You asked, we answered. Here’s all you wanted to know about pet insurance
We asked you, the vets and vet nurses of South Africa, what you want to know about pet insurance, and here it is! The first part of your (many) questions answered…
What are the qualifications of the claims officers, and do vets oversee the claims? We have seen companies decline a claim or only partially cover it, but who actually decides this and how?
MediPet is unique in a way that claims are processed and calculated by either a veterinarian or a vet nurse. Our insurance is only for dogs and cats, so we hire vets. As we are a broker, our clients have a representative assisting them with the underwriters and their claims. This makes all the difference. Clients do not only have someone motivating on their behalf, but someone motivating with qualified animal knowledge. This is something they are hired full-time to do. (As an aside, if ever we need your help with our motivations to have a claim paid, we will reach out to you, as the treating vet.)
The difference in claim processing ensures that we can get cover for the treatment that you, as the vet, choose to implement. We also adapt and change our cover as the veterinary industry and treatments evolve.
All our MediPet claim members are experienced in the veterinary industry, genuinely love animals, and work with the qualified vet team every day. This is unusual in itself as traditionally most claim officers do not have veterinary training. This is true, particularly in large corporates where car, home and business insurance is being sold in a bundle with pet insurance. Processors in these situations usually treat claim based on strict guidelines and they do not actually look at the line items and question why it was given or not. They are not trained or skilled enough to do that. And quite frankly, you should not have to justify your clinical decisions or fall in line with what an insurance company thinks is the right treatment for the animal you are treating!
Are vaccinations and sterilisations mandatory in order for clients to keep their pets insured?
Insurance products, like pet insurance, will not refuse a pet from having coverage if they are not vaccinated or sterilised. There are cases, however, where certain vaccinate diseases will not be covered if the pet has not been vaccinated in accordance with their vet’s protocol.
It works similarly to your car insurance. One would expect that the car insurance company should still pay you out if you are in a car accident, instead of denying your claim because you were late for your last service. Insurance is taken out to cover your pet for lifesaving procedures where the alternative would be devastating.
It is a general term and condition of MediPet’s coverage that pet owners take their pets for annual check-ups, and to act upon their vets’ medical advice. If an insured pet is ill and is not taken to the vet, it may be seen as neglect which could lead to the cancellation of the policy. We also strongly recommend pets are sterilised in South Africa but realise it is a personal decision and the landscape of pet owners is changing. Along with it, their views on sterilisation.
Why is microchipping not compulsory? We have had cases where clients try to commit fraud by taking out insurance for one animal and then trying to claim other pets under the same insurance.
We use the pet’s name, breed and age for our records and base our claims on the invoices received from the vet. If we see that it was for “Dexter” an 11yo Labrador, this is the information we use to validate and process the claim. Microchip numbers are, however, definitely the way forward.
MediPet strongly advises all pets are microchipped, and in fact, we offer it as an added benefit in our Routine Care optional add-ons.
What are waiting periods?
Underwriters take on the future financial risk of something significant and costly occurring down the road based on present, healthy circumstances. Waiting periods are important and standard across the insurance industry to protect against conditions that either already occurred prior to coverage or that would not be otherwise covered. They assist in preventing fraud, reducing unfair risk, and thereby keeping premiums fair and affordable for everyone.
Click here to see what MediPet’s waiting periods are:
What tests will medical aids cover and who decides this?
First, it is essential to understand that there is no such thing as pet medical aid in SA, only pet insurance. See the detailed explanation here: What every vet should know about pet insurance (part one) – LocumBaseVets
Secondly, you should not have to justify to insurance companies which tests you feel are clinically relevant for a sick patient. If you are a registered vet practising in SA and you think that a test should be run, then you should run it. People who spend their days selling car insurance shouldn’t question your clinical decisions. And this is where MediPet is unique. We have a team of vets and nurses who use their knowledge and experience to motivate the underwriters as to why a specific test needed to be run. Generally, elective and experimental procedures are not covered but if you write us a motivation, we can assess and work on getting the claim paid. Together with you, we want to get more dogs and cats covered and uplift the veterinary industry as a whole.
