Pet insurance

How we deal with complaints about insurance for pets and animals

Pet insurance is designed to help people pay for unexpected veterinary bills and related treatment. There are two types of pet insurance policy that we normally deal with complaints about:

Annual policies – these cover conditions that arise during the 12 month policy term (providing cover for each condition for 12 months) and are renewed annually
Lifetime policies – these provide cover for ongoing conditions throughout an animal’s lifetime, as long as the policy is renewed each year

People contact us with a range of complaints about insurance for pets and other animals. This might be because a claim has been rejected, or because premiums have increased at the policy renewal.

When we investigate these complaints, we look at all the facts to decide whether we think your decision was fair.

Types of complaints we see

We normally see complaints where a claim is rejected because of a disagreement about:

the policy wording
pre-existing conditions, or conditions that first became apparent soon after the policy was taken out
time limits on cover for treatment
a bilateral condition – which the insurer treats as a pre-existing condition, or says the 12 month time limit started when the condition was first seen on a different part of the body
equine policies – usually when a horse has been put down, but the decision didn’t comply with British Equine Veterinary Association (BEVA) guidelines

What we look at

When we investigate complaints about pet insurance, we’ll look at the policy wording and any other relevant documentation, such as the policy summary.

Most pet insurance policies contain exclusions and limitations. If we find any that are particularly significant or unusual, we’ll look at what you told the customer when they took the policy out.

We’ll take into account any medical evidence provided by vets – in particular, clinical notes and written submissions.

Read more about what we look at in detail for each complaint type:

Complaints about the policy wording
Complaints involving pre-existing conditions
Time limits on cover for treatment
Bilateral conditions
Complaints about increased premiums
Complaints involving equine policies

Handling a complaint like this

We can only look at complaints that you’ve had a chance to look at first. If a customer complains and you don’t respond within the time limits or they disagree with your response, then they can come to us.

Putting things right

If we decide something’s gone wrong, we’ll consider whether your customer has lost out as a result and what you need to do to put things right. This could mean refunding premiums, or paying all or part of a claim. We may also add interest on top of any compensation we award.

Case studies

Horse is put down without insurer’s consent

We helped Craig after his insurer rejected his claim when his horse was put down.

Pet Insurance

Customer doesn’t disclose pet’s pre-existing medical condition

When Rita tried to claim on her insurance when her dog became sick, her insurer rejected the claim, saying that it was a pre-existing condition. So she asked us to look at the case.