Pet insurance provides a financial safety net if your four-legged companion gets sick or injured. It allows you to give your dog or cat the medical care they need without putting a financial strain on your wallet by filing a claim for reimbursement after the vet visit.
But what happens next? How does the claims process work and when can you expect to get your money back? This step-by-step guide will teach you how to file a pet insurance claim to help make an already stressful ordeal a whole lot easier.
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Here’s what you generally need to include when filing a pet insurance claim:
Once you have all the necessary documents, it’s time to file a pet insurance claim. While the specific instructions will vary by provider, here are the general steps you need to follow.
Visit your provider’s website or mobile app to check your policy documents and see if you are covered for the claim you want to file. Depending on the insurer, you might be able to file your claim entirely online or you may need to give them a call to start the process.
Some providers require you to download and print out a pet insurance claim form, while others use digital forms that you can submit online, via email, or directly through your account portal. For instance, to file a claim with Nationwide Pet Insurance, you’d go directly to the Pet Account Access Page, and to file a claim with Embrace Pet Insurance, you’d log into MyEmbrace.
The information you’ll be asked to supply will vary based on the pet insurance claim form, but you’ll most likely need to provide the following details:
*If you’ve never filed a claim with your pet insurance provider before, they may request to see your pet’s medical history leading up to the date of the incident to confirm your claim is unrelated to a pre-existing condition.
Remember that each insurance company is unique in terms of the information they require to process claims. For example, to file a claim with Lemonade Pet Insurance, you will be asked to submit a short video explaining what your pet was treated for, what happened during the vet visit, and any other relevant details.
Confirm which supporting documents you need to submit along with your pet insurance claim. Some examples might include a bill of service, invoice or quote, receipts of payment, and signed medical records.
Your provider may also request the SOAP transcript, or a written report by the attending vet that provides a detailed account of the treatment your pet received. The SOAP notes are often included with your medical bill, but you can always request them from your vet at the end of your appointment.
Some pet insurance companies allow you to digitally upload photos of these documents directly from your smartphone, while others request they be scanned and sent my email, fax, or snail mail.
Confirm all of the information you filled out is complete and without error, then double check the requested documentation to ensure it is included. Finally, once you verify that everything is in order, submit the claim to your insurance provider. Once you've submitted your paperwork, it’s a good idea to keep copies of all your documents on hand until the claim has been paid.
There are certain steps you can take in order to make sure the pet insurance claims process goes smoothly, so you can get repaid sooner rather than later:
Verify that you’ve followed the pet insurance claim instructions to the T so you can avoid delays caused by skipping steps or missing information.
It is in your best interest to get the ball rolling as soon as possible, especially for first-time filers whose pets will require a medical history review. Be mindful of your provider’s claim expiration window, or the amount of time you have to file a claim after an incident occurs. For most companies, the window ranges between 60 and 270 days.
Regardless of whether you are submitting a pet insurance claim for the first or fifth time, you may need to include a copy of your pet’s medical records. Your provider might request this from the vet directly, but saving them a step could prevent any administrative delays at the front desk.
If you notice your claim submission is pending or under review, call your insurance provider to find out what the hold-up is and how to move the claim along. This will help you keep track of the progress and promptly address any issues they may have, which typically relate to missing or incomplete details. Promptly provide them and ask how long you can expect to wait for reimbursement.
If they determine they do need information from your veterinarian, give your vet office a call to alert them to the situation. Let them know your pet is a patient there and that your insurance company is requesting information from their last visit. If they don’t send it over by the end of day, follow up with a reminder in 24 to 48 hours.
If it’s an option with your insurance provider, be sure to enroll in direct deposit so you can get your reimbursement sooner. Rather than waiting for a check in the mail, this payout method allows you to have access to your money within a few days of your pet insurance claim being approved.
To ensure you’re satisfied with the outcome of your pet insurance claim, it’s a good idea to re-familiarize yourself with the specific details of your policy. If you don’t know your exact policy terms, you might be surprised by the amount insurance agrees to repay you, since only a few companies will cover 100% of veterinary bills and most require you to pay a deductible before your pet insurance coverage starts to kick in.
That said, here are a few things to keep in mind when filing a pet insurance claim and how you can expect your plan to work for you:
When you file a pet insurance claim, a claims adjuster will review your submission and determine whether insurance coverage applies and in what amount. However, if you're not happy with the payout sum you were awarded, or your claim is rejected altogether, you can try to appeal the verdict.
Look for a section titled "Claim Review" or "Appeal" within your policy’s fine print and follow the guidelines for the appeal process. You can usually find these instructions on your provider’s website, as well. If they find your reimbursement amount to be fair and you’re still not satisfied, you can file a complaint with the insurance department in your state. These agencies are tasked with policing insurance companies and keeping track of complaint patterns to protect consumers.
You can use pet insurance to cover the costs of treating unexpected illnesses and injuries but since plans vary in what they cover, it is very important to understand what is eligible for coverage by reading the details of your pet insurance policy. Be sure to also read the fine print so you didn’t miss anything in the exclusions and restrictions.
The time it takes to receive your reimbursement will differ depending on the insurer but in general, insurers process claims in five to 14 days, as long as you submit all necessary documentation. Call your pet insurance company if you'd want to find out when to expect your payout. Depending on the provider, you might be able to track your claim online
Insurance companies may reject pet insurance claims for a number of reasons. Most frequently, it's because the condition is regarded as pre-existing. As mentioned before, if this happens, you have the option to challenge the denial by filing an appeal.
Even if your four-legged friend has a pre-existing condition, you can still get pet insurance and it will cover ailments not related to the pre-existing condition. Use Pawlicy Advisor to compare different pet insurance plans side by side and select the best insurance provider for your pet.
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Kari Steere is a licensed P&C insurance agent in all 50 states and has focused entirely on pet insurance since 2019. As an animal lover with a rescued Terrier named Barry, when she's not helping pet owners find the perfect plan on Pawlicy Advisor, she runs a ranch in Oregon and rehabilitates any animals that come across her path.