Make an insurance claim

Petcover works alongside its insurance partners to be one of the only pet insurance providers that will cover behavioural treatment costs following veterinary diagnosis. Cover is included, subject to waiting periods and exclusions as part of our Superior Products. The Mid-Range products it is available only if the $50 Optional Day-to-Day Care Benefit was added to your policy at the time of application.

If this is your first claim for either the policy or the condition, you need to send us your pet’s clinical history as well as the treatment plan or behaviour modification plan specified by your vet.

If the claim is an ongoing condition, an updated history and treatment plan/behaviour modification plan may need to be provided every six months.

For an injury where your dog has been bitten by another dog, the claiming process is similar to regular claims in that we need the itemised invoice and the treatment history. However, instead of the standard claim form, a dog bite claim form must be completed and submitted.

This dog bite claim form provides us with additional details surrounding the bite injury that is usually not captured by the treating veterinarian in the clinical history.

Third-party liability claims are not the same as regular claims. If you find yourself in a position where your liability may come into question, you should:

• Not admit liability or make any offer to pay;
• Exchange details with the other party or parties and obtain the names and addresses of any witnesses.
• Notify us as soon as possible after the event;
• Send us any and all documentation relating to the event, including any legal documents you may be issued with.

Petcover does not assess these claims. They are assessed by your policy underwriter’s disputes and possibly the legal department. As a result, these types of claims may take longer than usual to be assessed and finalised. We will keep you up to date with any progress and communicate with you should additional information be required.

If dental treatment is needed for your pet as a direct result of an accident, illness or injury, you may be able to claim it, so long as your pet has had its annual dental check-ups and any advice provided has been followed.

Cover is not provided for routine, preventative, or elective dental treatments, which are expected and can be budgeted for. Insurance is provided for unexpected injuries and illnesses. Examples of routine, preventative, or elective dental treatments include, but are not limited to, Scale & Polish, Comprehensive Oral Health Assessment & Treatment (COHAT), and routine check-ups.

Physiotherapy is a claimable treatment under some of our plans (refer to your PDS), when carried out by a registered Physiotherapist with post-graduate qualifications in animal/veterinary Physiotherapy or a member of the Australian Physiotherapy Association (APA) Animal Physiotherapy Group (APG). You cannot receive payment for physiotherapy sessions that have not been completed in the event of bulk purchase (i.e./ buy 10 sessions at a reduced rate) as this would be considered pre-approval (refer to FAQ on pre-approval).  If you have purchased 10 sessions in bulk, you can only claim after each completed session or at the conclusion when all 10 sessions have been completed.

Hydrotherapy, when used as a complementary treatment for a musculoskeletal condition, can be claimed under the policy. Up to 10 individual sessions (inclusive of other alternative/complimentary sessions and subject to the maximum benefit) can be claimed in the policy period. The sessions must be performed either at a veterinary practice with the appropriate facilities or at a registered hydrotherapy business.

Payment can’t be provided for sessions that have not yet been completed. If sessions have been purchased in bulk, we can only pay for treatments that have already been completed.  (As per above)

Claims can’t be pre-approved, as there is no invoice (financial loss) and no supporting treatment notes before the treatment is made.

It won’t be known if the claim will be covered and paid before the treatment has been performed and the claim has been submitted. This is because the treatment provided and the pet’s full history must be reviewed to determine whether the condition and treatment can be claimable under the policy.

You can get advice if specific medications, tests, or procedures can be considered and if something is not covered under your policy, but you won’t be provided with pre-approval for any claim.

The fixed excess is the amount shown on your certificate of insurance that is withheld for each unrelated claim within the policy period. It is the threshold that the claim needs to reach before we can reimburse you for it.

The Share Excess or Co-Payment is a percentage of the payable value of every claim after any applicable fixed excess or deductions that will be withheld. This is an option you can select to reduce your premium.

The Age Excess is a percentage of the payable value of each and every claim after any applicable fixed excess, deductions, and share excess/co-payment that Petcover will withhold.

When your policy renews, an age excess of 20% is applied once your pet turns 8 for standard breeds and 4 for select breeds.

When your policy renews, an age excess of 35% is applied once your pet turns 10 for standard breeds and 7 for select breeds.

Pay Direct to Vet is offered, whereby you can elect to have your claim paid directly to your vet. You will need to have an agreement in place with your vet before submitting the claim. You will need to pay any applicable excess and not covered items directly to your vet, and the balance will be paid. Your vet can even submit your claim on your behalf.

Supplements can provide a drug-free treatment option for several conditions; however, these products can often be obtained without any required veterinary involvement. Many can be purchased without either a prescription from a veterinarian or without being directly dispensed by a veterinarian, and many can be purchased online without the pet ever seeing a veterinarian.

Under the policies available, the cost of medications that can only be legally obtained via a veterinary prescription or directly dispensed by a veterinarian will be covered. Supplements do not fulfil these criteria, so their cost cannot be covered under the policy.