Pet insurers don't talk like regular people...part 2

Here are another 5 insurance industry definitions which may not be exactly what you think they are. I believe we last left off with "deductible".

Fraud (concealment, misrepresentation): This is ANY statement the insurance company considers material to either its option to cover your pet or its option to pay or deny your claim that you make (or don't make). It does not have to be a lie or a purposely omitted fact or withheld medical record to be fraud (although if it is an innocent error there is very little chance of you ever being prosecuted for fraud on that).


Congenital Condition: Any disorder or condition that exists in utero (before birth). An example of this is a portosystemic shunt. Most insurers will completely exclude all coverage for this type of condition as in order to be a birth defect it MUST exist prior to the policy coverage. Some insurers do cover very specific congenital conditions which have limited evidence for their genetic link.


Hereditary Condition: Any disorder or condition that the INSURER states is specifically linked to one (or sometimes all) breeds. Examples here would be Von Willebrand disease in the Doberman Pinscher, Elbow or Hip dysplasia in the Labrador Retriever, Cystine Urolithiasis (bladder stones) in the Dachshund or Glaucoma in the Beagle. Different insurers have different coverage for this type of disorder. My best advice is read the sample policy thoroughly BEFORE you purchase a policy.


Lifetime Benefit: This is the maximum amount the insurer will pay out, regardless of other coverage factors, during the lifetime of your pet. Many policies have excluded lifetime limits at this point but some may still have them.


Illness (yes, they have to define this): sickness or disease not caused by an accident or injury.



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