With few exceptions (Trupanion), pet insurance still works off of a reimbursement model. Some companies (i.e. Nationwide) operate on a benefits schedule, but most base their repayment off of 70, 80 or 90% reimbursement rates of actual vet costs.
Luckily, making a claim is now quick and easy with the help of member portals and apps. And, the quicker you make your claim, the sooner you will receive your reimbursement.
Here are the typical steps to making a pet insurance claim:
Pay the veterinarian
Most insurers require you to pay your vet bill in full, prior to applying for reimbursement. There are some insurers who are moving to a model more similar to that of human insurance, but for now, this is how pet insurance works.
The only difference here would be with wellness plans – these are usually on a benefit schedule, meaning you know exactly how much is covered going in. In some cases, the insurance company will pay the vet directly, and in others, you will still have to go through the traditional claim filing process.
Check your policy
Make sure you know the details of your policy inside and out so there are no surprises. If you are unsure about anything, contact the insurer and their customer service should be happy to help. If you are concerned about an upcoming veterinary visit, you can get a preapproval in some cases.
Save all documents
To file a claim, you will need all invoices as well as the medical records for the visit, usually signed or initialed by your vet. With some insurers, you can take pictures of these documents and upload them into an app, with others you can email, mail or fax in copies. Be sure to save your documents even if you have already sent them in, at least until the claim is paid to your satisfaction.
Contact your insurance company
With most insurers, you do not have limited time to reach them once your pet has had a vet visit. Your policy documents will advise you of your actual time, but typically you have no more than 90 days to file a claim from the time of your vet visit.
Submit your claim
If you have completed all of the above steps, it is time to file the formal claim. With your documents in-hand, either upload them to your insurer’s app, email them to the company, or send them in however you are directed. You will likely need to fill out a claim form to send in with these documents, and then you will need to follow up with the company to see where they are in the claims process.
If you have filed your claim correctly, it is now time to get reimbursed. There are a couple of ways this can happen: by check or through an automatic deposit into your bank account, similar to direct deposit. This is the quickest way to get reimbursed, and many companies are moving to this model.
Filing a claim is a lot easier than it used to be, and quick claims processing should be something you look for when choosing a pet insurance company.