INDEPENDENCE AMERICAN INSURANCE COMPANY

NEBRASKA

Insurer Disclosure of Important Pet Insurance Policy Provisions

Policy Definitions

• "Chronic Condition" - means a condition that can be treated or managed, but not cured.
• "Pet Insurance" means a property insurance policy that provides coverage for Accidents and Illnesses of pets.
• "Pre-Existing Condition" means a condition for which any of the following are true prior to the pet’s Policy Effective Date or during any waiting period:
1. A veterinarian provided medical advice;
2. Your pet received previous treatment; or
3. Based on information from verifiable sources, your pet had clinical signs or symptoms directly related to the condition for which a claim is made.

A condition for which coverage is afforded on a policy cannot be considered a preexisting condition on any renewal of the policy.

• "Veterinarian" means an individual who holds a valid license to practice veterinary medicine from the appropriate licensing entity in the jurisdiction in which the individual practices.
• "Veterinary Expenses" means the actual costs associated with medical advice, diagnosis, care, or treatment provided by a veterinarian including, but not limited to, the cost of drugs prescribed by a veterinarian.
• "Waiting Period" means the period of time specified in this pet insurance policy that is required to transpire before some or all of the coverage in the policy begins. Waiting periods may not be applied to renewals of existing Coverage.

Required Disclosures

Policy Exclusions and Limitations

The policy excludes coverage due to any of the following:

1. Pre-existing Conditions on both accident & illness and accident only policies.
2. Any accident, condition, or Cruciate Ligament Event with respect to which the policyholder was advised by a Veterinarian to take Preventative measures, and did not meet the terms. Cruciate Ligament Events are not covered under the accident only policy.
3. Intervertebral Disc Conditions are not covered under the accident only policy.

Other exclusions may apply. Please refer to the exclusions section of the policy for more information.

The policy limits coverage through:

1. Waiting Periods.
2. Deductibles.
3. Coinsurance.
4. An Annual Limit.

We do not reduce coverage or increase premiums based on the policyholder's claim history.

We may increase premiums based on:

1. The age of the covered pet.
2. A change in the geographic location of the policyholder.

Insurance Carrier

The underwriting carrier, Independence American Insurance Company, differs from the brand names used to market and sell the product.

Right To Examine And Return A Policy

A policyholder has 30 days from the date the policy was received to review it and return it to us if the policyholder decides not to keep it. The policyholder does not have to tell us why they are returning it. If the policyholder decides not to keep it, it can be returned to us at our administrative office, or the policyholder can return it to the insurance producer that they bought it from, as long as the policyholder has not filed a claim under the policy. The policyholder must return the policy within 30 days of the date it was received. We will refund the full amount of any premium paid within 30 days after we receive the returned policy. The premium refund will be sent directly to the person who paid it. The policy will be void as if it had never been issued.

Claims Payments

Benefits are subject to all terms, conditions, and limitations of the policy.

Claim Payment Methodology:
Depending on plan selection and availability, We will process claims utilizing the following methodology:

• We first apply your coinsurance to the eligible charges. We then apply the remaining eligible charges to your annual deductible. Once your policy annual deductible has been met, claims for eligible charges are subject only to your coinsurance until any applicable annual maximum has been reached.

Claim Payment Methodology for Optional Preventive Care Benefit (EssentialWellness/BestWellness™ Endorsement):
Preventive Care services, if included as covered benefits under your policy, are reimbursed at the actual cost of the covered expense incurred, up to the applicable maximum allowable limit shown on the benefit schedule in the EssentialWellness/BestWellnes™ Endorsement.

Waiting Periods

Accident and Illness Plan:
This Policy includes the following Waiting Periods:

1. 14-days from the pet’s original policy effective date for illnesses.
2. 30-days from the pet’s original policy effective date for any Cruciate Ligament Events and any related Conditions.

This Policy does not apply any Waiting Periods:

1. to injuries sustained in an accident.
2. to orthopedic Injuries sustained in an accident.
3. upon renewal of existing coverage.

Accident Only Plan:
This Policy does not apply any Waiting Periods:

1. to injuries sustained in an accident.
2. to orthopedic Injuries sustained in an accident.
3. upon renewal of existing coverage.

All Plans:
Any applicable waiting periods begin on the covered pet’s original policy effective date. Once an applicable waiting period has expired, as calculated from the covered pet’s original policy effective date, additional waiting periods are waived for subsequent coverage periods, provided you maintain an active policy, with no gap in coverage, which is continuously in-force and renewed annually. Any applicable waiting period limitations are shown on the Declarations Page.

Waiver of Waiting Periods:
We may waive an applicable waiting period upon completion of a veterinary examination and submission of the Waiting Period Waiver Form. Please refer to the Waiver Form for all conditions and requirements that need to be met in order to obtain the waiver of the applicable waiting periods.

Once we receive the examination records and the completed waiting period waiver form from your Veterinarian, we will determine if it meets our review criteria. If it does, we will waive any applicable waiting periods shown on the Declarations Page. If the waiver of the waiting period is granted, any conditions identified during the veterinarian examination may be considered Pre-Existing Conditions under the terms and conditions of your Policy.

Contact Information

State Contact:
State of Nebraska
Department of Insurance Contact Information:
PO Box 95087
Lincoln, Nebraska 68509-5087
1-877-564-7323
https://doi.nebraska.gov/

Insurer Contact:
Insurance policies are issued and underwritten by Independence American Insurance Company
Independence American Insurance Company
11333 N Scottsdale Rd, Ste 160
Scottsdale, AZ 85254

Administrator Contact:
Plans are administered by Pets Best Insurance Services, LLC, a licensed agency
965 Keller Rd.
Altamonte Springs, FL 32714
1-877-738-7237
https://www.petsbest.com

Marketing Contact:
Plans are offered and marketed by Pets Best Insurance Services, LLC.
965 Keller Rd.
Altamonte Springs, FL 32714
1-877-738-7237
https://www.petsbest.com