Filing a pet insurance claim, especially as a first-time policy user, you're likely to encounter at least one of these three surprises: partial coverage, exclusions for pre-existing conditions, and slow reimbursement from your insurer.
According to the American Veterinary Medical Association, 6.4 million pets in the U.S. are insured as of 2026, a remarkable 50% increase from 2020. Although this is only a small fraction of the over 94 million pets in the country, it still shows that a rising number of pet owners are taking the important step to put their pets under insurance coverage.
You've secured the policy because pet healthcare costs can be high, and you don't want to be caught off guard. Unfortunately, filing a pet health insurance claim isn't always straightforward. From reimbursement delays to finding out that the claim will only be paid partially, you're bound for a few unexpected insurance surprises.
What Does Pet Insurance Cover?
Like health insurance for humans, pet insurance covers the medical expenses arising from sudden pet illnesses and accidents. Coverage typically includes diagnosis, surgeries, and prescriptions.
Can I get pet insurance for a pre existing condition?
The short answer is yes. Although pre-existing conditions are usually not covered, depending on the terms and conditions of a policy, coverage can kick in after a certain waiting period. Some insurers will deny coverage if the pre-existing condition is not curable.
How Often Are Pet Insurance Claims Denied?
The biggest surprise any pet parent filing a pet insurance claim would get is total denial of the claim. However, the good news is that claim denials don't happen often, and if it happens to you, it would usually be because of seeking reimbursement for a pre-existing condition that either wasn't covered or whose waiting period hadn't lapsed.
It's also possible for your claim to be rejected if you made a clerical error in the paperwork or didn't submit accurate supporting documents. For example, if you forgot to attach the vet's bill or attached the wrong bill, your insurer will reject the claim and ask that you make the necessary corrections.
The Partial Coverage Surprise
To keep premiums low for customers, many pet insurance companies offer partial coverage plans. During sign-up, you'll typically be required to select a reimbursement percentage, which will have a direct impact on your premiums.
Unfortunately, some policy buyers don't take a keen interest during the sign-up process and miss this important detail. When this happens, you'll inevitably be hit with a major surprise when you claim full reimbursement, only to be told that only funds equal to the reimbursement percentage will be sent to you.
Reimbursements Can Take Time
In the pet insurance industry, policyholders settle the bill at the vet, then seek reimbursement from the insurer. It's standard practice.
Most insurers will reimburse within 10-15 days, but sometimes it can take far longer than you'd like. If your insurer is processing thousands of claims at that period, it's possible to face significant delays.
Avoid Unpleasant Surprises After a Pet Insurance Claim
Filing a pet insurance claim should be a straightforward process -- and it is for most policyholders -- but once in a while, it can pull a surprise. Many of these pet policy challenges are preventable, though. Read between the lines before purchasing a policy so you have a clear picture of what you're signing up for, and choose a reputable insurance provider.
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This article was prepared by an independent contributor and helps us continue to deliver quality news and information.