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Pet insurance can help offset the cost of unexpected vet bills. But because most plans reimburse you after the visit, you’ll typically need to pay the bill upfront and submit a claim for reimbursement later.
Filing a claim is generally a simple process: you fill out a form online or through an app, attach a receipt and your pet's medical records, and wait. If everything checks out, the money could land in your account within a few days.
Even so, there are a few common missteps that can derail your claim. Here's a step-by-step guide to keep things running smoothly.
Key Takeaways
- Pet insurance policies usually work by reimbursement: you pay first and insurance pays you back later.
- Most claims require itemized invoices and medical records from the veterinarian who treated your pet
- From the time you submit your claim to when you receive reimbursement, the process can take between two and 30 days.
How do pet insurance claims work?
Unlike human health insurance, most pet insurance plans require you to pay the full cost of your dog or cat's treatment first and then submit a claim to your insurer. If the claim goes through without any hiccups, the reimbursement turnaround is usually quick — most people get a direct deposit or a check in the mail within a few days.
How to file a pet insurance claim
1. Take your pet to a licensed veterinarian
The first (and most critical) step is to visit a licensed veterinarian. Pet insurance has no network requirements, which means you can visit any vet at an emergency clinic or hospital in the United States (and sometimes Canada). However, if your pet insurance company allows direct payments to vets, and you want to use this benefit, your options are limited to pre-authorized vets or hospitals.
2. Be prepared to pay 100% of the bill first
When you go to a regular doctor, you usually pay the coinsurance, or "copay," and the doctor settles the rest of the bill with the insurance company. Pet insurance works differently. After paying the bill, you — not the vet — handle the claims process with the insurance company.
3. Have a look at your policy's fine print
In general, most companies accept claims within 90 to 180 days of the treatment date, so be sure to submit your reimbursement request during your policy's claims window. Another detail to remember is that pet insurance won't accept a claim if you haven't settled the bill at the vet; the invoice must show a balance of $0 or "paid in full".
4. Round up the necessary documents and submit your claim
Having the following paperwork ready can minimize unnecessary back-and-forth:
- Your veterinarian's contact info
- An itemized invoice
- Proof of payment (like a receipt)
- The veterinary diagnosis
- Test results, like bloodwork or X-rays
If this is your first claim with that company, the representative handling your case may also request your pet's full medical records.
Once you have everything, you can fill out the claim form online or on your phone. You will be asked to explain the incident, your pet's treatment and for supporting documents and medical records. This part typically takes just a few minutes.
5. Stay tuned for any follow-up questions
After you submit your claim, keep an eye on your notifications. It can take anywhere from two to 30 days for an insurer to process a claim, and the person who is handling your claim may reach out with questions during this time.
6. Hang tight for the refund
If the insurer approves your claim, the direct deposit or check should be on its way within a few days. How much money you get depends on the policy's deductible, reimbursement rate and annual coverage limit.
Let's say your insurance plan has an 80% reimbursement rate, a $10,000 annual coverage cap and a $250 deductible. If you submit your first claim for a $1,000 ER trip after your dog ate one too many chicken bones, and the claim is approved, insurance would reimburse you $600, 80% of the $750 remaining after the deductible is applied.
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FAQ
How long do pet insurance claims take?
The time it takes to process a pet insurance claim varies by company, but can take anywhere from two to 30 days.
Can my vet submit the claim for me?
Although some companies allow veterinarians to submit claims on behalf of clients, most insurers require the pet owner to submit the claim themselves.
Is there a deadline for filing pet insurance claims?
Yes, most claims must be filed within a specific time frame in order to be considered. The deadline varies by company, but it is usually between 90 and 180 days. After that, policyholders aren't entitled to a reimbursement, even if the expense qualified for coverage.
What are common reasons for claim denials?
Pet insurance companies typically deny claims for pre-existing conditions or illnesses that came up during the policy waiting period. Insurers can also deny claims if you're missing a document or if you reached the policy's coverage limit.
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