Pre-existing Conditions Updates - Pet Insurance

Pre-existing conditions.

What is a pre-existing condition?

A pre-existing condition is a condition that first existed or occurred:

prior to the commencement date of your first policy period; or

within any applicable waiting period;

AND

is a condition that you were aware of, or a reasonable person in your circumstances would have been aware of, irrespective of whether the underlying or causative condition has been diagnosed.

A pre-existing condition also includes a related condition or bilateral condition of a pre-existing condition.

Temporary pre-existing condition.

A temporary pre-existing condition is a pet health condition that usually resolves with treatment and is automatically removed as an exclusion from your policy.

If, after any applicable waiting period, your pet has a pre-existing condition that is a temporary condition which hasn't existed, occurred or shown noticeable signs, symptoms or an abnormality in the 18-month period immediately prior to your claim treatment date, it won't be excluded from cover as a pre-existing condition.

Chronic pre-existing condition.

Chronic condition means a long-lasting condition which is recurring or present in your pet over a period greater than three months in total, however the three-month period need not be consecutive.

Chronic conditions may also be intermittent or managed with medication and/or prescription diets with intervals of remission.

Examples include (but aren't limited to):

Chronic or seasonal allergies
Inflammatory bowel disease
Diabetes
Osteoarthritis
Cancer
Some autominnue diseases

If a chronic condition is a pre-existing condition, it will always be excluded from cover. That means, it will never be considered a temporary condition.

Hereditary conditions and congenital conditions.

Hereditary conditions and congenital conditions won't be considered a pre-existing condition if they have not shown noticeable signs, symptoms or an abnormality at any time before the commencement date of the first policy period or during any applicable waiting period.

An important reminder that these exclusions only relate to pre-existing conditions. If your pet requires treatment after the purchase of a pet insurance policy and its waiting period, all conditions outlined in the policy’s Product Disclosure Statement will be eligible for cover for the life of the policy subject to the terms and conditions of your cover.

How do I know if it's a temporary or chronic pre-existing condition?^#

Let’s take a quick look at some examples to help differentiate the difference between a temporary pre-existing condition (which can be removed as an exclusion after the 18 month asymptomatic period), and a chronic pre-existing condition (which will always be excluded if pre-existing).

Bella’s Gastroenteritis.

Before taking out a pet insurance policy, your pet Bella has a case of Gastroenteritis (a tummy upset). The condition is treated and Bella recovers. Following the surprise episode, you decide to purchase a pet insurance policy for Bella to help with future, unexpected Vet visits.

Two years later, Bella has another unrelated case of Gastroenteritis. Can you claim for this condition?

Yes! The Gastroenteritis is considered a temporary condition, given that it resolved with treatment, it’s not on the list of excluded conditions in the policy’s Product Disclosure Statement (PDS) and the two episodes were not related. There was also more than 18 months between each condition, and within that 18 month period, the conditions didn't exist or occur, show noticeable signs, symptoms or an abnormality.

Archie’s Luxating Patella.

You’ve noticed your pet Archie is limping a little on his rear leg. Your Vet diagnoses him with a Luxating Patella (a dislocating kneecap).

15 days ago, you took out pet insurance for Archie, meaning you’re currently mid-way through the policy’s waiting period for this condition. That means treatment for this condition is not covered by your policy given it arose during the applicable waiting period, as outlined in the policy’s Product Disclosure Statement (PDS).

Two years later, Archie requires surgery for the Patella Luxation. Can you claim for this condition?

No. You and your Vet were both aware of this condition during the pet insurance policy’s waiting period, so it’s not eligible for cover (as outlined in the policy’s PDS). Patella luxations are also specifically excluded under the temporary condition definition, so this condition will always be excluded under your policy.

Daisy’s broken leg.

You first got pet insurance for Daisy when she was just 10 weeks old.

Now at age three, Daisy broke her leg, and needs emergency treatment by your Vet. Can you claim for this condition?

Yes! As your selected pet insurance policy provides cover for accidents like broken bones (as outlined in your Product Disclosure Statement (PDS) and the policy’s waiting period has passed, the condition isn’t considered pre-existing (i.e. see definition above), and you’ve renewed your policy continuously each year without a break in cover, you’re able to claim for Daisy’s broken leg.

Note: The examples above are of a general nature and you should refer to the Product Disclosure Statement and Certificate of Insurance for information about conditions covered under your specific level of cover.

Want a pre-existing condition reviewed on your policy?

All temporary pre-existing conditions are automatically removed from your pet insurance policy as an exclusion if your pet hasn’t shown signs or symptoms of that condition for 18 months or more, so there’s nothing more for you to do.

A chronic pre-existing condition is a pet health condition that requires ongoing care or is more prolonged in nature, so if your pet displays one of these conditions prior to the purchase of a pet insurance policy or its’ waiting period, it will never be coverable under the policy.

If you would still like to have a pre-existing condition on your pet insurance policy reviewed, you can do so anytime. Simply complete the pre-existing condition policy review form with your Vet and we will provide an outcome.

Your vet will need to certify and provide veterinary records verifying that the condition is a temporary condition and hasn't existed, occurred or shown noticeable signs, symptoms or an abnormality for a period of 18 months. We'll let you know in writing whether or not the exclusion still applies.

Important information.

text: ^#Depending on your level of cover. Policy T&Cs, limits, exclusions, waiting periods and annual excess may apply.

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Everyday Pet Insurance policies entered into for the first time prior to 17 July 2023 and subsequent renewals of those policies are issued by The Hollard Insurance Company Pty Ltd ABN 78 090 584 473, AFSL 241436 (Hollard), arranged and administered by PetSure (Australia) Pty Ltd ABN 95 075 949 923, AFSL 420183 (PetSure) and promoted and distributed by Hollard’s Authorised Representative (AR) Woolworths Group Limited ABN 88 000 014 675, AR 245476 (Woolworths).

Everyday Pet Insurance policies entered into for the first time on or after 17 July 2023 and subsequent renewals of those policies are issued by PetSure and promoted and distributed by PetSure’s AR, Woolworths.

Any advice provided is general only and does not take into account your individual objectives, financial situation or needs. Please consider the Product Disclosure Statement (PDS) to ensure this product meets your needs before purchasing, or choosing to continue with the product. PDS and Target Market Determination available at insurance.everyday.com.au/pet-insurance.

Taking the pain out of pre-existing conditions.