Filing a claim
How a claim actually works
We examine and treat first
Your animal is examined and treated based on what it needs, in the order that is clinically right, entirely separately from any conversation about insurance.
We complete the claim form
Ask at the desk and we will fill in the clinical side of almost any insurer's claim form, usually within two working days of you asking.
Most policies reimburse you
Most pet insurance works by reimbursement: you pay us on the day, submit the paperwork, and your insurer pays you back. That means payment here is normally due at the time of treatment, whether or not you are insured.
Direct settlement for large claims
For a large bill, we will contact your insurer directly where they support it and discuss settling the claim with us rather than with you, so a large surgery does not have to sit on a credit card while the paperwork clears.
We tell you what we actually think
Before a procedure, we will tell you honestly whether we think it is likely to be covered — and just as importantly, we will tell you when we are not sure, rather than guess in your favour to make things easier in the moment.
Read the policy, not just the leaflet
What insurance typically does not cover
Pre-existing conditions
Almost every policy excludes a condition your animal already had, or already showed signs of, before the policy started or before a waiting period ended. This is the single most common reason a claim is refused, and it is worth reading your policy's own definition of pre-existing before you need to rely on it.
Waiting periods
Most policies will not pay out on anything, including accidents, in the first few days after you take them out, and some conditions carry a longer waiting period again. Buying a policy the week before a scheduled surgery is unlikely to help pay for it.
Routine and preventive care
Vaccinations, wellness examinations, parasite prevention and neutering are excluded from almost every insurance policy as a matter of course — that is what our wellness plans exist for instead. See /wellness-plans.html for how those work, and why they are not a substitute for insurance either.
Cosmetic and elective procedures
Anything done by choice rather than clinical necessity is typically excluded, and exactly where that line falls is occasionally a genuine judgement call worth having in writing before treatment rather than after.
A lifetime or per-condition payout limit
Many policies cap what they will pay for a single condition, either per year or for the animal's whole life. A chronic condition can eventually exceed that limit, at which point the remaining cost reverts to you regardless of how the earlier claims were handled.
Why we will not guess in your favour
A wrong guess told kindly is still a wrong guess
It would cost us nothing today to tell every worried owner that a procedure is almost certainly covered. We do not do it, because the bill that arrives if we were wrong is yours, not ours.
If we are not certain, we say so, and we suggest you call your insurer directly before you decide anything. We do not name or recommend any particular insurer, and we work exactly the same way with a claim regardless of who underwrites it.
A normal conversation, not an awkward one
If you cannot afford the treatment
Tell us, plainly. It comes up most weeks, and nothing about saying so changes how your animal is treated in that appointment.
Tell us before you decide anything
It is a normal conversation and we have it most weeks. Saying so early very often changes what we recommend next, and it never changes how your animal is examined that day.
A staged treatment plan
Where it is clinically safe to do so, we can split necessary treatment into stages across several visits and several paydays rather than one large bill on one day.
A cheaper, clinically acceptable plan
There is very often a less expensive way to reach an acceptable outcome, and where there is, we will set out both options and be honest about exactly what the cheaper one gives up.
A written prescription for elsewhere
Ask, and we will write a prescription you can fill anywhere that is cheaper for you, including for ongoing medication, for the standard $25 prescription fee and no pressure to fill it here.
What does not help anybody
Waiting and saying nothing, hoping it resolves on its own, is the one path that tends to make both the animal's outcome and the eventual bill worse. Whatever the honest number is, we would rather tell you early.
Questions
Insurance & payment — the questions we are asked most
Do you accept my pet insurance?
We work with claims from any insurer — we are not tied to one provider and we do not sell insurance ourselves. Bring your policy details and we will complete the paperwork regardless of who you are insured with.
Do I have to pay upfront if my pet is insured?
Usually, yes. Most policies reimburse you rather than paying us directly, so payment is normally due on the day of treatment. For a large claim, ask about direct settlement — we can sometimes arrange for your insurer to pay us instead.
Will you tell me if something is covered before I agree to it?
We will tell you what we honestly think, including when we are not sure. We will never promise that a policy covers something without having seen confirmation, because the risk of being wrong is yours to carry, not ours.
What if my claim is refused?
Ask us for a copy of everything we submitted and query the refusal with your insurer directly — a refusal is sometimes a paperwork issue rather than a genuine exclusion. We are glad to resend or clarify anything the insurer asks for.
Is a wellness plan a form of insurance?
No. A wellness plan prepays routine, predictable care; insurance pays out against the unpredictable. See /wellness-plans.html for exactly what a plan does and does not cover — the two are not interchangeable, and a lot of owners benefit from having both.
What if I cannot afford a recommended treatment at all?
Tell us before you decide anything. There is very often a staged plan or a less expensive, clinically acceptable option, and we would rather set both out honestly than have you go without care because you assumed there was only one price.
Do you charge extra for completing insurance paperwork?
No. Completing a claim form is free, whoever your insurer is and whatever the outcome of the claim turns out to be.
Do you require payment in full before my animal goes home?
For most routine visits, yes, at the time of the appointment. For a staged treatment plan agreed in advance, payment follows the agreed schedule instead — ask at the estimate stage if a staged plan would help.
Ask before you worry
Talk to us about cost, at any stage
Before a procedure, during a claim, or if a bill has landed larger than you expected — call the desk and we will talk through the honest options rather than let you sit with it alone.