Pet Insurance Claims: When Is it Worth Claiming on Pet Insurance?

When it comes to your pet's health, expenses quickly add up. The cost of veterinary care—especially for surgeries or ongoing treatments—can be overwhelming, as can understanding whether it's worth making a claim after balancing potential premium increases, excess fees, and coverage limits. If you’re unsure whether filing a claim is the right choice, you’re not alone. Understanding the pet insurance claims process and knowing what your insurance covers is essential for peace of mind.

In this article, we’ll provide practical advice so you can make informed decisions and give your pets the care they deserve—all while protecting your bank balance.

Pet insurance covers veterinary costs for accidents, illnesses, and/or treatments for your pet. Many types of insurance are available, including lifetime pet insurance or accident-only, multi-pet, and even exotic pets.

With pet insurance, you pay a monthly premium, and the insurer reimburses you for the cost of the treatment once you’ve paid an excess fee. The amount of coverage you have depends on the policy you have signed up for, with the cost of pet insurance varying between suppliers.

Likewise, the claims process will be different depending on which of the best pet insurance providers you choose. Usually, claims can be filed online or via the phone, though some providers allow you to claim directly through your vet.

Pet insurance typically covers:

Some policies also cover dental treatment or accidents, hereditary and congenital conditions, and alternative therapies, such as acupuncture, hydrotherapy, or chiropractic care. However, you’ll need to check your specific policy for full coverage details.

While each provider has different exclusions—so it’s always worth checking your policy’s terms and conditions beforehand—some claims that pet insurance usually doesn’t cover include:

That said, some policies can offer add-ons to cover certain exclusions, so shop around to find a provider that suits your needs or discuss directly with your insurer.

It’s always worth claiming unexpected or expensive treatments on your insurance, provided your coverage extends to them. For instance, if your pet needs surgery or unexpected hospitalisation, your insurance will significantly reduce the amount you need to pay.

You may also want to claim for ongoing conditions—such as diabetes—and specialist or emergency care, such as if your pet is hit by a car.

If your pet requires lower-cost veterinary care, it likely isn’t worth claiming for. This is because the cost of your excess may outweigh the cost of the treatment itself. Likewise, if the treatment is only slightly more expensive than your excess, consider whether the effort of claiming is worth the small amount of money you’ll get back. It may also cost you more in the long term if your monthly premium increases as a result, so review your policy to ensure you're making the most logical decision.

Additionally, repeatedly filing smaller pet insurance claims can result in exclusions from your pet’s policy, especially if you can only claim for a condition once. Check with your insurer to see if the condition will be excluded from coverage, even if they haven’t paid for it yet. Otherwise, you might be unable to claim again if the condition reoccurs.

While every provider will have their own process, you’ll usually follow these general steps to submit pet insurance claims:

Read through your coverage and exclusions to ensure your pet’s issue is covered. Check the cost of your excess payment to confirm this isn’t higher than the treatment itself. If you’re uncertain about anything, give your provider a call.

Obtain a detailed invoice from your vet to show all treatments, diagnoses, and costs incurred. Collect any necessary clinical records or notes from your vet so you can complete your insurer’s claims form in detail.

Insurance providers offer numerous ways to claim, including online, via email, or directly through your vet. Submit your claim as soon as possible with all required documents, ensuring you keep copies of everything for your records.

Pet insurance claims processing can take anywhere from a few days to weeks, so make sure to monitor your claim in case further information is required.

If your claim is approved, your insurer will reimburse you based on your policy terms. If your claim has been denied, review the reason. If applicable, appeal the decision with any additional clarification.

If you already have insurance, seek treatment for your pet and file your claim as soon as possible. Prompt medical care is crucial for your pet's health, and submitting your claim quickly ensures you won’t be out of pocket for long.

Usually, there’s a pet insurance waiting period for all new policies to prevent people from purchasing insurance to claim for an existing issue and ‘cheat the system.’ The waiting period is usually around 10-30 days, but read your policy documents to be sure.

Pet insurance premiums can increase after you claim, but it depends on several factors:

Your claims history

If you’ve made several claims—especially for expensive treatments—the insurer may consider you ‘higher risk’ and raise your premium.

The type of claim

Minor claims, such as for an injury, may not increase your premium since your insurer will recognise it’s likely a one-off. However, major claims—such as a diagnosis requiring long-term treatment—will likely cause an increase.

Your insurer’s policy

Some insurers may increase your premium after a claim, while others may not adjust it until renewal. It’s worth checking your insurer’s approach to premium increases.

Policies usually renew every year, giving you the opportunity to shop around and compare the cheapest pet insurance providers. This may help to lower costs if your current insurance has gone up substantially from the previous year.

It can be frustrating if your claim is rejected, but there are steps you can take to address the issue:

Your insurer should detail why your claim was denied, such as exclusions, lack of documentation, or issues with your policy.

Understand your coverage and any conditions that might be rejected. Compare the insurer’s reasons with your policy terms to see if they’re valid.

Call your insurer to ask for clarification, especially if their reason is unclear or seems incorrect. Ensure you have all documents to hand, such as your pet's medical records, invoices, and the claim form.

If you believe the rejection is unfair, request a formal review of your claim by submitting additional evidence to support your case. Include any vet notes, medical records, test results, and a clear explanation of why you believe the claim should be accepted.

If you’re dissatisfied with the appeal outcome, you can escalate the matter by asking for a second opinion from a senior claims handler. Consider seeking advice from the Financial Ombudsman Service to help resolve disputes between you and your insurer. If you feel your insurer isn’t treating you fairly, consider switching to a different provider.