9. For any cost of spaying, or partial cost of any treatment that includes ovarian hysterectomy as a preventative, or treatment solution for any illness , including (but not limited to) false pregnancy, or mammary tumours. 10. Preventative or elective treatments , routine examinations and treatment including but not limited to :
not continue to pay as a preventative measure to stop the stones re- occurring. We will pay you for your vets recommended treatment for b ehavioural illness which could not have been avoided by training or medical intervention. Behavioural modification treatment to be carried out only after pre- approval and carried out by a member of approved behavioural training body as listed on page 3. Fees for putting your pet to sleep (Euthanasia) - It is a condition of this policy that we provide cover or benefit in respect of Euthanasia up to a maximum of £100 and only if it is recommended by your vet to alleviate incurable and inhumane suffering. This insurance also extends to cover your pet whilst temporarily located within a member state of EU but only for a maximum stay of 30 days during the policy period for 365Flex £2,500, 365Flex £5,000, LifetimeFlex £2,000 and LifetimeFlex £4,000 and 180 days under LifetimeFlex £6,000, LifetimeFlex £8,000, LifetimeFlex £10,000 and
24. Every claim will be reviewed by an internal pet claims assessor and compared to charges for the same or similar treatment within the same area to ensure that the treatment and veterinary fees are reasonable, necessary, essential, and not excessive. 25. Any charge for surgical equipment that can be used more than once. 26. Any fee charged by your vet to complete the claim submission or any ancillary administration fees for example dispensing fees, late payment fees, claim completion fees, administration referral fees to specialist vets, or referral fees and x-ray referral fees. 27. Prescription foods or diets of any type including obesity and weight control prescription foods except prescription food subject to a maximum of £100 to prevent the formation of bladder stones and crystals in urine where we will pay the difference above normal feeding costs. 28. Nutritional supplements and vitamins unless prescribed by a vet to take the place of medication and if they have a proven effect upon an injury or illness or something directly caused by an injury or illness . 29. Any treatment administered outside the period of insurance . 30. Fees for unapproved alternative medicine or complementary medicine (including but not limited to pulsed magnetic field therapy, matrix energy field therapy, the Bowen technique, Reiki massage, and faith healing). 31. The cost of any treatment or complementary therapy connected to or resulting from organ transplants and fitting full or partial artificial limbs (prosthesis) with the exception of costs relating to replacement hip, elbow and or knee joints including pre and post- operative care. 32. The cost of any treatment , or issues arising from treatment , that you choose to have carried out that is not directly related to an injury or illness , including cosmetic dentistry or surgery. 33. Any overseas treatment costs where the journey abroad was specifically made to obtain treatment or where the vet confirms treatment can be delayed safely until your return home. 34. Complementary treatments that are not carried out under the direction of a vet or listed therapist and previously authorised by us . 35. The cost of routine or investigative tests or diagnostic procedures, unless these are being undertaken specifically to diagnose an injury or illness due to specific existing symptoms or clinical signs and where such a diagnosis will potentially alter the course of treatment . 36. The cost of any procedures involved in the diagnosis of an injury or illness that are carried out again when your pet is referred to another vet . 37. The cost of routine blood tests including blood tests carried out before surgery, or before anaesthetic for surgery or routine blood tests before any other procedure if your pet is less than eight years old. Unless there is something in your pet’s medical history to suggest your pet’s health may be at risk from the anaesthetic, surgery, or procedure. 38. Fees resulting from an injury or illness that is excluded on your policy schedule. 39. The cost of dentistry except as a result of an accident unless your pet has had at least one dental check with your vet in the previous 12 month period and all treatments recommended by your vet have been carried out at your own expense.
Section 1: Veterinary fees (treatment to your pet) What is covered?
Cover level - 365Flex We will pay you for charges made for treatment carried out by a vet. Cover is provided for an accident, illness, or injury occurring to your pet, subject to the policy vet fees limit shown on your policy schedule. The limit of cover, is on a per accident, illness or injury basis and is for a period of 12 months from the date that the incident is first noted. The fixed excess and variable excess are on a per incident , per period of insurance basis. Example of how to calculate the amount you will have to pay in the event of a claim. A valid claim arises for a dog’s veterinary fees totalling £300.00 Amount Claimed £300 Less Fixed Excess £100 £200 Less Variable Excess 10% = £20 £180 Total Excess paid by you £120 Total paid by us £180 Cover level - LifetimeFlex – All covers The cover is provided for an accident , illness , or injury occurring to y our pet , subject to the limit of cover shown on your policy schedule for each period of insurance to cover all injuries or illness from the one annual policy limit. The fixed excess and variable excess are on a per incident , per period of insurance basis. Cover is continuous for each separate illness or injury up to the limit overall of the policy for the period of insurance , subject to cover still being in force and relevant premiums having been paid. Treatment in respect of any illness or injury can continue into the next period of insurance . Continuous treatment is subject to the policy remaining in force, being continuously renewed at each anniversary and premiums paid up to date. We cover fees for any alternative or complementary medicine which the vet recommends and as approved by us , up to the limit shown in the table of benefits including up to ten sessions of hydrotherapy provided by hydrotherapy pool operators who are members of the CHA (Canine Hydrotherapy Association ) or NARCH (National Association of Registered Canine Hydro-therapists ). Dental (all levels of cover) - we will pay fees for dental treatment as a result of an accident and subject to evidence of yearly dental check-ups where any work recommended is carried out at your own expense we will also cover dental treatment as a result of illness . We will contribute to the cost of your pet’s prescription food, up to a maximum of £100 per period of insurance as long as it is prescribed by your vet and can only be bought from a veterinary surgery or online pharmacy and it is to dissolve bladder stones or crystals in urine and for no other purpose. We will not be liable for any other dietary costs under this policy . The maximum that we will pay for special diet is £100 for up to 60 days per period of insurance . Please note any special diet payment for bladder stones or crystals in urine will cease once these are dissolved. We will
i. Killing and controlling fleas. ii. Routine spaying or castration. iii. Whelping or kittening. iv. Routine removal of dewclaws. v. Routine worming. vi. Routine blood tests.
vii. Any treatment in connection with pregnancy or parturition. viii. Or any cost as a result of failure to carry out these procedures. 11. We exclude all costs for elective spay or castration, and in situations where the spay or castrate are in order to prevent future medical or behavioural issues of any sort. Cover will be provided when your pet is suffering an immediate and critical medical condition and the spay or castrate is essential and necessary for the treatment of that condition. 12. Any claim or treatment for cryptorchidism (retained testicle(s)) unless your pet was under 12 weeks of age at the start of the policy. 13. The cost of bathing, grooming or de-matting your pet unless a vet confirms only a vet or a member of a veterinary practice can carry out these activities. 14. Behavioural problems and training unless caused as a direct result of an insured incident occurring during the period of insurance . 15. The cost of spay or castrate as a treatment of a behavioural condition. 16. Sex hormonal problems unless directly resulting from a valid claim. 17. Any cost of pheromone products, including DAP diffusers and Feliway and/or similar feline facial pheromone products used in either a spray or an electric diffuser format unless pre-approved as part of a behavioural program for a maximum period of six months; 18. The cost of any treatment outside normal surgery hours except for treatment that a vet considers cannot wait until normal surgery hours (necessary treatment ) because it would seriously endanger your pet’s health. The vet that treated your pet must also confirm this in writing when, your veterinary claim is submitted for necessary treatment outside of normal hours the additional charge is limited to a maximum of £150. 19. Non-essential hospitalisation and/or ambulance charges and/or house calls unless the vet declares that to move your pet would seriously endanger its life. 20. Travelling expenses incurred by your vet unless the vet deems that to move your pet would seriously endanger its health. 21. Any charges greater than £100 in respect of euthanasia even in the case of your vet putting your pet to sleep to alleviate incurable and inhumane suffering following an accident or illness . 22. Any charges in respect of euthanasia in the event that this was caused by a pre-existing condition or condition not covered by the insurance. 23. Any claim for any form of housing, cage, or bedding needed for the treatment or wellbeing of your pet.
LifetimeFlex £12,000. What is not covered? 1. Policy excess, this is shown on your policy schedule . i.
The fixed excess, which is a fixed amount payable once per injury or illness per period of insurance , each separate injury , or illness not resulting from the same incident will require a separate fixed excess . Depending on the age of your pet , or if you choose it, there may also be a variable excess - this will be detailed in your policy schedule . If treatment is received at the same time for a number of injuries or illnesses , including treatment carried out under one anaesthetic. A fixed excess will apply and depending upon the age of your pet or if chosen, a variable excess will also apply to the treatment received for each injury or illness . Where treatmen t for different, injuries or illnesses are carried out at the same time and the cost of treatment cannot be identified. The cost of treatment will be split equally between each injury or illness and the fixed excess and depending upon the age, breed of your pet or if chosen, a variable excess applied to each part.
i.
i.
i.
2. For 365Flex policies, any treatment where the policy limit per injury or illness has been used up. 3. For 365Flex policies, any treatment more than 12 months from the date that the injury or illness has been first noted by you or your vet. 4. For all LifetimeFlex policies, any treatment more than the policy limit shown on the policy schedule for all incidents in the period of Insurance. 5. Any treatment after the policy has ended. 6. Any illness arising prior to or during the first 14 days of the inception date of the insurance or pre-existing condition. 7. Any accident or injury arising prior to or during the first 24 hours of the inception date of the insurance or pre-existing condition. 8. More than 10 hydrotherapy sessions per illness or injury, or hydrotherapy as an aid to weight loss.
8
9
Made with FlippingBook - professional solution for displaying marketing and sales documents online