Best forms for Washington and New York, underwritten by a different insurer, American Pet Insurance Company (base form APIC-PBI0001-ILL (12/2015) with state endorsements). None of them has a cancer clause. For Washington, Pets Best’s sample policy page lists only the APIC form. A Washington file under the IAIC name opens by direct link and does contain the clause, but its text matches the general IAIC form. If you are in Washington, ask Pets Best which form you will get.

Figo, Washington

Exclusion 3 in Figo’s Washington policy (the insurer is also IAIC):

“Veterinary Expenses or Treatment for a specific type of cancer if the covered Pet has received a diagnosis of the same type of cancer at any time prior to the Pet’s Original Start Date or prior to the end of any applicable Waiting Period, regardless of whether the subsequent diagnosis of the same type of cancer is related to the prior diagnosis of the same type of cancer.”

The cured-condition rule (Part III Coverage, 2.l, p. 6) lifts only the pre-existing exclusion. It does not apply to exclusion 3.

Washington law does not limit this clause. The law’s definition of a pre-existing condition is narrow: “signs or symptoms directly related to the condition for which a claim is being made” (RCW 48.205.020(6)). Exclusion 3 goes further: it applies “regardless of whether” the new cancer is related to the old one. But the law also says: “Nothing in RCW 48.205.020 shall in any way prohibit or limit the types of exclusions pet insurers may use in their policies” (RCW 48.205.030(2)). The insurer’s burden of proof (RCW 48.205.050(1)) is written only for the pre-existing condition exclusion. Whether it also reaches a separate cancer clause is an open question; that is our inference. Figo’s required Washington disclosure of important provisions (IAIC FPI ML NOTICE 0124 WA) does not name the cancer clause. It lists pre-existing, hereditary and congenital conditions, then says only “Other exclusions apply.” More on the Washington page.

Sources: Figo, policy IAIC FPI POL WA 0724 AI2, Washington, Part IV Exclusions, no. 3, p. 7; Part III Coverage, 2.l, p. 6; Figo, Washington disclosure IAIC FPI ML NOTICE 0124 WA.

Figo, Illinois and other states

Figo’s Illinois policy has the same clause, word for word: it excludes a cancer type diagnosed “at any time prior to the Pet’s Original Start Date or prior to the end of any applicable Waiting Period”. A cancer type first diagnosed after the waiting period has ended is not excluded by this clause. That is the difference from Pets Best.

Source: Figo, policy IAIC FPI POL IL 1025, Illinois, Part IV Exclusions, no. 3.

The same wording is in Figo’s forms for Arizona (IAIC FPI POL AZ 1025), Texas (IAIC FPI POL AI TX 1025), Pennsylvania (IAIC FPI POL PA 0424) and Indiana (IAIC FPI POL AI IN 1025).

What it looks like for an owner

  1. Your dog is insured with Pets Best in Illinois. The vet finds a mast cell tumor and removes it. Pets Best pays for the treatment.
  2. Some time later, a new mast cell tumor appears.
  3. Read literally, clause 5.B.4 lets Pets Best refuse it, wherever it is, along with any “related Conditions”.
  4. There is a chance of cover only if the first tumor’s histopathology showed it was fully removed with clean margins at an early stage, and the new tumor is in a different place. Even then, Pets Best “may” cover it, or may not.
  5. Switching insurers is unlikely to help: for a new insurer, the cancer is already in the record before the policy. At Figo, for example, that cancer type would be excluded for good, whether or not the new case is related to the old one. Why switching is hard is covered in the pet insurance trap.

There are no dollar amounts in this example. The documents we read give no prices for cancer treatment, and we will not make them up.

What to do

  • Before buying Pets Best, ask in writing: does clause 5.B.4 “Prior instances of cancer” apply to a cancer first diagnosed and paid for while the pet is insured? Who decides, and on what records, that a later case “may be covered”?
  • Check which policy form you will get. Search the policy for “Prior instances of cancer” and “same type of cancer”, and look beyond the exclusions list, in the coverage sections too. Pets Best’s IAIC-PB10001-ILL samples for Illinois, Arizona, Texas, Pennsylvania, Florida, New Jersey and Ohio have the clause. We did not find it in the California form or in the APIC forms for Washington and New York.
  • If your pet has had no cancer before the policy, Figo’s cancer clause does not exclude a cancer first diagnosed after the waiting period. We have not compared Figo’s other terms here.
  • If your pet has already had cancer before the policy, Figo excludes that cancer type with no time limit, even for an unrelated new tumor, and its cured-condition rule does not help. If it is one of the five types, Pets Best’s clause 5.B.4 also excludes that type, apart from the narrow clean-margin exception. More in pre-existing conditions.
  • After any tumor is removed, ask for a histopathology report that assesses the margins, and keep it. At Pets Best it is the only route to the exception in clause 5.B.4.
  • If a claim is denied, ask the insurer to name the policy provision in writing. You can complain to your state’s insurance regulator. In New Jersey, from 1 January 2027, you can also cite the renewal protection (see above), though we found no regulator or court ruling that it reaches this clause.

Insurer pages: Pets Best, Figo.

Sources

  • Pets Best, Accident and Illness sample policy, IAIC-PB10001-ILL, Illinois, with endorsements IAIC-PB10001-AE-IL and IAIC-PB10001-PO-AE (06/2026): PDF. Section 5.B.4, p. 7; definition T, p. 14.
  • Pets Best, New Jersey sample, IAIC-PB10001-ILL: PDF. Section 5.B.4, p. 7.
  • Pets Best, IAIC-PB10001-ILL samples for Arizona, Texas, Pennsylvania, Florida and Ohio, section 5.B.4.
  • Pets Best, forms without the clause: California, IAIC-PBI0001-ILL (02/2023); Washington and New York, APIC-PBI0001-ILL (12/2015) with state endorsements. List of samples: Pets Best sample policy page.
  • Figo, policy IAIC FPI POL WA 0724 AI2, Washington: PDF. Part IV Exclusions, no. 3, p. 7; Part III Coverage, 2.l, p. 6. Disclosure IAIC FPI ML NOTICE 0124 WA: PDF.
  • Figo, policy IAIC FPI POL IL 1025, Illinois: DOCX. Part IV Exclusions, no. 3. The same wording is in forms IAIC FPI POL AZ 1025, IAIC FPI POL AI TX 1025, IAIC FPI POL PA 0424 and IAIC FPI POL AI IN 1025.
  • Washington: RCW 48.205, §§48.205.020(6), 48.205.030(2), 48.205.050(1).
  • New Jersey: P.L. 2025 c.224 (N.J.S.A. 17:46D), C.17:46D-5, C.17:46D-6b, C.17:46D-8a; in force from 1 January 2027.

History

  1. First published