All About Claims
An excess is the minimum amount you pay for some insurance claims. This is deducted from your refund as is standard with all insurance as it is not like human medical aid.
Some of our members choose to save on their claim excesses by selecting one of our Premium Saver options with a fixed excess. Find out more here.
Lite Plan:
The Lite plan excess is 15% of the claim, minimum of R250 excess per claim.
Essential & Ultimate360° Plans:
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- General Policy Excess, applicable to all mainstream vet treatments, is 18% of the claim, minimum of R350 excess per claim.
- Specific Policy Excess replaces the General Policy Excess for the following conditions only: gastro-intestinal conditions, lameness, skin conditions, ear & eye conditions, respiratory & spinal conditions. This is 25% of the claim, minimum of R500 excess per claim.
- Multi-Claimant Sliding Scale Excess is applied:
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- After your pet’s paid claims (of 3 or more) in a policy year totals more than R6 000, your future claim excesses will be 30% of the claim, minimum of R1 000 per claim.
- After your pet’s paid claims (of 3 or more) in a policy year totals more than R9 000, your future claim excesses will be 30% of the claim, minimum of R1 250 per claim.
- This would replace the General, Specific & Dental Excess for the rest of that policy year.
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- Holistic Wellness, Supplements & Emergency Boarding excess is 18% of the claim.
- Dental Care is 25% of the claim, minimum of R500 excess per claim.
Accident Plan:
The Accident plan excess is 10% of the claim, minimum of R150 excess per claim.
Chronic Care Support Add-Ons:
The Chronic Care Support Add-On claim excess is 18% of the claim.
Claims for behaviour treatment, costs due to theft, missing pet advertising, cremation, & prescription food do not have an excess.
Benefits Booster claims have an excess of 18%.
Waiting periods
All pets requiring medical attention must be seen by a vet, even if it is during a waiting period, & doing so is a general condition of our cover.
- Accidental injuries for all plans have no waiting periods, & are covered immediately, so long as the accident happened and the cost was incurred after you joined. See the full list of accidents here. Diagnosis must be made within 48 hours of the time of the accident.
- There is an initial 30-day no-claims waiting period for illness claims on Lite, Essential & Ultimate360° plans. Any condition that showed clinical signs &/or symptoms in this no-claims waiting period will have an endorsement added excluding this condition.
- For Essential & Ultimate360° plan members, there is a 50% co-payment period from day 31 after joining to day 60. Any condition that shows clinical signs &/or symptoms in this co-payment period will have an endorsement added stating this condition carries a 50% co-payment going forward.
A waiting period of 6 months from joining is applicable to all treatment & surgery for conditions affecting the following: knees & hips, elbows & shoulders, eyes, respiratory system & spine.
What happens if any of the above conditions present themselves, &/or require treatment during this waiting period:
- Your pet may have an endorsement (exclusion or additional waiting period) placed on their cover for any one of the above conditions.
- The alternate side (if a limb/eye/vertebral condition) will have an additional 6-month waiting period added from the initial date of diagnosis. If the condition then manifests within this additional waiting period, that condition will be excluded from cover.
- It is important to note that all diagnostics within either waiting period for both sides will be limited to a maximum of R5 000, & then the condition will be excluded going forward.
- Pets under 4 months of age at joining may be considered for part or full cover of the above treatments. A motivation & pre-approval may be submitted in order to consider full or part payment for one of the above surgeries, on a case-by-case basis.
- There is a 4-month waiting period for dental, prescription food, & sterilisation claims.
- There is a 6-month waiting period for cremation contribution claims.
- There is a 30-day waiting period for routine care optional add-on benefits.
How To Claim
Pre-existing conditions
Lite plan is unique in that it covers pre-existing conditions after the initial 30-day no-claims period, for all other plans, pre-existing conditions are excluded.
FAQs
How to “Smart Claim”
MediPet offers short-term insurance cover for your pet – not medical aid. Pet medical aid, unfortunately, does not exist in this country. All insurance, including car, pet & house insurance, is not devised, nor structured for small, everyday claims (unless you have added routine care, chronic care support, &/or Benefit Booster, of course). Therefore, “smart claiming” is our recommendation – keeping your insurance claims for the bigger, unforeseen, significant incidents, accidents & illnesses, not the everyday vet expenses which can be reasonably expected – that way you are using insurance as it was meant, & are helping keep premiums affordable for everyone. Don’t forget, we have a No-Claim Discount for those not claiming too, helping you save.
How To Claim
- Make sure you submit your claims to us within 60 days of initial treatment on the invoice so we can process them.
- Our in-house vets, vet nurses & vet-trained team will partner with you, your vet practice & the underwriters using their expertise to help process your claim smoothly, quickly & successfully. We are proud of our 96% claim success rate – just one of the reasons 99% of our members choose to stay with us every month.
Our Most Common Claims
Gastro
Skin
Ear & Eye
Cancer
”MediPet is an exceptional and professional service provider. My experience with them has been nothing but smooth and simple with friendly staff helping us along all the way through our claim. Thank you again for great service.
Brolin De Leur