Everything you need to know about pet insurance

A Pet Circle Pet Insurance policy is designed to provide cover for a portion (70%, 80% or 90%) of the cost of necessary treatment provided to your pet by, or under the supervision of a vet to relieve or cure an illness or injury. This may include, but is not limited to, hospitalisation, surgery, x-rays, medication, diagnostic tests, nursing and other care and procedures.

There are Exclusion Periods applicable to different conditions and there are some things that are not included as standard, but you have an option of including them in your cover. See “360 optional care” below.

It is important to note that Pet Circle Pet Insurance is designed to provide cover for the vet costs of treatment that is required to relieve or cure an unexpected illness or injury.

This means:

• Preventative and routine items & treatments, such as general check-ups and vaccinations, things you would expect to do in order to keep your pet healthy, are not covered.
• Pre-Existing Symptoms and Conditions: Treatment of conditions that have occurred, have shown signs or symptoms and/or you knew about the condition (or a reasonable person in the circumstances could be expected to have known) prior to purchasing your policy or during an applicable Exclusion Period are considered Pre-existing Symptoms and Conditions, and are not covered. Brachycephalic Obstructive Airway Syndrome (BOAS) can appear from birth in some breeds, so future costs to address it are predictable, For absolute clarity BOAS is not covered by our policy unless a BOAS Cover Application is accepted by us. We recognise the concerns of policyholders with pets with partial brachycephalic breeds lines, like Cavoodles. For those seeking more certainty, we offer a BOAS Cover application form. This allows you to gain additional cover certainty.
• Elective procedures, including desexing or additional vet costs, such as after-hours treatment and house calls when a vet doesn’t consider there was an emergency, are not covered.

There is no cover for specialised/supported therapies, dental illness or behavioural problems, unless you choose to include them in your policy.

You will be provided with an option to include Optional Extra Benefits, as part of the process of getting your quote.

The Optional Extra Benefits available are:

• Supportive Therapies
• Dental Illness
• Behavioural Conditions

Yes, you will have cover for the cost of vet consultations related to required treatment of an injury or illness, but there still won’t be cover for the cost of vet consultations or other vet costs related to preventative and routine items, Pre-existing Symptoms and Conditions, elective procedures and/or other exclusions.

An Exclusion Period is the amount of time during which no benefit is payable under the policy and this means you cannot claim for vet costs for treatment your pet receives in relation to an illness or injury which occurs during an Exclusion Period.

So for any condition that occurs, has shown signs or symptoms and/or you come to know about it during an Exclusion Period, will meet the definition of a Pre-existing Symptom and Condition and will therefore be excluded from your cover.

Exclusion Periods apply from the time your policy starts, even if you have decided to switch to Pet Circle Pet Insurance from another provider’s pet insurance policy, and also when you upgrade your level of cover with Pet Circle.

If you upgrade your level of cover or decide to add Optional Extra Benefits after the initial purchase of your Pet Circle policy, then Exclusion Periods will apply from the time of the upgrade or addition of Optional Extra Benefits. You will still be entitled to the benefits payable under your previous level of cover during the Exclusion Period for the higher or additional benefits.

If Exclusion Periods didn’t exist, people could take out pet insurance or upgrade their cover only when they know or suspect that they might need cover, and then immediately make a claim. If these customers then cancelled (or downgraded) their cover after making a claim, it would not only be unfair to other customers, but it could also lead to increased premiums for all customers.

Yes! We offer customers the chance to submit an additional application to request the 6-month Exclusion Period for the Specified Conditions (and others, e.g. Dental Illness) to be reduced.

To consider whether a reduction of the Exclusion Period can be provided, we require:

• a completed request form from you, which will require you to have your pet examined by a vet at your own expense; and
• copies of your pet’s medical history & clinical notes. You will need to assist us in the process of obtaining these, for example, by providing details of any vets your pet has seen in the past.

During our assessment of the application, we will review the available information, and if sufficient, confirm whether there are any identified or suspected Specified Conditions (and others). Where we are comfortable that there aren’t any identified or suspected Specified Conditions (and others), we will reduce or waive the Exclusion Period for those conditions.

We will confirm the outcome of your application and if we decide to approve the reduction of the Exclusion Period, we will provide you with an updated Certificate of Insurance which lists the agreed Specified Conditions (and others) and the new reduced Exclusion Period applicable.

Pre-existing Symptoms and Conditions: There is no cover for vet costs associated with the treatment of conditions, including symptoms of a condition, your pet had before your pet’s first date of cover under a Pet Circle Pet Insurance policy or which arises during an applicable Exclusion Period.

• There is a definition for what is a Pre-existing Symptom and Condition in the Product Disclosure Statement and it’s important you understand this.
• A symptom is considered a Pre-existing Symptom and Condition, even if it’s not been officially diagnosed or identified.
• We may confirm, in certain circumstances, that a condition is no longer considered a Pre-existing Symptom and Condition. This will usually occur when we are satisfied that the condition has been successfully resolved. This is typically done after a specified time period has elapsed during which your pet was free of symptoms as confirmed by a vet.
• Brachycephalic Obstructive Airway Syndrome (BOAS) can appear from birth in some breeds, so future costs to address it are predictable, and is not covered by our policy. We recognise the concerns of policyholders with pets with partial brachycephalic breeds lines, like Cavoodles. For those seeking more certainty, we offer a BOAS Cover application form. This allows you to gain additional cover certainty.
• Vaccinatable diseases: There is no cover for vet costs associated with the treatment of a disease which is vaccinatable if you have not maintained your pet’s vaccinations (preventative treatment).
• Any conditions that are the result of intentional harm or neglect.
• Any conditions that are the result of or requiring ongoing or repeat treatment due to you not following your vet’s advice.
• Any conditions that are related to an epidemic, pandemic, or new influenza.
• Vet costs for the treatment of Behavioural Conditions (including any injury or illness which arises as a result of a Behavioural Condition) or Dental Illness, unless you have Optional Extra Benefits included in your cover. Other limits, exclusions and conditions still apply.
• Even if you have included Optional Extra Benefits and have cover for Dental Illness, there is no cover for vet costs associated with the removal of deciduous teeth (commonly called baby teeth in humans).

Pet Circle Pet Insurance was designed to offer extensive cover, but even if an injury or illness is covered under your Policy, there are certain treatments which are not covered:

• Treatment during an applicable Exclusion Period.
• Any vet costs resulting from breeding, pregnancy, whelping or queening.
• Any vet costs for desexing. We do, however, cover additional vet costs for treatment of complex cryptorchid (undescended testicles). If this is the case, we will reduce the vet costs by the amount the vet would have charged for neutering when calculating the payable benefit.
• Non-customary and experimental treatments, such as prosthetic limbs and devices and organ or valve transplants.
• Medications that are not registered or approved in Australia.
• Supportive Therapies, unless you have included Optional Extra Benefits included in your cover.
• Expenses to board or transport your pet including by ambulance. However, we do cover boarding costs in specified circumstances.
• Costs incurred after your pet’s death, including storing, transporting or disposing of your pet’s remains and autopsy, burial, cremation, funeral or other procedures.

There are certain exceptional circumstances in which Pet Circle Pet Insurance does not provide cover for required treatment. For example, there is no cover when an injury or illness is due to:

• Nuclear or radioactive weapons, materials or radiation.
• Utilisation of nuclear, chemical or biological weapons of mass destruction.
• Acts of war or civil unrest.
• Natural Catastrophe or Natural Disaster

After consideration of what is covered and what is not covered, you may want to confirm whether a specific condition or treatment for your pet is covered.

If a condition or treatment is not excluded under your policy, then it is covered.

Please remember if it is a Pre-existing Symptom and Condition, it occurs during an applicable Exclusion Period or another exclusion applies, then there is no cover.

Brachycephalic Obstructive Airway Syndrome (BOAS) can appear from birth in some breeds, so future costs to address it are predictable, if BOAS appears from birth, this is a Pre-Existing condition and is not covered by our policy. We recognise the concerns of policyholders with pets with partial brachycephalic breeds lines, like Cavoodles. For those seeking more certainty, we offer a BOAS Cover application form. This allows you to gain additional cover certainty.

To help you better understand the coverage, we’ve created the following table to show the types of things we cover, subject to determining if there is an exclusion, as explained above.

1. Lumps are not considered a Specified Condition if Your Pet was under one (1) year old on the First Date of Cover or when Your cover increased.
2. Lumps are not considered a Specified Condition if Your Pet was under one (1) year old on the First Date of Cover or when Your cover increased.
3. We do not cover Vet Costs or any other costs attributable to Treatment for Brachycephalic Obstructive Airway
4. Syndrome (BOAS) unless the Brachycephalic Obstructive Airways Syndrome (BOAS) Application form is completed and accepted by Us.