The most common reasons pet insurance claims are refused - and how to get your claim accepted

Brean Horne
18 October 2021 - 6 min read

Vet fees can be expensive and lots of people take out pet insurance so they can afford medical treatment.

At ManyPets we receive thousands of claims each year and most of those claims we accept and pay out for. In fact during the past 12 months, we have rejected no more than 3% of claims we received during this period.

It's understandable that some pet owners are left upset and frustrated when a claim is rejected by their insurer.

Whether you are searching for a policy or in the process of making a claim, we've put together a list of some of the most common reasons why claims are rejected.

Check out our pet insurance. Our policy documents are easy to understand and will clearly explain what you can claim for.

1. The owner has claimed for something that isn't covered

You should always read the policy wording before taking out insurance. It is vital that you understand the terms and conditions of your cover and double check anything that is unclear with your insurer.

Insurers include the definitions of important words in their policy documents. When taking out your policy, read it thoroughly. You shouldn't assume the meaning of certain terms based on their everyday use or your previous experience with a different insurer.

Once you’ve agreed to a particular set of terms, it is difficult to make a claim for something that is not included in those terms.

2. The claim is made outside the policy's time or vet fee limit

There are different types of pet insurance policies available that include: Accident Only, Time Limited, Maximum Benefit and Lifetime. Depending on the policy you choose, there will be a limit on what you can claim for and this can result in claims being refused.

In the case of a time-limited policy, there is a 12-month limit for claims. This refers to the period you can claim for a specific condition.

For example, if your dog suffers from a condition such as cancer and you claim for treatment, your insurer will pay for your claim. You can continue making a claim for this condition for up to 12 months or up to your vet fee limit (eg. £4,000, £7,000, £12,000).

Once you've reached your 12 month limit for making claims, the condition (in this case cancer) will be excluded from the policy and you won't be able to claim for this condition again.

By comparison, a Maximum Benefit policy has a vet fee limit for each condition you can for. If you claim for a condition, such as cancer and the vet fee limit is £4,000; once you reach that figure, that condition will be excluded from your policy.

You can avoid these exclusions by choosing a lifetime policy. They allow owners to claim for a condition throughout a pet's life. Lifetime covers vet fees up to a certain amount each year; as long as you renew your policy you'll get the same amount of cover each year no matter how many claims you make.

ManyPets only offer lifetime, while other companies normally offer a mixture of lifetime, maximum benefit and time limited. With a lifetime product, it is important to note that your premiums may increase each year at renewal.

3. The policy does not cover pre-existing conditions

Most UK insurers do not cover pets with pre-existing conditions. Always check how the insurer defines existing conditions - the best case scenario is likely to be any injury or illness experienced during the two years before a policy is taken out, together with any related conditions. Chronic illnesses are almost never covered by new policies.

If your pet does have a condition that you would like to be covered, you must check whether this is possible with the insurer first.

At ManyPets we offer pet insurance that owners are looking for so all our policies cover conditions that ended at least two years ago and we have a policy that can cover more recent pre-existing conditions.

Lifetime (or ‘yearly limit’) insurance covers vet fees up to the stated limit every year. This can be a good option if you worry about your pet developing a long-term or recurring illness. So long as you renew a lifetime policy each year, the level of vet fees will reset to the full stated limits that you started with.

Annual policies with 12-month limits are likely to be cheaper than lifetime policies but can cost owners more in the long term if they have to pay for treatment that has been excluded.

4. The claim was made during the initial exclusion period

Pet insurance will often not begin until after the first 14 days of your policy. This is known as the "exclusion or waiting period".

It gives you the chance to change your mind about a policy, it also means you can't make a claim during the first two weeks for an illness (claims for accidents are often excluded for the first 48 hours).

If you're unclear on the official start date of your policy, always check with your insurance provider. At ManyPets, we've removed the 14-day waiting period for owners who switch to our cover with no gap in cover from their previous provider.

5. Your policy does not provide cover for 'routine treatment'

There are a number of treatments that most insurers won't cover, including vaccinations, spaying, neutering and pregnancy-related issues.

You will have to pay for these basic treatments and some insurers will require you to have them for your cover to remain valid.

If you’re insured with Petplan, for example, your dog must be vaccinated against distemper, hepatitis, leptospirosis and parvovirus. And cats must be vaccinated against infectious enteritis, cat flu and feline leukaemia.

If they aren’t vaccinated against these and develop a related condition, Petplan may refuse your claim.

7. Your pet needs dental cover

Dental cover is not always included as standard in pet insurance policies. If your pet needs dental care, find out if your insurer includes this in your policy or whether it is an optional extra before purchasing a policy.

Most pet insurers will not provide cover for routine dental care. Dental treatment can also be expensive and is one reason why pet insurers exclude it from their policies. Some policies will include cover for dental treatment if your pet has an accident but treatment for dental illness is often only included on the most comprehensive policies.

ManyPets' Complete policy offers up to £15,000 of vet fee cover and includes dental cover for illnesses and accidents as standard. This is the most comprehensive pet insurance on the market.

Dental issues can be assessed through video and online vet consultations if pet owners can't immediately visit their local vet surgery. ManyPets pet insurance customers have unlimited free access to video consultations with qualified vets through the FirstVet app.

Learn more about which companies offer dental cover for pets.

8. The age of your pet has affected your claim

Understanding how your pet's age affects insurance is an important factor to be aware of.

Before taking out a policy, check if there's an age limit. Some insurers have limits that won't allow you to get cover for older pets.

ManyPets believe all pets should be covered and we provide policies for dogs and cats of any age. If you're not sure about your pet’s age, you can get an estimate from your vet.

Minimum age requirements might only be a few weeks. At ManyPets we won't insure pets under four weeks of age. However, any maximum age limits can vary between insurers and breeds. You should again check your policy for details.

Most insurers will state that once a pet reaches the age of 8 or 9 they will be classified as older pets. Like humans, pets are more likely to need medical treatment as they get older, and insurance premiums tend to be higher for this age group.

Once you've taken out a policy, your cover will continue even after your pet passes the maximum age stated, as long as you continue to pay your premiums. If you allow your policy to lapse, you may find it difficult to find a new policy or claim for a previous health condition.

For older pets, you may be required to pay what's known as a co-payment. It means that once your pet reaches a certain age you will need to pay a percentage of the claim cost.

When your pet reaches a certain age, you can't claim death from illness. At ManyPets, we don't pay for pets over 9 years old that die from illness. When a pet reaches old age, the likelihood of death from illness increases. Insurance is designed to cover vet fees for accidents and medical treatment.

We've listed some of the providers that offer cover for older dogs here.

9. There are exclusions for pets used for commercial purposes?

Most insurers will not cover pets used for commercial purposes. That includes security, track racing, breeding and more. If you are unsure whether your pet will fall into this category, make sure that you double-check with your insurer.

It is possible to get specialist liability policies for working dogs.

10. Your pet's details are not up to date

Tell your insurer about any changes to your pet’s circumstances. This includes moving house or even changing owners. Your insurer must be aware of your pet’s details because they can affect your premium and ability to claim.

Your claim has been refused

If you believe that your claim has been unfairly refused the first step is to file a complaint through your provider. If this is rejected, you can take your claim to the free Financial Ombudsman Service .

To find out about the Financial Ombudsman’s approach to insurance check out their website.

You can also find more advice on how to deal with a rejected insurance claim on the Citizens Advice Bureau website.