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Pet Insurance Fraud: Claims & Cases

Jan 26, 2022

If you have a pet, then you will most likely want to take out insurance. Pet insurance can provide a wide range of cover for your pet – from the cost of veterinary treatment, a pay-out if your pet should die, be lost or stolen or cover if your pet harms someone or damages property.

But as with all insurance covers, you must provide accurate information to your insurer in order for the policy to be valid.

Here we look at the information you must give your pet insurer and why you must always give accurate information to avoid committing pet insurance fraud.

What information must you give a pet insurer?

You must give complete and accurate information to all the questions asked by the insurer you are looking to take a pet insurance policy out with. All insurers will ask a range of different questions, but the most important thing is to answer them honestly.

This will include declaring if your pet has any pre-existing medical conditions. According to the Association of British Insurers (ABI), a pre-existing condition is an illness or injury that your pet had or showed signs of having before the policy started. They go on to state that ‘this usually includes illnesses and injuries that can happen again or may appear in different parts of your pet’s body.’

All pet insurers will have their own definition of a pre-existing condition so you must make yourself aware of this before buying your policy. In many cases, a pet insurer will not provide cover for a pre-existing condition. And this is why you must declare a pre-existing condition when taking out your policy.

How do pet insurers know about pre-existing conditions?

In most cases, if you need to make a claim, your insurer will ask your vet for your pet’s medical records. From here, they will be able to ascertain whether the condition was pre-existing or not.

If the condition was pre-existing (and meets your insurers definition of pre-existing) then it is likely that your claim will be rejected. You may face additional consequences if you had not declared the pre-existing condition when you took out your policy.

What is pet insurance fraud?

The most common type of pet insurance fraud involves the policy holder withholding or misrepresenting information about their pet. For example, not declaring a pre-existing condition.

This is typically done by the policyholder in the hope they will be able to make a claim for a condition which they pet has already suffered with.

Whilst you may not see it this way, withholding or providing incorrect information to an insurer is insurance fraud.

Other instances of pet insurance fraud can see policyholders;

  • submit claims for treatments which never took place
  • using one policy to make claims for multiple different pets (each pet must have its own cover)
  • creating fake vet bills
  • filing several claims for the same vet’s bill
  • exaggerating the costs of a vet’s bill

Possible punishments for committing pet insurance fraud

Committing any type of insurance fraud is a serious offence, including pet insurance fraud. Insurance fraud can be punishable in several ways depending on the severity of the case:

  • criminal conviction
  • potential imprisonment
  • having an insurance policy cancelled
  • finding it hard to obtain insurance or other financial services in the future

If you are looking to take out any type of insurance policy, then you must accurately represent all the facts about your situation when doing so. And remember, if any of your details change during the course of the policy, it will again be important to update your insurer or insurance broker so that these can be reflected in your circumstances and policy details.

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