Pet Insurance Q&A

Important note:

The following questions are to be used as a reference guide only and do not substitute or replace your insurance contract, the PDS or Certificate of Insurance.

How old does my pet have to be to get pet insurance?

You can insure your pet as soon as they’re eight weeks old. With our Premium and Standard Accidental Injury and Illness Cover, they also need to join before they turn nine, and before they turn sixteen for our Classic Accidental Injury and Illness Cover.

Can I continue to insure my pet as it gets older?

Absolutely. Once you have insurance for your pet, you can keep renewing your policy with us for the rest of its life, provided there is no break in your cover, with cover subject to the terms and conditions of your renewal policy.

I already have a wonderful vet. Can my pet still visit them?

Absolutely! Our pet insurance helps to cover eligible vet bills from any registered vet in Australia.

Does my pet insurance have an excess?

No, Real Pet Insurance does not have a fixed excess. Depending on the plan you choose, we reimburse either up to 75% or up to 80% of all eligible veterinary expenses.

My pet has a hereditary problem. Is that covered by pet insurance?

Hereditary and congenital conditions will be 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.

Are ongoing conditions covered for the life of the pet?

Yes – as long as you continue to renew your policy with us each year with no break in cover and we continue to offer the product, 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. See Policy Booklet for more information on pre-existing condition coverage.

What is a Pre-existing condition?

A Pre-existing condition is:

  • A condition that existed or occurred prior to the commencement date of your first policy period or within any applicable waiting period.
  • A condition that you or your vet were aware of, or a reasonable person in your circumstances would have been aware of.

This is irrespective of whether the underlying or causative condition was diagnosed at the time.

Whether it is a pre-existing condition will depend on its nature and experience. If your pet has a temporary condition that has not existed, occurred or shown noticeable signs, symptoms or an abnormality in the 18 month period immediately prior to your claim treatment date, it will no longer be excluded from cover as a pre-existing condition. Chronic conditions and several other specified conditions cannot fall within this category. See your Policy Booklet for more information.

Can I seek pre-approval of my pet’s upcoming treatment?

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.

How do I apply to have a pre-existing condition reviewed?

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.

How do you calculate my premium?

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.

Will my premium increase every year?

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.

Will my premium increase even if I don’t submit claims?

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.

Is my premium calculated the same way as my Private Health Insurance?

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.

How can I pay my pet insurance premiums?

You can pay your premiums either by credit card or direct debit. To make budgeting easy, you can choose to pay fortnightly, monthly or annually at no extra cost.

How do I make a claim?

To make a claim, simply download our Pet Insurance Claim Form. Complete and sign this form, take it to your vet, and have them complete the applicable sections. Then mail your completed claim form and original receipts to:

Real Pet Insurance
Locked Bag 9021
Castle Hill, NSW 1765

Once we receive these documents, your claim will be processed without delay and payment will be made to you either by cheque or transferred directly into your nominated account.

How much of the vet’s bill will be covered?

Depending on the plan you choose, Real Pet Insurance covers up to 80% of your pet’s treatment costs, up to your annual benefit limit. And there’s no excess to pay. There are a few treatments that aren’t covered; you can read all about them in the relevant Policy Booklet.

Is there anything that isn’t covered?

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.

When will my policy start and when can I claim?

Your pet insurance policy will commence at 11:59pm on the commencement date listed in your certificate of insurance. You can claim immediately for specified accidental injuries (refer to your Policy Booklet) occurring after your policy has started. You can claim for illness conditions that emerge 30 days after the start of the policy.

Please be aware that there is a 6 month waiting period for cruciate ligament claims (which may be waived on application).

Why should I insure my pet?

Breakthroughs in veterinary medicine over the last few decades mean that your pet can now enjoy a longer and more contented life than ever before. But that higher standard of care comes at a cost. In fact, something as simple as a Urinary Tract Infection can cost up to $6,805.*

So, just as you take out private health insurance to ensure you can give the other members of your family the best medical care, it can make sense to insure your pet. That way, you can always decide on the best treatment for them, without worrying about the cost.

* Source: PetSure (Australia) Pty Ltd highest Urinary Tract Infection claim 2011–2012.

Who is the underwriter?

Real Pet Insurance is issued by:

The Hollard Insurance Company Pty Ltd (Hollard)
ABN 78 090 584 473
Level 5, 100 Mount Street,
North Sydney, NSW 2060

Hollard Australia is a member of the international Hollard Insurance Group, which includes businesses in Australia, throughout Africa, in the United States, the United Kingdom and South East Asia. Hollard provides a wide range of insurance products and services to more than 7.2 million policyholders worldwide.

What if I have another question?

Simply email us at service@realpetinsurance.com.au or call one of our Customer Service Specialists on 1300 665 965.

What is GapOnly®?

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® is 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 our Pet Portal or as a paper claim by visiting realinsurance.com.au

I’d like to use GapOnly®, what do I need to do?

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.

Can I get a pre-approval for a GapOnly® claim?

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 Friday 8:00am to 8:00pm, and Saturday 8:00am to 5:00pm AEST (excluding NSW public holidays).

How do I know if my vet uses GapOnly®?

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

What if my vet doesn’t have GapOnly®?

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 (https://www.realinsurance.com.au/pet-insurance/claims). Claims would then be assessed and paid in the form of reimbursement of any eligible vet bill.

What if my GapOnly® claim does not cover any of my treatment costs?

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 665 965. Alternatively, you can put your concerns in writing, care of Real 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.

When are GapOnly® claims available?

GapOnly® claims are available at participating vets Monday to Friday 8:00am to 8:00pm, and Saturday 8:00am to 5:00pm AEST (excluding NSW public holidays). When GapOnly® isn’t available, your vet may be able to submit an electronic pet insurance claim instead.

How long does a GapOnly® claim take to process?

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.

Can I use GapOnly® for all vet treatment costs?

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.

Can my GapOnly® claims be processed before I pick up my pet?

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.