| Exclusions & additional limitations |
- Diagnosis or treatment of any pre-existing conditions.
- Procedures performed prior to the effective date of this policy.
- Diagnosis or treatment of any condition identified as an Additional Excluded condition on the Declarations Page or Renewal Certificate of your policy.
- Diagnosis or treatment of any complication or progression of any condition or procedure excluded by this policy.
- Diagnosis or treatment of any condition caused intentionally by you or any other resident of your household.
- Any behavioral training, therapy or treatment that is: (1) not prescribed by a licensed veterinarian or (2) pet obedience training.
- Any service or procedure used to prevent, preserve or improve general nutrition or health, even if prescribed by a veterinarian. For example, we will not pay for: dietary or nutritional supplements, acupuncture, chiropractic care, holistic care, etc. unless it is prescribed by your veterinarian to treat your pet’s covered condition.
- Pet foods, treats, or commercial pet diets that are used to prevent, preserve or improve general nutrition or health and can be purchased without a prescription, including foods such as: life stages (puppy, senior, etc.), low calorie, sensitive stomach, or limited ingredients, even if recommended by a veterinarian for treatment of your pet’s condition.
- Boarding, storage, transportation, grooming, or bathing.
- Diagnosis or treatment that is experimental, investigational, or otherwise not within the standard of care accepted by the veterinary medical board of your state.
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- Aesthetic, cosmetic, endodontic dental services such as caps, crowns or crown amputation, fillings, implants and root canals or planing.
- Anal sac (gland) expression and/or resection when no infection is present.
- Boarding.
- Breeding, pregnancy, whelping or nursing.
- Conditions that occur during a waiting period.
- Cosmetic and elective prostheses or procedures.
- Dental cleanings unless used to treat a covered illness or covered by an applicable endorsement.
- Experimental or investigational treatment or medication (including clinical trials) that is not generally accepted in the veterinary medical community as effective or proven.
- Grooming or grooming supplies.
- Herbs.
- House call fees, time and travel expenses to and from the veterinarian’s premises or hospital.
- Illness or injury that results from intentional, malicious, or grossly negligent activities or from failure to perform actions commonly accepted as responsible pet care by you, a member of your household or a caregiver for your pet.
- Non-medical supplies such as but not limited to toys, training devices, and leashes.
- Non-Veterinary services (including but not limited to administrative fees, medical records expenses, medical waste, postage and tax).
- Pre-existing Conditions that occurred on or before the effective date of the policy or during a waiting period.
- Prescription food, pet food, diets or treats used for prevention or general health maintenance (including weight loss) even if prescribed or dispensed by a veterinarian.
- Preventive care without an occurrence (including but not limited to general health maintenance diagnostics, laboratory procedures, medications, physical examinations and surgery) unless covered by an applicable endorsement.
- Supplements and vitamins used for prevention or general health maintenance (including weight loss) even if prescribed or dispensed by a veterinarian.
- Veterinary expenses related to coursing, organized fighting, law enforcement or guarding, personal protection or racing.
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- All pre-existing conditions.
- Routine and wellness care.
- Any injury or illness/disease for which clinical signs were observed prior to the policy effective date.
- Any injury or illness/disease for which clinical signs were observed prior to the policy effective date or illness during the 15 day waiting period or injury during the 5 day waiting period.
- The portion of the cost of treating an illness or injury that is greater than the reasonable cost(s) for treating such illness or injury.
- The cost of any treatment for oral health, including but not limited to dental disease, malocclusions and deciduous teeth, where clinical sign(s) (including, but not limited to, tartar, gingivitis, pulp exposure or halitosis) were observed prior to the effective date of the policy or during the first fifteen (15) days beginning on the effective date of this policy.
- Damage or rupture of cruciate ligaments, luxation of the patellas or other soft tissue disorders of the knee where clinical sign(s) occur during the first six (6) months that the policy is in effect. However, coverage will be afforded if your pet is examined by a veterinarian within the first thirty (30) days of the policy and the medical record specifically notes your pet does not have any pre-existing conditions relating to the knees.
- Cruciate or soft tissue conditions on one knee are excluded for 12 months if the other knee was pre-existing or treated during the first 6 months of the policy.
- Cruciate or soft tissue injury to one knee prior to the effective date of this policy or during the first six (6) months of the policy (where no certification of knee health has been provided as described in Section V.g.) and appropriate treatment has not been performed, then the other knee is automatically excluded from coverage. Once appropriate treatment has been performed, the other leg is excluded from coverage for a period of twelve (12) months from the date of last treatment to the affected leg.
- IVDD when another disc in the same or neighboring spinal region (e.g. cervical, lumbosacral) was previously treated or showing clinical sign(s) prior to the PED or during waiting period.
- Behavioral disorders where clinical sign(s) were apparent prior to the effective date of the policy or that became apparent during the first fifteen (15) days beginning on the effective date of this policy.
- Congenital defects or abnormalities where clinical sign(s) were apparent prior to the effective date of the policy or that became apparent during the first fifteen (15) days beginning on the effective date of this policy.
- Elective or specialty procedures.
- Grooming or grooming supplies.
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- Pre-Existing Conditions.
- Bilateral Conditions, if your Pet had at any time any Pre-Existing Conditions consistent with that same Bilateral Condition on either side of the body.
- Intervertebral disc Conditions, if your Pet had at any time any Pre-Existing Conditions involving the intervertebral discs (due to either degeneration or trauma).
- Preventive Care.
- Elective and cosmetic procedures.
- Spaying or neutering at any time or for any reason unless recommended by your Veterinarian following a Condition that involves damage to the reproductive organs. Cryptorchidism and retained ovarian remnants are not Illnesses for the purpose of this exclusion and are not covered.
- Preventive Care.
- Claims for Pets found to be healthy and presenting with no clinical symptoms.
- Treatments, therapies, and services described under the Supplemental Benefits coverage, if this coverage is not purchased at enrollment.
- Any prescription or over-the-counter medications that are not included in our formulary of covered medications.
- Administrative charges for the processing of insurance claims and/or sending medical records. Injuries due to any intentional act, including organized dog fighting, that involves you or a member of
- Breeding and Conditions related to pregnancy.
- Boarding and transport expenses, including ambulance transportation.
- Complications of or diagnostic tests, treatments, therapies, and/ or medications related to Conditions not covered or restricted by this policy.
- Anal gland expression.
- Bedding, housing, crates, cages, ramps, bowls, feeding, exercise, pet foods, supplements, grooming, nail trims, toys, clothes, leashes, collars, biohazardous waste fees, and treats.
- Any Condition resulting from activities related to training for or participating in racing, including track or sled racing.
- Any Accident, Condition, or Cruciate Ligament Event with respect to which the Policyholder was advised by a Veterinarian to take preventive measures, and did not meet the terms.
- Alternative and Holistic Treatments.
- Experimental therapies and medications, including any therapy for which there are no published articles in peer-reviewed journals for the indicated Condition.
- Conditions arising from a repetitive and specific activity that leads to decontamination (e.g., the induction of vomiting), medical, or surgical treatment of your Pet, if the same or a similar activity occurred two times within 18 months prior to the treatment date, whether before or after the Policy Effective Date.
- Training and treatment of Behavioral Conditions, with the exception of consultations and prescription medications (if the appropriate Supplemental Benefits are purchased).
- Cremation and burial.
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- All pre-existing conditions.
- Elective procedures, cosmetic surgeries, including but not limited to tail docking, dewclaws, skin folds, nail trims, and cropping of ears.
- Expression or removal of anal glands, or anal sacculitis.
- Breeding or conditions related to breeding.
- Special diets, pet foods, vitamins, mineral supplements, grooming costs and bathing (including medicated baths).
- Treatment of external parasites such as fleas, lice and ticks and preventable internal parasites such as heartworms, hookworms, roundworms, tapeworms, and whipworms.
- Orthodontics, endodontics and removal of deciduous teeth.
- Diagnostic test(s) and treatment(s) for conditions excluded or limited by this policy and complications of conditions excluded or limited by this policy.
- Time and travel expenses to the Veterinarian’s premises or hospital.
- Illness or injury which arises out of racing, coursing, commercial guarding, or organized fighting of Your Pet.
- Preventive treatments and diagnostics for or conditions relating to preventable parasites, including heartworms.
- Routine examinations, routine tests or screens, vaccines, teeth cleaning, or polishing.
- Spaying and neutering.
- Diagnosis, medical management, or surgical correction of interverterbal disc(s) regardless of the procuring cause (unless otherwise agreed with You) during the first twelve (12) months of the Policy Period. However, this exclusion does not apply if this policy is a renewal of a Pet Insurance Policy issued by Us.
- Breeding or conditions related to breeding.
- Diagnosis, medical management, or surgical correction of cruciate ligament damage or rupture to include treatment for the anterior cruciate ligament (ACL), medial cruciate ligament (MCL), posterior cruciate ligament (PCL), and cranial cruciate ligament (CCL). However, this exclusion does not apply if this policy is a renewal of a Pet Insurance Policy issued by Us.
- Payment of any service not provided a Veterinarian.
- Diagnosis or treatment for organ transplants.
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- Veterinary exams, unless you purchase coverage through our ExamCare endorsement.
- Inherited and Congenital conditions, unless you purchase coverage through our InheritedPlus endorsement.
- Pre-existing conditions.
- Treatment or diagnostics for cruciate ligament injuries over a $2,000 reimbursement lifetime limit for each leg. This includes any associated meniscal injury or another condition secondary to cruciate ligament injury, tear or rupture.
- Treatments or diagnostics of an illness, injury, or service excluded by the policy as well as secondary complications from such excluded illness, injury, or service.
- Intentional, neglectful, or preventable acts, caused by you or a member of your household, that result in injury or illness to your pet(s).
- Elective, cosmetic, grooming, bathing and nail clipping.
- Fees to diagnose or treat any illness or injury related to breeding, pregnancy, whelping, and nursing.
- The cost of dental care or to spay or neuter your pet(s) regardless of the reason, unless you purchase coverage through our DefenderPlus endorsement.
- Necropsy.
- Preventive care including but not limited to wellness exams, flea control, worm medication and vaccinations, unless you purchase coverage through our Defender/DefenderPlus endorsement.
- All diets, pet(s) food, vitamins and nutritional supplements, whether prescribed or not.
- Alternative treatments including but not limited to holistic, acupuncture, chiropractic, herbal and homeopathic. (Laser therapy, hydrotherapy and physical therapy are not considered alternative treatments and therefore covered expenses.)
- Any diagnostics or treatment associated with anal glands.
- More than one illness or injury per coverage period arising from a repetitive and specific activity or similar activity that has previously occurred and displayed the propensity for this activity to happen again and cause injury or illness to your pet(s). (Examples include but are not limited to: foreign body ingestion, dog fights, and toxin ingestion)
- Diagnostics or treatment for internal or external parasites including but not limited to fleas, heartworms, and roundworms.
- Illnesses for which a vaccine is available, unless your veterinarian has recommended that your pet(s) not receive such vaccine. This includes but is not limited to; Canine and Feline Distemper, Parvovirus, Parainfluenza, Hepatitis, Leptospirosis, Calicivirus, Feline Immunodeficiency Virus, Feline Infectious Peritonitis, Bordetella, Rabies and Feline Leukemia.
- Injuries caused by your pet(s) being attacked or attacking another pet(s) in your household.
- Experimental, investigational treatment, organ and tissue transplants, or prosthesis.
- Sales tax, medical waste, veterinary administrative, shipping, and postage fees.
- House calls, travel time, boarding and/or transportation.
- Treatment or diagnostics related to behavior.
- Any conditions related to teeth including but not limited to gingivitis, periodontal disease, root canals, caps and crowns, vital pulpotomies, deciduous teeth, diseased or abscessed teeth (except medically necessary extractions for permanent broken teeth due to an accident).
- Conditions resulting from activities related to training or participating in track or sled racing, guard security, working, or organized fighting.
- Injury or illness caused directly or indirectly by: a) enemy attack by armed forces, with or without a state of war, including actions taken in resisting the attack; b) insurrection; c) rebellion; d) revolution; e) invasion; f) civil war; g) illegal acts; h) usurped power; i) nuclear radioactive contamination; j) pandemic conditions.
- The cost of treatment or diagnostics for bilateral conditions presenting on one side of the body, if that condition was a pre-existing condition on the other side of the body. (For example, but not limited to, if a dog has been diagnosed with a cruciate tear in his left leg before the coverage period or during the waiting period, a subsequent cruciate tear in his right leg shall be considered pre-existing).
- Obesity or overweight, if not due to an underlying medical condition.
- Osteoarthritis, Spondylosis, Luxating Patella and Diabetes, unless you purchase coverage through our InheritedPlus endorsement.
- Necropsy.
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- Pre-existing Conditions.
- Preventive Care.
- Treatment for Dental Illness.
- Treatments for Accidents or Illnesses arising from any Preexisting behavioral problems.
- More than one (1) removal of an ingested foreign body in one (1) period of insurance.
- Any Illness as a result of a covered Accident that is not part of the initial course of Treatment for that Injury.
- Ambulance transportation.
- The cost of disposing of your Pet’s remains.
- The cost of boarding your Pet.
- Orthodontic Treatment.
- Costs of Treatments arising from your decision to pursue a course of Treatment other than that which was recommended to you by your Veterinarian, unless specifically authorized by us prior to Treatment.
- Treatment for any Injury or Illness resulting from activities related to racing, personal protection, law enforcement or guarding, unless specifically authorized by us prior to the Pet Original Start Date as shown on the Schedule Page.
- Treatment for any Injury or Illness resulting from activities related to racing, personal protection, law enforcement or guarding, unless specifically authorized by us prior to the Pet Original Start Date as shown on the Schedule Page.
- Cosmetic, aesthetic, or elective surgery including tail docking, ear cropping, de-clawing or any other surgical procedure not related to Injury or Illness.
- Prescription Medication that is not directly administered by a Veterinary Provider (e.g., take-home drugs). This exclusion does not apply to policies with the optional Prescription Drug Coverage.
- Natural supplements, vitamins, and all foods, whether prescribed or not.
- Treatments for any Illness for which a vaccine is available for your Pet to prevent such Illness and for which vaccination is both recommended by your Veterinary Provider and rejected by you.
- Any administration fees charged by a Veterinary Provider or others, including chart set-up fee or for providing information which may be required by us.
- Services performed by Veterinary Provider for his/her own cat or dog.
- Costs for any Treatment for Prosthetic limbs and devices; Organ transplants; Genetic/chromosome testing; Procedures to determine the suitability or categorization of your Pet for breeding or genealogical purposes, including PennHIP and OFA evaluations.
- Costs resulting from breeding, pregnancy, whelping or queening.
- Costs arising from cell-replacement therapies, except where deemed Medically Necessary by our Medical Director.
- Costs for any Treatment arising from avian, swine, or any other type of influenza or any mutant variation; intentional slaughter by, or under, the order of any government or public or local authority; epidemics or pandemics as declared by the U.S. Department of Agriculture.
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- All pre-existing conditions.
- Examinations.
- Any injury or illness/disease for which clinical signs were observed prior to the policy effective date or illness during the 30 day waiting period or injury during the 5 day waiting period.
- Administrative charges and Taxes.
- Processing of insurance claims and transmission of medical records.
- Preventive care.
- Injuries due to any intentional act that involves You, or a member of Your household.
- Breeding, Illnesses or Injuries related to breeding, whelping, and queening unless You add the Breeding Rider to Your policy.
- Elective, cosmetic, or preventive procedures, including, but not limited to: tail docking, ear cropping, declawing, dew claw removal, and microchip implantation.
- Vaccinations, titer tests, flea control, tick control, heartworm Medication, and deworming.
- Complications or sequelae to Illnesses, Injuries, procedures, diagnostic tests, treatments and/or Medications excluded or restricted by this policy.
- Anal gland expression.
- Bedding, housing, crates, cages, ramps, feeding bowls/ platforms, feeding, exercise, non-prescribed special diets, raw food diets, Pet foods, routine or preventive supplements (unless covered under section 8.C.), bathing, non-medicated shampoo, grooming, nail trims, ear cleaning, ear irrigation, toys, clothes, leashes, collars, and treats.
- Any Illness or Injury resulting from activities related to training for or participating in racing, including track or sled racing.
- Spaying or neutering at any time or for any reason unless recommended by Your Veterinarian following an Illness or Injury that involves damage to the reproductive organs.
- Parasite control, including, but not limited to: internal or external parasites.
- Cremation and burial.
- Optional coverage not selected.
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- Veterinary examination fees.
- Injury from an accident that occurs within the first fifteen (15) days following the pet policy effective date.
- Illness that occurs or recurs within the first fifteen (15) days following the pet policy effective date.
- Illness related to hip dysplasia that occurs or recurs within the first twelve (12) months following the pet policy effective date. For pets six (6) years of age or greater on the date of enrollment, no coverage shall apply for illness related to hip dysplasia.
- Pre-existing conditions.
- Spaying and neutering.
- Preventive healthcare including vaccinations or titer test, flea control, heartworm medication, de-worming, nail trim, and grooming.
- Parasite control including but not limited to internal and external parasites for which readily available prophylactic treatments are available.
- Dental health care, however if injury to teeth is caused by an accident, we do cover the cost of extraction and/or reconstruction of damaged teeth.
- Anal gland expression.
- Injury or illness due to any intentional, neglectful or preventable act, including organized dog fighting, by you or a member of your household.
- Elective procedures, cosmetic procedures, preventive procedures.
- Ear cleaning.
- Boarding or transport expenses.
- Conditions arising from a specific activity if the same or a similar activity occurred prior to the pet policy effective date and displayed the propensity for the activity to recur and cause injury or illness to your pet.
- Pre-existing cruciate ligament problems to one leg as respects the cost of future treatment for problems of the other leg.
- Diseases preventable by vaccines and prophylactic medications (such as heartworm, lice, internal parasites and fleas).
- Complications of conditions excluded or limited by this policy.
- Abnormalities where clinical symptoms were apparent prior to the pet policy effective date. This includes conditions that are detectable by a routine physical exam by your veterinarian.
- Claims in any way arising from the lack of use and/or implementation of preventive healthcare products and/or methods when such products and/or methods would be in accordance with generally accepted veterinary standards. Routine healthcare includes: vaccinations, flea control, heartworm medication, de-worming, dental care, ear plucking, grooming, and prudent regular care.
- Special diets, pet foods, vitamins, supplements, grooming, nail trims, shampoo and bathing (including medicated baths).
- Conditions arising from any specific activity if the same or similar activity occurs after you have received written notice from us regarding the specific activity.
- Experimental or investigational treatment or medicine.
- Breeding or conditions relating to breeding, whelping, and queening.
- Diagnostic tests for conditions excluded by this policy.
- Diagnostic tests due to complications of conditions excluded or limited by this policy.
- Feeding, housing or exercise.
- Behavioral modification, training, therapy or medications for behavioral modification.
- For working pets, no coverage shall apply for any condition resulting from activities related to racing, breeding, law enforcement, guarding or for any commercial use.
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- Any and all pre-existing Clinical Symptoms/Clinical Signs, Medical Conditions, diseases, Illnesses, and/or Accidents.
- Any and all Illness Conditions within the Illness Waiting Period.
- Any Treatment related to a Temporary Exclusion or Permanent Exclusion.
- Any Treatment for a Bilateral Condition in which that Condition was already pre-existing on one side of the body.
- Any Treatment for an Accident, Illness or procedure with respect to which You were advised by a Veterinarian to take preventative measures, and You did not comply.
- Any Treatment for an Accident or Illness Condition resulting directly from Your Pet’s usage for occupational, professional, or business purposes, breeding, racing, hunting, organized fighting, coursing (the pursuit of game by Your Pet), law enforcement, or guarding.
- Any Treatment for an Accident or Illness including mistreatment, injury or neglect caused by You, any member of Your household, or anyone employed or contracted by You.
- Preventive Care and Routine Treatment intended for the maintenance of good health of Your Pet. This includes but is not limited to vaccinations (including Vaccine Titers), prophylactic medications (such as heartworm, lice, internal parasites and fleas), spaying (including for false pregnancy or pyometra), neutering (including cryptorchid neuters), and anal gland expressions, unless otherwise specifically covered by Our Wellness Fees Coverage and Coverage is in force under the Wellness Fees Coverage as indicated by Your Document of Insurance.
- Elective procedures and cosmetic procedures and any related Associated Conditions due to these procedures. This includes but is not limited to: tail docking, ear cropping, ear hair plucking, declawing or tenectomy, dew claw removal, nail trims, grooming, debarking, treats and supplements.
- Any Treatment for Medical Conditions arising from lack of use and/or failure to follow a preventative health care plan generally accepted by veterinary standards or recommended by Your Veterinarian. Preventative health care plan includes but is not limited to; vaccinations, flea control, heartworm medication, de-worming, Dental care, grooming.
- Any Treatment related to breeding, whelping, fertility Treatment and care related to pregnancy including false pregnancy, giving birth and nursing and any and all related issues, Conditions and complications including pyometra and mastitis.
- Any Treatment for Medical Conditions that would be preventable with sterilization (spaying or neutering the Pet) such as prostate problems, testicular problems, perianal tumors, mammary tumors, uterine and/or ovarian Conditions that occur in an unsterilized Pet.
- Non-essential and/or non–medical related boarding and/or hospitalization.
- Shipping expenses.
- Transport expenses, except as may be covered by Our Ambulance and Paramedical Services in Sect. 5.
- Any Treatment You choose to have carried out that is not directly related to a covered Accident or Illness.
- Any and all training, and any other behavioral modification techniques considered experimental.
- Therapeutic Food specifically prescribed by a Veterinarian, with the exception of 50% of the cost, for a covered Medical Condition up to the Maximum Benefit Amount of $500 per year as stated in Section 5.
- Dental and orthodontic health care, Dental Treatment, Dental procedures and/or Dental diseases including but not limited to Treatment of the teeth and gums, Dental caries (cavities), gingivitis, periodontitis, retained deciduous teeth, malocclusion, periodontal disease, root canals, caps, crowns, or abscessed teeth.
- Experimental or investigational medical procedure, Treatment or service.
- Euthanasia or destruction of a Pet deemed ‘dangerous’.
- Euthanasia or destruction of a Pet due to financial reasons.
- Additional memorial options elected by You at the time of cremation including but not limited to urns, caskets, paw prints, memorial stones.
- Any Medical Condition(s) that arise due to specific exposure that results in subsequent occurrences of what is now determined to be a preventable Medical Condition (examples. vaccine reactions and flea allergy dermatitis) for which You can take preventative measures.
- Any Medical Condition that arises due to repetitive activity that results in Your Pet requiring repeated medical Treatment. After three separate but similar incidents of such claims coverage these Medical Conditions would be considered or diagnosed preventable or behavioral, such as but not restricted to Foreign Body Ingestions, Porcupine Quills, Fight/Bite Wounds/Lacerations, Motor Vehicle Injuries and Poison Ingestions.
- Any claims for monies over and above the Maximum Benefit Amount stated in the Policy and/or Product Coverage Chart.
- Shipping expenses.
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- Costs or fees for treatment of pre-existing conditions.
- Costs or fees for any injury that is the same as, or has the same diagnosis or clinical sign(s) as any injury that occurred to your pet before the effective date of this policy or during the first five (5) days beginning on the effective date of this policy.
- Costs or fees for congenital defects or abnormalities where clinical sign(s) were apparent prior to the effective date of the policy or that became apparent during the first fourteen (14) days beginning on the effective date of this policy.
- Costs or fees for the treatment associated with damage or rupture of cruciate ligaments, luxation of the patellas or other soft tissue disorders of the knee where clinical sign(s) occur during the first six (6) months that the policy is in effect; provided, however, that this exclusion does not apply if your pet is examined by a vet within the first thirty (30) days of the policy and the medical record specifically notes your pet does not have any pre-existing conditions relating to its knees.
- Costs or fees for the treatment associated with damage or rupture of cruciate ligaments, luxation of the patellas or other soft tissue disorders of the other knee if your pet has received treatment for a cruciate or soft tissue injury to its first knee prior to the inception date of the policy or during the first six (6) months of the policy, no certification of knee health has been provided as described in Section G.5.; and the treatment occurs within a period of twelve (12) months from the date of last treatment to the first affected knee.
- If your pet has shown clinical signs of a cruciate or soft tissue injury to one knee prior to the effective date of this policy or during the first six (6) months of the policy (where no certification of knee health has been provided as described in Section G.5.) and appropriate treatment has not been performed, then the other knee is automatically excluded from coverage. Once appropriate treatment has been performed, the other knee is excluded from coverage for a period of twelve (12) months from the date of last treatment to the affected knee.
- Intervertebral disc disease if another disc in the same or neighboring spinal region was trated or showed clinical sign(s) prior to the effective date or the first 14 days of the policy.
- Costs or fees for the treatment of intervertebral disc disease when another disc in the same or neighboring spinal region (e.g. cervical, lumbosacral) was previously treated or showing clinical sign(s) prior to the effective date of this policy or during the first fourteen (14) days beginning on the effective date of this policy.
- Costs or fees arising out of or related to Breeding; Pregnancy; or Whelping or nursing provided, however, that costs or fees for treatment arising out of complications resulting from breeding, pregnancy or whelping will be covered if the date of breeding falls after the fourteenth (14th) day after the effective date of your initial policy.
- Costs or fees for routine and preventive treatment.
- Costs or fees for any of the following regimens or therapy not administered or prescribed/referred by a vet (or under a vet’s direct supervision): Holistics; Homeopathic; Acupuncture; Chiropractic; or Physical therapy.
- Costs or fees for experimental procedures and treatments.
- Costs or fees for cloned pets or cloning procedures, whether or not deemed experimental or for research.
- Costs or fees for organ transplants not deemed medically necessary or not first approved by us.
- Costs or fees for treatments or preventive treatments for parasites or conditions related to parasites (internal or external) unless there is no preventive medication for the parasite.
- Intervertebral disc disease if another disc in the same or neighboring spinal region was trated or showed clinical sign(s) prior to the effective date or the first 14 days of the policy.
- Costs or fees for elective or specialty procedures.
- Costs or fees for treatment of illness or injury arising out of Racing, Coursing, Commercial guarding, Organized fighting, or any other occupational, professional or business uses of your pet.
- Costs or fees for treatment of an intentional injury or condition as a result of abuse (including persistent neglect) of your pet, by you or a member of your household.
- Costs or fees for treatment of an illness or injury for which you were advised by a vet to take preventive measures and did not do so.
- Costs or fees for treatment, death or humane destruction of your pet directly or indirectly caused by, happening through, arising or resulting from, or contributed to or by Avian Influenza or any mutant variation.
- Costs or fees for decontamination (i.e., the induction of vomiting, stomach pumping, or treatment with charcoal), medical, or surgical treatment of your pet arising from a repetitive and specific activity if the same or a similar activity has occurred two (2) times within the eighteen (18) month period prior to the initial coverage effective date.
- Costs or fees for food, including food prescribed by a vet, to treat or prevent illness unless the food is used to dissolve existing bladder stones and crystals in urine. In such circumstances we will only pay for the food for a period of up to six (6) months of treatment. After six (6) months of treatment, we reserve the right to request a urine sample from your pet to determine whether continued treatment is necessary.
- Costs or fees for bathing your pet unless a vet certifies that bathing was medically necessary and that only a vet or a member of veterinary staff should bathe your pet.
- Costs or fees for telephone consultations, except if provided for an immediate life-saving emergency Consultation.
- Except as provided under the Boarding Kennel and Cattery Fees Benefit, costs or fees the boarding of your pet at a veterinary facility; or having a certified pet sitter look after your pet; unless such boarding or supervision is medically necessary.
- Costs or fees for any form of housing, including cages – rented or bought.
- Costs or fees for the rental of a pool or hydro-therapy equipment of any type.
- Costs or fees arising from any non-veterinary services.
- Costs or fees for obedience or training classes, including puppy classes.
- Training, correctional devices, or preventive products; or the treatment of coprophagia or other eating disorders.
- Costs or fees for grooming or grooming supplies.
- Costs or fees for time and travel expenses to a vet’s premises or hospital.
- Costs or fees for treatment for house calls, unless a vet certifies them essential in an emergency.
- Extra costs or fees for treating your pet outside of usual surgery hours, unless the treating vet certifies that an immediate life-saving consultation is needed.
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- Aesthetic, cosmetic, endodontic, or orthodontic dental services such as caps, crowns or crown amputation, fillings, implants and root canals or planing.
- Anal sac (gland) expression and/or resection when no infection is present.
- Boarding.
- Breeding, pregnancy, whelping or nursing.
- Conditions that occur during a waiting period.
- Cosmetic and elective prostheses or procedures (including but not limited to claw removal, ear cropping and tail docking).
- Dental cleanings unless used to treat a covered illness or covered by an applicable endorsement.
- Experimental or investigational treatment or medication (including clinical trials) that is not generally accepted in the veterinary medical community as effective or proven.
- Grooming or grooming supplies (including but not limited to non-prescription baths, ear cleanings, non-prescription shampoos and nail trims).
- Herbs.
- House call fees, time and travel expenses to and from the veterinarian’s premises or hospital.
- Illness or injury that results from intentional, malicious, or grossly negligent activities or from failure to perform actions commonly accepted as responsible pet care by you, a member of your household or a caregiver for your pet.
- Non-medical supplies such as but not limited to toys, training devices, and leashes.
- Costs or fees for elective or specialty procedures.
- Non-veterinary services (including but not limited to administrative fees, medical records expenses, medical waste, postage and tax).
- Pre-existing conditions that occurred on or before the effective date of the policy or during a waiting period.
- Prescription food, pet food, diets or treats used for prevention or general health maintenance (including weight loss) even if prescribed or dispensed by a veterinarian.
- Preventive care without an occurrence (including but not limited to general health maintenance diagnostics, laboratory procedures, medications, physical examinations and surgery) unless covered by an applicable endorsement.
- Supplements and vitamins used for prevention or general health maintenance (including weight loss) even if prescribed or dispensed by a veterinarian.
- Veterinary expenses related to coursing, organized fighting, law enforcement or guarding, personal protection or racing.
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