How to File a Pet Insurance Claim: A Step-by-Step Guide
Pet insurance can help reduce the cost of unexpected pet bills. But because most plans reimburse you after the visit, you’ll usually need to pay the bill upfront and file a claim for reimbursement later.
Filing a claim is usually a simple process: you fill out a form online or through an app, attach a receipt and your pet’s medical records, and wait. If all goes well, the money can be in your account within a few days.
However, there are a few common steps that could affect your claim. Here’s a step-by-step guide to keep things running smoothly.
Key Takeaways
- Pet insurance policies usually work on a reimbursement basis: you pay first and the insurer pays you later.
- Most claims require written invoices and medical records from the veterinarian who treated your pet.
- From the time you submit your application to the time you receive your refund, the process can take between two and 30 days.
How do pet insurance claims work?
In contrast of a person health insurance, most pet insurance plans require you to pay the full cost of your dog or cat’s treatment first and then submit a claim to your insurer. If the claim goes through without a hitch, getting a refund is usually quick – most people get a direct deposit or check in the mail within a few days.
How to apply for pet insurance
1. Take your pet to a licensed veterinarian
The first (and most critical) step is to visit a licensed veterinarian. Pet insurance has no network requirements, which means you can visit any veterinarian, emergency clinic or hospital in the United States (and sometimes Canada). However, if your pet insurance company allows direct payments to veterinarians, and you want to use this benefit, your options are limited to pre-approved veterinarians or hospitals.
2. Be prepared to pay 100% of the debt first
When you go to a regular doctor, you usually pay coinsurance, or “copay,” and the doctor pays the entire bill with the insurance company. Pet insurance works differently. After paying the bill, you – not the vet – manage the claims process with the insurance company.
3. Check the fine print of your policy
Generally, most companies accept claims within 90 to 180 days of the date of treatment, so be sure to submit your reimbursement request within your policy’s claims window. Another detail to remember is that pet insurance will not accept a claim if you have not paid the bill to the vet; the invoice must show a balance of $0 or “paid in full”.
4. Collect the required documents and submit your application
Preparing the following paperwork can reduce unnecessary back and forth:
- Your veterinarian’s contact information
- Selected invoice
- Proof of payment (such as a receipt)
- Veterinary diagnosis
- Test results, such as blood or X-rays
If this is your first claim with that company, the representative handling your case may also request your pet’s medical records.
Once you have everything, you can fill out the application form online or over your phone. You will be asked to describe the incident, your pet’s treatment and supporting documentation and medical records. This part usually only takes a few minutes.
5. Stay tuned for any follow-up questions
After submitting your claim, keep an eye on your notifications. It can take anywhere from two to 30 days for the insurer to process the claim, and your claim handler may be in touch with questions during this time.
6. Wait for a while to get a refund
If the insurer approves your claim, a direct deposit or check should be available within a few days. How much you get depends on the deductible, the rate of return and the annual performance limit.
Let’s say your insurance plan has an 80% reimbursement rate, a $10,000 annual cap and a $250 deductible. If you submit your first claim for a $1,000 ER trip after your dog ate one too many chicken bones, and the claim is approved, the insurance will reimburse you $600, 80% of the remaining $750 after the deductible is applied.
FAQ
How long do pet insurance applications take?
The time it takes to process a pet insurance claim varies by company, but it can take anywhere from two to 30 days.
Can my vet apply for me?
Although some companies allow veterinarians to submit claims on behalf of clients, most insurers require the pet owner to submit the claim themselves.
Is there a deadline for filing pet insurance claims?
Yes, most claims must be filed within a certain time frame to be considered. The deadline varies by company, but is usually between 90 and 180 days. After that, policyholders are not entitled to a refund, even if the expenses are eligible for reimbursement.
What are the common reasons for application rejections?
Pet insurance companies often deny claims for pre-existing conditions or illnesses that developed during the policy waiting period. Insurers may also deny claims if you are missing a document or if you have reached the policy’s coverage limit.
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