Pet insurance

With the Basic policy, which covers a range of specified accidental injuries for your pet, you can cover your pet at any age from 8 weeks old. With Standard and Ultimate policies, pets need to be aged between 8 weeks and younger than 9 years of age when you purchase your policy.

Yes, as a loyal Bupa customer we are pleased to offer you a 10% discount on Bupa Pet Insurance to help you take care of your pet’s needs when it counts.

Bupa Pet Insurance offers cover for domestic cats and dogs across Australia.

As with most insurance products, there are certain situations in which you will not be covered. There are some general exclusions such as pre-existing conditions, dental procedures and fractured teeth (unless you have Major Dental), routine or preventative treatments (unless Routine Care cover is purchased, which provides a contribution up to the Routine Care limits), some elective treatments and procedures and breeding or obstetrics. There may also be specific exclusions which may apply to specific levels of cover.

For a more detailed list of general exclusions, refer to the applicable Combined Product Disclosure Statement, Policy Terms and Conditions and Financial Services Guide.

A pre-existing condition is:

• A condition that existed or occurred prior to the commencement date of your first policy period or within any applicable waiting period.
• A condition that you or your vet were aware of, or a reasonable person in your circumstances would have been aware of.

This is irrespective of whether the underlying or causative condition was diagnosed at the time. Whether it is a pre-existing condition will depend on its nature and experience. If your pet has a temporary condition that has not existed, occurred or shown noticeable signs, symptoms or an abnormality in the 18-month period immediately prior to your claim treatment date, it will no longer be excluded from cover as a pre-existing condition. Chronic conditions and several other specified conditions cannot fall within this category.

Similar to other forms of insurance, anything that existed or that you were aware of before your pet was insured is generally excluded from cover. Insurance policies are there to protect against the unexpected so for this reason, claims relating to pre-existing conditions are not covered. This helps keep coverage fair for all of our customers.

However, we know that some conditions can genuinely be resolved or cured. So, for that reason, pre-existing conditions are assessed differently depending on whether they are chronic conditions or temporary conditions for your pet.

A temporary condition is a condition, which normally resolves with treatment, other than:

• Cruciate ligament conditions
• Intervertebral disc disease (IVDD)
• Hip dysplasia
• Elbow dysplasia
• Patella luxation
• Endocrine diseases
• Any other chronic condition

If your pet has a temporary condition which has not existed, occurred or shown noticeable signs, symptoms or an abnormality in the 18-month period prior to your claim treatment date, it will no longer be excluded from your policy as a pre-existing condition. Chronic conditions and several other specified conditions will not be categorised as a temporary condition and will always be excluded from cover.

Examples of pre-existing temporary conditions

1. You have specified accidental injury and illness cover for your pet. Prior the commencement date of the first policy period, your pet has a case of gastroenteritis due to some dietary indiscretion. The condition is treated and your pet recovers.
   
   You then purchase a pet insurance policy. Two years later, your pet has another unrelated case of gastroenteritis. Your claim would be eligible for benefits because:
   
   
   • The first gastroenteritis episode was a temporary condition, given that it normally resolves with treatment and is not on the list of excluded conditions for temporary conditions. (Refer to the question ‘what is a temporary condition’ and the PDS.)
   • There was more than an 18-month gap between the conditions.
   • The second episode of gastroenteritis was not a related condition. See ‘What is a related condition?’ in the PDS.
   • The condition was not specifically excluded in the PDS.
2. You have specified accidental injury and illness cover for your pet. Your pet had a case of demodectic mange 18 months prior to the commencement date of the first policy period. The condition is resolved after your pet receives treatment.
   
   Two years into the policy, your pet contracts another unrelated case of demodectic mange. This claim would be eligible for benefits because:
   
   
   • The first condition was a temporary condition that is normally resolved with Treatment and is not on the list of excluded conditions in that definition. See ‘What is a temporary condition?’ and the PDS.
   • Your pet did not have demodectic mange, or show any noticeable signs, symptoms or abnormality in relation to that condition for more than an 18-month period.
   • The second episode of demodectic mange was not a related condition. See ‘What is a related condition?’ in the PDS.
   • The condition was not specifically excluded in the PDS.

Note: Examples above are of a general nature and you should refer to your Product Disclosure Statement and Certificate of Insurance for information about conditions covered under your policy.

A chronic condition is long-lasting or recurring in its effects and affects (or is present in) a pet over a period greater than three months in total. The three-month period does not need to be consecutive.

Chronic conditions may also be intermittent or managed with medication and/or prescription diets with intervals of remission. If your pet has a chronic condition that occurred or existed prior to the commencement date of the first policy period or during any applicable waiting period, it will always be excluded from your policy as a pre-existing condition.

Examples of pre-existing chronic conditions

1. Your pet is limping and is diagnosed with a grade two luxating patella (dislocating kneecap) within the applicable waiting period of the policy. Your vet prescribes anti-inflammatory medication. This claim is not covered, because you and your vet became aware of the condition within the 30-day waiting period for this condition.
   
   Two years later, your pet requires surgery for the patella luxation. This condition is excluded from cover because:
   
   • You and your vet first became aware of the condition in the applicable waiting period.
   • The condition (patella luxation) is not a temporary condition, as it is specifically excluded from that definition.
   • As a result, it remains a pre-existing condition two years later.
2. Your pet has had recurring seasonal allergies every spring and summer since it was two-months old. This recurs for a period greater than three months. You purchase a pet insurance policy and two years later make a claim for another round of allergy treatment.
   
   Your claim would not be eligible for benefits and excluded from cover because:
   
   • The condition is a pre-existing condition, given that you were aware of it prior to commencement of your first policy period.
   • Your pet’s seasonal allergy condition is not a temporary condition, as it is specifically excluded as a chronic condition. This is because it was long-lasting, recurring and affected your pet for a period greater than three months.
   • As a result, it remains a pre-existing condition two years later.

Note: Examples above are of a general nature and you should refer to your Product Disclosure Statement and Certificate of Insurance for information about conditions covered under your policy.

A related condition is something that results from the same disease process, arises as a consequence of or has the same diagnostic classification as another condition. This is regardless of the number of areas of your pet’s body that are affected.

For example:

1. If your pet suffers from arthritis in its legs, all future occurrences of arthritis (e.g. in the back or neck) will be related conditions.
2. If your pet suffers from diabetes and then develops a cataract as a consequence of the diabetes, the cataract will then be a related condition.
3. If your pet suffers from a skin hotspot, then later suffers from ringworm on its skin, these are not related conditions, as the ringworm is not as a consequence of the hotspot, nor do they follow the same disease process or diagnostic classification.

Yes. If your pet requires treatment and you wish to seek pre-approval of those costs, you can provide us with the itemised estimate of costs from your vet, along with the treatment required and relevant clinical records and/or veterinary history, and we will respond to you in writing with the outcome.

If your pet has had a temporary condition that was subject to the pre-existing condition exclusion, it will no longer be excluded from your policy as a pre-existing condition. When you submit a claim, we will automatically review it for you, but you can also apply to have it reviewed.

Your vet will need to certify and provide veterinary records verifying that the condition remains a temporary condition and has not existed, occurred or shown noticeable signs, symptoms or an abnormality for a period of 18 months. The pre-existing condition exclusion(s) will not be deemed to have been lifted unless agreed to by us in writing.

You can download a copy of the Pre-existing Conditions exclusion review form here.

If your pet has a chronic condition that existed or occurred before the commencement date of your first policy period or during any applicable waiting period, that condition will always be excluded from your policy.

To find out more information about pre-existing conditions and how they apply to your cover, please ensure you review the relevant Product Disclosure Statement and Certificate of Insurance.

With Bupa Pet Insurance we will cover up to 80% of eligible vet expenses, subject to any excess and annual benefit limits and sub-limits associated with your policy. Any applicable excess will be subtracted from your claim benefit amount.

There is no waiting period for specified accidental injury on all three levels of cover. Waiting periods begin from the commencement date of the first policy period. With Standard and Ultimate policies there is a 30-day waiting day period for conditions covered under the illness cover. Alternative therapy cover is subject to a 30-day waiting period. Dental illness cover is subject to a 6-month waiting period. Additionally, cruciate ligament conditions for all three levels of cover are subject to a 6-month waiting period, which may be waived on application by completing the Cruciate ligament examination form. For more information on waiting periods please refer to the Product Disclosure Statement (PDF, 2.9MB).

New policies

Your premium is calculated using a combination of factors about you and your pet. These factors can affect the premium amount up or down depending upon whether we believe it increases or decreases the risk to us, such as the cover you have chosen, the excess selected, the benefit percentage applicable to the cover you have chosen, where you and your pet permanently live, your age and the species, breed, gender of your pet, the current age of your pet, the age you first insured your pet, and other factors related to our cost of doing business. These same factors may be used to calculate your premium when you amend your coverage.

Renewing policies

Factors that are taken into consideration for renewal premium calculation include your pet’s age, breed, location, duration for which your pet has been insured, claims history, as well as data relating to the health of pets that are a similar age and breed. Each year we review premiums based on these factors to ensure we can accommodate the costs of possible treatment up to your annual benefit limit, in the event that your pet becomes injured or ill.

Yes, your premium will increase each year. This is for two main reasons:

Reason #1: Just like humans, the older our pets get, the more likely they are to have health hiccups. Cats and dogs age faster than we do, which means that their likely veterinary treatment costs go up rapidly each year too. As a result, the cost of insuring your pet will also increase as they get older.

Reason #2: Advancements in Veterinary Treatments. The overall cost of medical treatment for pets has increased in recent years due to the increased availability of medical treatments and technology-enabled services and ongoing demand for these services. The treatment options and advancements in technology are providing us with great opportunities to give our pets a great quality of life for longer.

Every year, we review the cost of everyone’s insurance with regards to a combination of factors as well as claims inflation across all our insured pets. Increases in our claims costs due to increases in the range of available veterinary procedures, or due to an increased take-up of those services, impacts everyone’s premiums. Your premium takes into account the average cost of care for pets like yours. To provide an example of this, a pet parent with a three-year-old French Bulldog will be affected by the trends we see in our data from hundreds of three-year-old French Bulldogs that we insure, as well as the specific claims history of their own pet.

No. Pet insurance does not work like health insurance. Health insurance is ‘community rated’, which means that everyone pays the same premium for their health insurance regardless of their individual health status, age or claims history. This is not the case for pet insurance. Health insurance providers are able to community rate health insurance because there are many other factors at play in the human health care system, such as Medicare and government rebates and subsidies, which is not the case with veterinary care and pet insurance. Pet insurance claim reimbursements are paid for purely by the premiums received by those who insure their pets. In order for each person to pay a fair price for their pet insurance, premiums vary depending on your and your pet’s risk factors.

We have recently made a change to our claims procedure. You no longer need to submit your claims within 90 days of treatment. There is no time limit to submitting a claim for your pet.

Yes, you can visit any vet (other than yourself) that is licensed to legally practice as a veterinarian in Australia. Please note, although it is rare, if expenses incurred by you with respect to the Treatment significantly exceed what is reasonable and expected, having regard to the circumstances in which the Treatment was provided, then claim payments may be adjusted to the amount of reasonable and expected expenses. If your Pet requires treatment, you can seek a claim pre-approval, whereby we can provide you with the details of your claim reimbursement. To request a pre-approval, simply call us on 134 135.

You may cancel your policy at any time. We understand circumstances can change and would like to see if we can help keep your cover active. Please call our customer service team on 134 135 or send us an email at bupa@petsure.com.au so we can discuss your options.

If you do decide to cancel, we will issue a pro-rata refund for the uninsured period where premiums are paid annually, less any applicable government or statutory charges. If you pay by instalments, we will not deduct any further premiums after the date of cancellation.