Understanding Your Pet Insurance Inclusions and Exclusions

Owning a pet is never without surprises, with some less welcome than others. Accidents happen, and pets get sick, injured, or need specialised treatment when you least expect it. And the costs can climb quickly!

Pet Insurance from Auto & General Insurance protects pet owners from unexpected vet bills, allowing your pets to receive the care they need without added financial stress. Like all insurance, some things are covered, while others are excluded. In this guide, we’ll help you understand how Pet Insurance works before you choose a plan.

What is Pet Insurance, and why is it necessary? 

Pet Insurance is financial cover that helps you pay for veterinary treatment when your pet becomes ill, injured, or needs emergency care. Instead of facing unpredictable vet bills alone, you pay a regular premium, and your insurer reimburses part or all of the approved costs. It works much like medical aid for people but is designed specifically for animals.

With Auto & General Pet Insurance, you can take your pet to the vet without worrying about urgent tests, hospital stays, or surgery costs. When accidents happen or chronic conditions develop, you can make decisions based on what’s best for your pet’s health rather than on cost.

Which pets can get Pet Insurance?

Most insurers, including Auto & General, offer Pet Insurance for dogs and cats, regardless of their size or breed. 

Quotes are typically based on the type of pet, its life stage, and its unique needs. Puppies and kittens tend to have fewer health issues, while older pets may be more expensive to insure or have certain limitations, such as pre-existing conditions. Although many providers insure senior pets, there’s often a maximum enrolment age, after which new cover may not be available. 

What does Pet Insurance include?

Pet Insurance helps you afford the right medical care for your pet at the right time. Most plans share a few core benefits, even if exact details differ between providers. 

Auto & General Insurance offers flexible options to suit different pets, lifestyles, and budgets. Allowing you to manage routine and unexpected costs.

Accident and illness cover

Accident and illness cover is the foundation of most pet policies. It covers veterinary expenses for accidental injuries (such as broken bones, burns, or car-related injuries) and a wide range of illnesses like infections, diabetes, arthritis, and even cancer. The goal of this benefit is to ensure that you can receive professional care for your pet without hesitation.

Cover for accidents and illness often includes prescribed medications and diagnostic tests such as X-rays and Ultrasounds.

Depending on your plan, your cover may also include emergency out-of-hours consultations. . These events are unpredictable, but with cover in place, you can focus on getting your pet treated rather than worrying about the cost.

Wellness cover

Prevention is always better than a cure. Wellness cover, also called routine or preventive care, helps with everyday health expenses such as:

• Vaccinations

• Sterilisation

• Microchipping

• Flea and tick control

• Deworming

• Annual check-ups

Regular vet visits enable the early detection of conditions such as dental disease or obesity, both of which are common in pets and easier to manage when detected early. It’s worth taking extra steps to ensure pet safety in the festive season and other busy times of the year.

Surgery and hospitalisation

Major surgeries and hospital stays can cost thousands of rands. This type of cover includes:

• Operations

• Anaesthesia

• Medical imaging

• Post-operative monitoring

• In-patient care

Some comprehensive plans also cover post-surgery rehabilitation, such as physiotherapy, hydrotherapy, or pain management sessions. These treatments can improve recovery outcomes after orthopaedic or spinal procedures, but can also be quite costly.

Day-to-day benefits

Many modern policies offer cover for the small but frequent costs associated with responsible pet ownership. This may include:

• Routine vet consultations

• Dental cleaning

• Diagnostic testing

• Follow-up visits 

While not all plans include this, it’s worth considering if your pet has regular medical needs or chronic conditions that require monitoring.

Prescriptions and specialist treatments

When your pet needs long-term medication or advanced care, these benefits make a big difference. Cover can extend to:

• Prescribed medicines

• Repeat prescriptions

• Blood tests

• Scans

• Referrals to veterinary specialists

Chronic conditions like skin allergies, heart problems, or arthritis often require repeat visits and medication over many years. With this cover in place, managing ongoing health costs is easier.

What does Pet Insurance exclude? 

Even the most comprehensive policy has limits. Understanding these exclusions helps you avoid disappointment when submitting a claim. Exclusions exist to keep premiums affordable for everyone and to ensure cover remains fair and sustainable.

Pre-existing conditions

A common question is: Does Pet Insurance cover pre-existing conditions? Usually not. Insurers typically exclude cover for illnesses or injuries that existed before the policy started or during a waiting period. This includes chronic conditions your pet was diagnosed with before you took out cover. The reason Pet Insurance excludes pre-existing conditions is to prevent claims for known issues. This helps keep premiums fair for everyone.

Congenital or hereditary conditions

Some breeds are prone to genetic or birth-related issues such as hip dysplasia or heart defects. Whether these are covered or not depends on the policy and insurer. Typically, waiting periods for congenital and hereditary conditions are 12 months. Once this period has passed, your pet may become eligible for cover related to these conditions.

Elective procedures

Procedures that are not medically necessary are almost always excluded. These include procedures such as tail docking, ear cropping, claw removal, or cosmetic dental work. They are considered lifestyle or appearance choices, not essential health treatments.

Breeding and pregnancy costs

Expenses linked to breeding, pregnancy, whelping, or complications during birth are not covered. These costs are considered part of responsible breeding practices, rather than general pet healthcare.

Behavioural conditions

Treatment for behavioural issues such as aggression, anxiety, or compulsive habits is generally excluded. These problems often require training or environmental changes rather than medical treatment.

Experimental or alternative treatments

Treatments still under research or lacking veterinary consensus are excluded until proven safe and effective. While treatments and medicine change, these usually include things like stem cell therapy, unregistered supplements, or untested alternative therapies.

Some exclusions can vary depending on your plan, so always read policy schedules carefully and ask questions before committing. 

Frequently asked questions about Pet Insurance

1. What is the best Pet Insurance in South Africa?

The best Pet Insurance depends on your pet’s breed, age, and lifestyle, and what you want covered. Auto & General Insurance offers reliable and transparent cover options that suit different budgets. 

2. Is Pet Insurance for dogs worth it?

Yes. Vet costs for dogs can be high, especially for emergencies or chronic illnesses. Insurance helps you plan ahead and avoid financial strain when your dog needs treatment.

3. How do Pet Insurance claims work?

Most veterinarians expect the bill to be settled immediately, so you will need to pay for it out of your pocket. You can then submit your vet invoice and claim form to your insurer. Once approved, you’ll be reimbursed for covered expenses in accordance with your policy terms.

4. Can senior pets be insured?

Yes, but it depends on their age and health. Most insurers, including Auto & General, allow existing pets to stay on cover regardless of age. But they may not accept new policies or policy changes beyond a specific age limit. Auto & General offers cover for pets up to 11 years.

Get an Auto & General Pet Insurance Quote

Owning a pet shouldn’t be complicated or stressful. With Auto & General Pet Insurance, you can rest easy knowing your furry family member is covered for the unexpected. Get a Pet Insurance quote today by speaking with our team. We’ll help you find the right level of cover and answer any questions you may have.

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Sources:

1 BusinesTech: https://businesstech.co.za/news/lifestyle/781598/the-real-cost-of-owning-a-pet-in-south-africa/

2 South African Veterinary Council: https://savc.org.za/dont-skimp-on-veterinary-care-warn-south-african-vets-as-animal-owners-feel-the-financial-pinch/ 

Disclaimer: The information in this article is provided for informational purposes only and should not be construed as financial, legal, or medical advice. Auto and General  is a licensed non-life insurer and FSP, Ts & Cs online.