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Focus on pet insurance terminology: Excesses and co-payments

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Insurance terminology can be tricky and policy wording documents lengthy.  Whilst having policy wording is very important – for the insurance company and client alike – we understand that they can also be daunting.  With so many different policies to choose from the terminology used may be fairly consistent, but the terms and conditions associated with words such as ‘excess’ and ‘co-payment’ will vary greatly from one insurance provider to another.

Here we will look specifically at ‘excesses’ and ‘co-payments’ and what you might want to look for when it comes to these terms.

Excess:  The policy excess is a monetary amount that the policy holder must pay towards the cost of a claim.  This is simple enough, but the amount you are required to pay and the frequency in which you are required to pay an excess will vary greatly between pet insurance providers and, sometimes, between individual policy cover levels from the same provider.
For example, some lifelong policies (where benefits are reinstated each time you renew) will require you to pay an excess per condition / per year whilst others will only apply an excess once per condition whilst the policy is in force.  Some will apply a separate excess for Veterinary Fees and Complementary Medicine such as Physiotherapy.  So, if your pet was unfortunate enough to suffer from an injury that required both conventional initial veterinary treatment and then follow-up hydrotherapy sessions to aid rehabilitation you could end up paying two excesses for this condition per year.
Another consideration is that excess amounts can vary greatly and some are ‘fixed’ whilst others will increase over time as your pet gets older. Excess amounts can even vary based on where you live.

Vetsure Excess:  The excess for Veterinary Fee claims on for all Vetsure policies is chosen by you – either £69, £109 or £149 per each distinct illness, injury or condition if your pet is treated at any Vetsure-affiliated clinic and £20 more if you independently elect to have your pet treated elsewhere.  If your Vetsure vet refers you to another veterinary practice (e.g. a specialist referral centre) or you attend an out of hours emergency treatment provider as recommended by your Vetsure clinic the excess is not increased.
This excess is applied ONCE per condition – not per condition per year.  A separate excess for Complementary Medicine does NOT apply.  Where you live has no impact on the excess amount.

Co-payments:  A co-payment is typically a percentage of the claim settlement amount that a policy holder will be required to pay in addition to the Excess.  The co-payment amount is usually calculated from the balance left after the Excess has been deducted, but this may vary between providers.

The % amount payable and when the co-payment applies from differs greatly across the pet insurance market.  Some providers will apply the co-payment from the policy start date, some after 1 year and some once your pet has reached a certain age and may increase over time in some cases.

Vetsure co-payment:  The co-payment on our Premier and Premier Plus policies is 15% and applies only once your pet has reached its 8th birthday.  It is calculated based on the amount left after the excess has been deducted.  The co-payment does not apply to the Accident Only policy as we do not believe your pet is anymore likely to have an accident as it gets older whereas, unfortunately, they are more likely to become poorly the older they get – just like you and I.

I hope this guide to excesses and co-payments has been useful.  It may be important to consider these elements when choosing a pet insurance policy as the amount and frequency of excesses and co-payments can make a big difference to the overall cost of a policy if you have to make a claim – particularly for a long-term, chronic condition.

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