Helping you Decipher the Terminology used in Pet Medical Insurance
Below are some of the most commonly used terms in pet medical insurance policies.
The list is not exhaustive and the definitions of the terms might differ from underwriter to underwriter.
Accident / accidental means any external, visible, violent, sudden, and fortuitous occurrence resulting in bodily injury to your pet and which requires immediate medical attention. Accidental conditions are covered from the date of inception of the policy. Babesia (tick bite fever) and erlichia are deemed to be accidents.
Annual / per annum refers to the 365 day period from the date of inception of the policy to the day before the anniversary date of the policy (both days included).
Behavioural conditions / disorder mean any changes in your pet’s normal behaviour as a result of a mental or emotional disorder certified by a Vet.
Certificate of Insurance means the current certificate containing your personal details, your pet's details, the Plan you selected and the benefits payable thereunder.
Complementary treatment / alternative treatment are treatments not forming part of mainstream veterinary science and for the purpose of this policy include but are not limited to acupuncture, chiropractic, gold bead implants, homeopathy, hydrotherapy, physiotherapy, rehabilitation therapy and supplements.
Cover means the benefits of the Plan selected by you.
Excess is the first amount payable towards a claim which you must pay subject to the terms and Conditions of the policy.
Inception date means the date when the insurance cover incepts. The policy incepts at 24h00 on the inception date as shown on your Certificate of Insurance.
Injury means physical injury caused to your pet by an accident not excluded.
Illness means any changes to your pet’s normal healthy state or bodily functions, sickness or disease as diagnosed by a Vet, which is not caused by injury to your pet and first manifests itself 31 days or later after the inception date of the policy.
Insured means the policyholder named in the Certificate of Insurance.
Medical Condition means a disease, illness or injury that manifests in clinical signs not normal to the animal. It is an abnormal condition of a part, organ or system of an animal resulting from various causes such as infection, inflammation, old age, trauma and injury and environmental factors. It is characterised by an identifiable group of signs or symptoms or both. A biological state which is within the range of normal animal variation is not a medical condition.
Pandemic disease means any disease that causes illness occurring over a wide geographic area and affecting an exceptionally high proportion of the cat or dog population.
Pet means any dog and/or cat older than 8 weeks and younger than nine years at the time of application for insurance and which is named and described on the Application Form and on the Certificate of Insurance.
Policy means the ABC Pet Insurance Policy underwritten by (Insurance company name).
Policy benefit / benefit means that portion of a claim payable by us subject to the terms and conditions of the policy.
Policy period commences on the policy inception date and ends the date upon which your policy automatically terminates or its cancellation date.
Pre-existing condition means a condition, disease, illness, injury, infirmity or weakness, which either existed or showed clinical signs of existing or which was treated before the inception date of the first policy period or within the applicable time excess or the recurrence of such a condition, disease, injury, illness, infirmity or weakness.
Time excess means the period between the inception date of the policy and the date from which you may claim benefits for illness. You may claim for illness conditions which arise 31 days or longer after the inception date of your policy.
Treatment means any examination, consultation, advice, tests, hospitalisation, surgery, X-rays, medication, nursing and other care provided by or under supervision of a Vet.
Vet means any general or specialist Veterinarian who at the time of treatment was registered with the South African Veterinary Council (SAVC).
Veterinary fees / expenses / costs mean the reasonable and customary fees vets in general or referral practices usually charge subject to the Veterinary Fees Advice as published by the South African Veterinary Council (SAVC). If fees charged are considered by us to be excessive or unreasonable, then benefits will be paid based on the reasonable, customary and normal fees typically charged for the treatment of that condition
Veterinary practice means a Veterinary hospital, clinic or consulting rooms/surgery legally registered with the South African Veterinary Council (SAVC).
We, our, us means (Name) Insurance Company Limited, an authorised financial service provider, (FSP Number ________, company registration number _______________) or their authorised representatives.
Year refers to the 365 days period from the date of inception of the policy to the day before the anniversary date of the policy (both days included).
You, your, yours means the Insured.
The list is not exhaustive and the definitions of the terms might differ from underwriter to underwriter.
Accident / accidental means any external, visible, violent, sudden, and fortuitous occurrence resulting in bodily injury to your pet and which requires immediate medical attention. Accidental conditions are covered from the date of inception of the policy. Babesia (tick bite fever) and erlichia are deemed to be accidents.
Annual / per annum refers to the 365 day period from the date of inception of the policy to the day before the anniversary date of the policy (both days included).
Behavioural conditions / disorder mean any changes in your pet’s normal behaviour as a result of a mental or emotional disorder certified by a Vet.
Certificate of Insurance means the current certificate containing your personal details, your pet's details, the Plan you selected and the benefits payable thereunder.
Complementary treatment / alternative treatment are treatments not forming part of mainstream veterinary science and for the purpose of this policy include but are not limited to acupuncture, chiropractic, gold bead implants, homeopathy, hydrotherapy, physiotherapy, rehabilitation therapy and supplements.
Cover means the benefits of the Plan selected by you.
Excess is the first amount payable towards a claim which you must pay subject to the terms and Conditions of the policy.
Inception date means the date when the insurance cover incepts. The policy incepts at 24h00 on the inception date as shown on your Certificate of Insurance.
Injury means physical injury caused to your pet by an accident not excluded.
Illness means any changes to your pet’s normal healthy state or bodily functions, sickness or disease as diagnosed by a Vet, which is not caused by injury to your pet and first manifests itself 31 days or later after the inception date of the policy.
Insured means the policyholder named in the Certificate of Insurance.
Medical Condition means a disease, illness or injury that manifests in clinical signs not normal to the animal. It is an abnormal condition of a part, organ or system of an animal resulting from various causes such as infection, inflammation, old age, trauma and injury and environmental factors. It is characterised by an identifiable group of signs or symptoms or both. A biological state which is within the range of normal animal variation is not a medical condition.
Pandemic disease means any disease that causes illness occurring over a wide geographic area and affecting an exceptionally high proportion of the cat or dog population.
Pet means any dog and/or cat older than 8 weeks and younger than nine years at the time of application for insurance and which is named and described on the Application Form and on the Certificate of Insurance.
Policy means the ABC Pet Insurance Policy underwritten by (Insurance company name).
Policy benefit / benefit means that portion of a claim payable by us subject to the terms and conditions of the policy.
Policy period commences on the policy inception date and ends the date upon which your policy automatically terminates or its cancellation date.
Pre-existing condition means a condition, disease, illness, injury, infirmity or weakness, which either existed or showed clinical signs of existing or which was treated before the inception date of the first policy period or within the applicable time excess or the recurrence of such a condition, disease, injury, illness, infirmity or weakness.
Time excess means the period between the inception date of the policy and the date from which you may claim benefits for illness. You may claim for illness conditions which arise 31 days or longer after the inception date of your policy.
Treatment means any examination, consultation, advice, tests, hospitalisation, surgery, X-rays, medication, nursing and other care provided by or under supervision of a Vet.
Vet means any general or specialist Veterinarian who at the time of treatment was registered with the South African Veterinary Council (SAVC).
Veterinary fees / expenses / costs mean the reasonable and customary fees vets in general or referral practices usually charge subject to the Veterinary Fees Advice as published by the South African Veterinary Council (SAVC). If fees charged are considered by us to be excessive or unreasonable, then benefits will be paid based on the reasonable, customary and normal fees typically charged for the treatment of that condition
Veterinary practice means a Veterinary hospital, clinic or consulting rooms/surgery legally registered with the South African Veterinary Council (SAVC).
We, our, us means (Name) Insurance Company Limited, an authorised financial service provider, (FSP Number ________, company registration number _______________) or their authorised representatives.
Year refers to the 365 days period from the date of inception of the policy to the day before the anniversary date of the policy (both days included).
You, your, yours means the Insured.
If you have any other questions relating to Pet Medical Insurance, Munro would love to hear from you. Just click here to go to the Q & A Page or visit Genricpets website. www.vetsown.co.za
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