Pet Insurance FAQs

Yes. Once you have insurance for your pet, you can keep renewing your policy with us for the rest of its life – as long as we continue to offer the product, and there isn’t a break in your cover, with cover subject to the terms and conditions of your renewal policy.

No. There’s no excess to pay – so depending on your level of cover, you may get back up to 80% of all your eligible vet expenses.

Hereditary and congenital conditions will eligible for cover if they have not shown noticeable signs, symptoms or an abnormality at any time before the first policy period or during any applicable waiting period.

Yes – as long as you continue to renew your policy with us each year and pay your premiums with no break in cover, we will continue to provide cover for chronic, recurring or lifelong conditions such as cancer or arthritis. Benefits for these conditions, like any other, are subject to the annual policy limits and exclude some pre-existing conditions. Review the relevant Policy Booklet for more information on pre-existing conditions.

Yes. With our insurance, you can choose to visit any vet you like, as long as they are registered to practice in Australia.

Paying your premiums is easy, by credit card or direct debit from your bank account. You can also set the frequency of your premium payments to suit you, whether fortnightly, monthly or annually.

We have a fast and simple claims process. See How to Make a Claim on Your Cover to get started.

We’ll cover up to 80% of your vet bill (up to your annual limit) with Top Accident & Illness Cover, or up to 75% with Essential Accident & Illness Cover and up to 60%, subject to the $2,000 annual condition limit, with Basic Accident & Illness Cover. Not all conditions and treatments are covered and limits apply, however, so check out the relevant Policy Booklet for more information.

Of course! You can take out a single insurance policy that covers all of your dogs and cats, but you’ll still need to pay a separate premium for each one.

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, fractured teeth, 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.

Review the relevant Policy Booklet for more information.

Your policy will begin at 11.59pm on the day we accept your application. The following waiting periods apply:

• No waiting period for specified accidental injuries
• 30 days for illnesses
• 6 months for cruciate ligament conditions

(may be waived on application – refer to the relevant Policy Booklet for more information)

You can claim for specified accidental injuries as soon as your policy begins. You can claim for illnesses where symptoms appear 30 days after the start of your policy.

For cruciate ligament claims only, there is a six month waiting period – which you can apply to waive. See the ‘Cruciate Ligament Exam Form’ available here.

Thanks to modern vet science, your pet can enjoy a higher standard of care than ever before – but treatments can be expensive, and may cost you hundreds or even thousands of dollars. If your pet is sick or injured, the last thing you want is to have to worry about vet bills or make the difficult decision not to go ahead with a procedure because of the cost. Pet insurance gives you peace of mind knowing your furry companion will always get the care they need, when they need it.

After you take out insurance with us, you’ll have 30 days to review and cancel your policy. As long as you haven’t submitted any claims, we’ll be happy to give you a full refund for your premium if you cancel during this cooling-off period. If you cancel after 30 days, you won’t receive a refund for any premiums you’ve paid.

Our Top and Essential Accident & Illness Cover is available to any cat or dog that is between the age of eight weeks and less than nine years old when you apply for your policy. Once your pet is insured, you can continue to cover them for the rest of their life just by renewing your policy with us. For Basic Accident & Illness Cover your pet must be eight weeks and less than 16 years old to apply.

Ask us! Simply email at service@seniors.com.au or call 1300 674 590.

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 benefit percentage applicable to the cover you have chosen, the species, breed and age of your pet and other factors related to our cost of doing business.

Renewing policies

Factors that are taken into consideration for renewal premium calculation include your pet’s age and breed, as well as data relating to the health of pets that are of 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.

While this is great news for the care of our pets, these treatments come at a significant cost. Year on year treatment costs increase, and this is factored into the cost of pet insurance.

Please see ‘How do you calculate my premium?’ for more information about calculation of premiums.

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.

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.

GapOnly® allows your vet to lodge your claim during your visit, which is assessed in approximately 10 minutes. Once the claim for your insured pet has been processed and a benefit outcome is calculated, you simply pay the gap¹. That’s the difference between the vet’s invoice and your insurance benefit amount, so you don’t need to worry about being out of pocket while your claim is being processed.

1. ‘The gap’ is the difference between the vet’s invoice and the eligible claim benefit under your policy. GapOnly® available at participating vets only. When GapOnly® isn’t available, an eClaim can be submitted by your Vet for reimbursement. Alternatively, you can submit the claim online using your Pet Portal or as a paper claim by visiting seniors.com.au

Firstly, check that your vet is enabled by visiting gaponly.com.au. If they are, simply let your vet know that you’d like to submit a GapOnly® claim the next time you are there. To minimise delays, it’s best to let your vet know that you intend to make a GapOnly® claim as early as possible so they can prepare your claim ahead of time.

You can request a pre-approval (from any participating vet practice) prior to your pet's treatment, or have your claim processed ahead of picking up your pet from the vet. Pre-approvals can be lodged Monday to Saturday, 8:00 AM – 10:00 PM AEST (excluding NSW public holidays).

You can contact your current vet and ask if they offer GapOnly®, or simply visit gaponly.com.au.

When GapOnly® isn’t available, an electronic pet insurance claim can either be made online by your treating vet or you can submit the claim yourself via your online pet portal. Claims would then be assessed and paid in the form of reimbursement of any eligible vet bill.

If the claims assessment concludes a $0 benefit, you will need to pay your vet for the full invoice amount. If you’re not totally happy with the outcome of a claim decision, we will do our best to work with you to resolve it. You can get in touch with us by calling one of our trained consultants on 1300 674 590. Alternatively, you can put your concerns in writing, care of Seniors Pet Insurance, Locked Bag No. 9021, Castle Hill NSW 1765, Fax Number: 1300 738 979 or email: claimreview@petsure.com.au. Remember to provide us with your name, policy number and full details relating to your concerns. Further detailed information about our complaints process can also be found in your Policy Booklet.

GapOnly® claims are available at participating vets Monday to Saturday, 8:00 AM – 10:00 PM AEST (excluding NSW public holidays). When GapOnly® isn’t available, your vet may be able to submit an electronic pet insurance claim instead.

A GapOnly® claim made in a vet clinic will take around 10 minutes to process. If the claim is likely to take a little longer, the vet clinic staff will let you know so you can decide whether you’d like to wait or not. If you’re not able to wait, you will be required to pay your vet the full invoice amount so your vet clinic can adjust your GapOnly® claim to a standard electronic claim, and your insurance provider will consider the claim and reimburse you the calculated benefit of an eligible vet bill.

GapOnly® works in partnership with participating vets, and as long as your vet is GapOnly® enabled, you can use it for all eligible vet fees covered in your policy.

Yes, you can ask your vet to submit a GapOnly® claim so you don’t have to wait for your claim to be processed when you pick up your pet. Simply let your vet know when you drop off your pet that you’d like them to submit a GapOnly® claim for your pet’s treatment and, if available, they can arrange this for you.

Like all insurance, anything that existed or you were aware of prior to your policy 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.

Review the relevant Policy Booklet for more information.

If your pet has had a temporary condition that was subject to the pre-existing condition exclusion, you can 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 Condition 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.

Review the relevant Policy Booklet for more information.

Pre-existing condition means a condition that first existed or occurred:

• prior to the commencement date of the first policy period; or
• within any applicable waiting period; and
• which you were aware of, or a reasonable person in your circumstances would have been aware, irrespective of whether the underlying or causative condition has been diagnosed.

A pre-existing condition also includes a related condition or bilateral condition of a pre-existing condition.

For more information, please refer to the relevant Policy Booklet.

Yes. You can check the Pet Portal for a summary of your coverage or refer to your Policy Booklet and Certificate of Insurance for all your coverage information.

Pre-approvals aren’t mandatory, but can provide you with additional reassurance, if you want to know if an upcoming or specific treatment for your pet will be covered, email us at claimreview@petsure.com.au with the following information:

• Policy number or policy holder and pet name
• Name of the condition being treated and the proposed procedure
• Name of your regular vet and the vet where the procedure will take place
• An itemised estimate of costs relating to the procedure (optional)     

Once we receive this information, you can expect to hear back from us within two business days. 

Note: A pre-approval will not be deemed to be valid unless we have agreed to it in writing. The reimbursed amount may vary from the pre-approval if the treatment provided by your vet differs from the treatment request in the pre-approval.

We hope that you never have a reason to complain, but if you do, we will do our best to work with you to resolve it. To make a complaint, visit our complaints page.