How to Make a Pet Insurance Claim

Anyone who knows you knows that you view your pets as family members. You put as much love into maintaining their well-being as you do with your human children, providing them with healthy food, stimulating toys and medical aid. While these investments can improve your pet’s quality of life, additional insurance can come in handy to help you afford the best care for your pets should they get sick or injured — or recoup unexpected costs relating to this. 

1st for Women knows how you feel and wants to help you understand how to place a Pet Insurance claim when the time comes.

The importance of understanding your policy

Pet Insurance is something that allows you to claim the cost of specific veterinary procedures or treatment back from an insurer. In other words, you pay the service provider (usually the vet) and then claim the money back from your insurer. If you have some form of insurance or are considering taking it out, you can pat yourself on the back for being part of the 6% of the South African population who've taken this critical step to protect their finances while having a pet.

Negotiating a claim after your car is stolen or someone snatches your handbag can be stressful. However, these stolen items are merely tools that help you live your life—having to submit a claim concerning an injured or ill pet will naturally be more stressful. You might find yourself accountable for huge costs, and having to deal with this can be financially taxing when you're already emotionally concerned about your pet's recovery.

For this reason, getting affordable Pet Insurance and then forgetting about it until you want to make a claim is a bad idea. We recommend familiarising yourself with the details of your chosen cover before you need to use it — by examining its inclusions, exclusions, waiting periods and terms and conditions. Your next step will be familiarising yourself with the claims process.

4 easy steps to file a Pet Insurance claim

To make your Pet Insurance claim process as simple and painless as possible when it does happen, here's how you should organise yourself in advance.

1. Create a file

When you take out medical aid, your insurer collects important details on you to create a medical record of your care. This is updated to include treatments and procedures you've undergone, medication you've taken as well as details on the dates, costs and paperwork involved.

Creating a document like this for your pet will help your insurer get an up-to-date summary of your pet's status when you claim, so they can process it more accurately and quickly. Important details include your pet's medical records and history, your insurance policy number, proof of payment for the procedure or treatment they underwent and detailed and itemised invoices with relevant billing codes.

2. Check your cover

Before making a claim, you need to know if it will be covered or not or if terms and conditions might apply. For example, if you notice your dog has developed a mild limp that you suspect is age-related, you could be subject to a 30-day waiting period to access a diagnostic benefit and confirm this – and if your dog was limping before you took out the Pet Insurance policy, it might not be covered at all.

3. Complete the paperwork

Notify your insurer of your proposed claim. They will be able to advise you on how to proceed. Once you have all your information and know that your claim falls under your coverage, you can go ahead and make the claim, completing the provided form in as much detail as possible. When doing this, take your time and make sure you have all the supportive paperwork handy and that this paperwork includes the correct treatment or billing codes. Ensure that every required section is completed legibly and correctly, avoiding spelling or numerical errors – and keep a copy of it. In addition, make sure you have a digital copy of any relevant bills or payment invoices before submitting it to the provided email address.

Remember that even an accidental omission or error can result in your claim being rejected, so be as accurate and careful as possible.

4. Follow up

Once your claim is lodged, make a note of the claim processing number you'll be provided with and the turnaround time for feedback given. Follow up if this time lapses without you getting a response.

What happens when you submit a Pet Insurance claim

Typically it takes between 7 - 10 working days to process a Pet Insurance claim in South Africa. On submission of your claim, you will be given a reference number. Make sure that you keep this number handy. You can usually track this online to see how it’s progressing. Once the claim has been decided, you will be notified of the outcome: approval or rejection. If it is approved, the insurer will calculate the payment due to you and pay it directly into your bank account.

What to do if your Pet insurance claim is denied or rejected

What happens if your claim is rejected or denied? Before you panic, realise that in many cases, this might be an automatic rejection due to missing details or paperwork. In this case, your insurer will let you know how to resolve the issue. A common cause for a claim rejection is when customers scan a print invoice from a vet or animal hospital and email this to their insurer — not realising the scanned image is unclear and illegible. In this case, you can solve the issue by requesting a digital copy of your invoice from the vet or animal hospital. 

A claim might also get rejected because you simply aren't covered for it, indicating that you need to revisit your cover.

Get a Pet Insurance quote

As you can see, Pet Insurance can offer you valuable peace of mind and keep both your wallet and fur child healthy for years to come. A trained 1st for Women consultant is always on hand to help you learn more about getting coverage or answer any questions you have about placing a claim. To get started, get a Pet Insurance quote today.