Pet insurance is as complex as healthcare insurance for people and, in some instances, even more confusing.  While the Affordable Care Act (“ACA”) was enacted, in part, to set minimum coverage standards for healthcare insurance for people, pet insurance remains largely unregulated.  Because pets are considered “property,” pet insurance is considered a type of property and casualty insurance.  There are no (obvious) regulations pertaining specifically to pet insurance in New Jersey.

In the past decade, the number of pet healthcare insurers has increased significantly, but so has the complexity of insurance plans.  If you are in the market to purchase pet insurance, you must look beyond the price.  Examples of questions you might ask before purchasing pet healthcare insurance are:

  • How does the plan work – do you pay costs and then apply for reimbursement?
  • Is there an annual deductible?
  • Is there a co-pay?
  • Can the insurer drop your pet’s coverage for excessive claims or age?
  • Can your rates increase at renewal if your pet is diagnosed with a chronic disease?
  • Will the insurance cover pre-existing conditions?
  • Is there a waiting period before the insurance takes affect?
  • Does the policy place caps on claims annually?
  • Does the policy place lifetime caps on claims?
  • Are veterinarian office fees covered?
  • Are reimbursements based on what your pet’s veterinarian charges or is there some other basis, such as “reasonable charge” for services provided?
  • Are spay/neuter procedures covered?
  • Are there any policy exclusions for your specific pet?  (Such as exclusions for certain breeds of dogs that are known to be predisposed to disease.)

If you are in the market for pet insurance and you do not understand the different coverage options and exclusions, there are many sources for customer assistance.  Quite a few internet websites and consumer organizations, such as ConsumerReports, offer comparisons of the various policies available.  In addition, with pet insurance costing thousands of dollars over the course of a pet’s life, it may be worth consulting with an attorney to review the terms and conditions of a policy before purchasing it.

Finally, if you have already purchased pet insurance and are in a dispute with the insurer over whether a certain claim is covered, you have several options.  Consider suing to recoup your losses since your legal fees may be awarded if:

If you do not want to go to court, you can file a complaint with the Better Business Bureau, New Jersey’s Department of Banking and Insurance, or New Jersey’s Attorney General’s Office, Division of Consumer Affairs.

In New Jersey, pet healthcare insurance is loosely regulated.  Pet owners need to come to the purchasing table fully informed and should seek assistance if they do not understand the terms and conditions of a policy before they purchase it.