Health - A-Z Pet Insurance Glossary

 

 

 

Age

Your pet's age, as confirmed by a veterinarian.

 

Accident

An unexpected, unintended event causing injury to your pet

Alternative therapies include, but are not restricted to treatments involving homeopathic remedies,acupuncture, chiropractic treatments and physiotherapy. Alternative therapies are excluded from this policy unless otherwise specified on the Schedule of Benefits.

 

Annual

Periods of one year, or part of a year, starting with the date the Policy was first issued, or starting with the effective date of a change in Coverage Plan.

 

Associated Condition

Any medical problem that is directly related to and caused by a primary medical Condition. This includes any medical condition resulting from any Treatments for the Associated Conditions such as alternative therapies, diagnostic testing, medication and prescription diets.

 

Benefit or Coverage

Benefit means the refundable portion of a claim payable under the policy, less any applicable excess or levy. The refundable portion is determined by the level of cover selected subject to applicable policy limits or sub-limits..

 

Benefit Limits

To keep premiums down, most pet insurance providers have limits on how much they'll reimburse per incident, year, or over the lifetime of a pet.

 

Benefit Schedule

Some pet insurance providers pay claims based on a benefits schedule, which is a list of diagnoses and corresponding reimbursement amounts.

 

Bi-Lateral Condition

Any Condition affecting body parts of which your pet has two, one on each side of the body (examples: cruciate ligaments, ears and eyes).

 

Certificate of Insurance

The most recent certificate issued by insurance company  containing your details, your pet's details, the level of cover selected and the schedule of benefits payable under your policy.

 

Chronic condition

Is a condition, which once developed, is deemed incurable or is likely to continue for

the remainder of your pet's life

 

Claim

After your pet receives treatment, you submit a claim for reimbursement.

 

Clinical Signs

Changes in a Pet's normal healthy state, bodily function or behaviour.

 

Condition

All manifestations of Clinical Signs resulting from the same diagnostic classification or disease process, regardless of the number of incidents or areas of the body affected (example: all cancer is considered one Condition).

 

Congenital Condition

A condition that is considered a birth defect, or a defect in growth development. Congenital conditions can show symptoms any time during a pet's life.

 

Coverage Plan or Plan

The Coverage and Benefits as specified and defined in the Policy.

 

Deductible

A fixed amount that you must pay prior to receiving claim reimbursement.

 

Document of Insurance

The Policy page which identifies the Policy number, the insured Pet, the Coverage Plan and the Period of Insurance.

 

End date

Means the date upon which your policy terminates and benefits claimable under the policy cease. If the policy is cancelled, then the date of cancellation will be deemed to be the end date.

 

Exclusion

A restriction from Coverage that may be temporarily, or permanently placed on a Policy.

 

Effective Date

The day your coverage takes effect.

 

Excess

The amount shown on your Certificate of Insurance that you must pay towards a claim.

 

Genetic Condition

A condition that is passed down through a pet's genes. Genetic conditions can show symptoms any time during a pet's life.

 

Hereditary Condition

A condition that may have been passed down from an animal's parents or through the breed. Hereditary conditions can show symptoms any time during a pet's life.

 

Illness

Sickness, disease and any changes to a Pet's normal healthy state.

 

Injury

Physical harm or damage which happens accidentally to your pet as a result of external, violent and visible means and, which results solely and directly and independently of any other causes including any known or unknown pre-existing physical, congenital or hereditary condition. To be eligible for benefit, the injury must have occurred on or after the commencement date of the policy.

 

Insured

The policyholder as shown on the Certificate of Insurance.

 

Insurer

The insurance company that underwrites the policy, or assumes the risk.

 

Lifetime Limit

The maximum amount covered over a pet's lifetime.

 

Maximum Payable Amount

The most the insurer will pay.

 

Member

The policyholder who is subsequently part of the insurance.

 

Member Card

A printed carrying card which holds pertinent membership and insurance information, for ease of use and accessibility. Not to be construed as a legal document or as proof of membership.

 

New pandemic disease

Any new disease that causes widespread illness in dogs or cats

 

Ongoing Condition

An illness or injury that occurs in one plan period, and needs continuing care in subsequent plan periods.

 

Per Incident Limit

The maximum amount covered for a particular accident or illness.

 

Pet

Any canine (dog) and/or feline (cat) listed on the Certificate of Insurance and owned by you

 

Pre-existing or Foreseeable Condition

A Condition which first occurred or showed Clinical Signs before your Pet's coverage started or within the policy waiting period. Since insurance is designed to protect you from the unexpected, most insurance will not cover any condition that is pre-existing. If your pet has a condition that neither you nor your veterinarian are aware of, then it would not be considered a pre-existing condition.

 

Premium

The amount you'll be charged for your pet insurance coverage.

 

Reimbursement

The amount of money paid for a claim.

 

SPCA

The South African Society for the Prevention of Cruelty to Animals® (SPCA). The SPCA is dedicated to putting an end to animal cruelty.

 

Treatment

Veterinary care, hospitalization, dentistry, surgery, diagnostics, medication, nursing, specialist referral, medical devices, alternative therapies and behavioural therapies performed by a Veterinarian.

 

Vet

A legally licensed veterinarian or specialist veterinarian, currently registered and practising in accordance with the applicable laws in South Africa.

 

Vet practice

Means a legally registered South African veterinary hospital, clinic, centre or surgery.

 

Veterinary Services

Veterinary care professional fees, hospitalization, dentistry, surgery, diagnostics, medication, nursing, specialist referral, medical devices, alternative therapies and behavioural therapies performed by a Veterinarian.

 

Waiting Period

An amount of time you may have to wait before a certain type of coverage starts.

 

Wellness Care

Routine preventive treatments, like vaccinations, annual check-ups, and dental cleanings.

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