Underwriting

AMERICAN PET INSURANCE COMPANY

 

a New York Domiciled Stock Company, NAIC #12190
Administrative Office: 6100 4th Ave S. Seattle, WA 98108

 

Pennsylvania

Insurer Disclosure of Important Policy Provisions

Pets Best Pet Health Insurance is underwritten by American Pet Insurance Company

Right to Return

You have 30 days from the day you receive this policy, certificate or rider to review it and return it to the company if you decide not to keep it. You do not have to tell the company why you are returning it. If you decide not to keep it, simply return it to the company at its administrative office or you may return it to the agent or Insurance Producer that you bought it from as long as you have not filed a claim. You must return it within 30 days of the day you first received it. The company will refund the full amount of any premium paid within 30 days after it receives the returned policy, certificate or rider. The premium refund will be sent directly to the person who paid it. The policy, certificate or rider will be void as if it had never been issued.

Exclusions

A policy excludes coverage due to any of the following:

  1. A Pre-existing Condition
  2. A Chronic Condition if manifested prior to coverage

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

Waiting Periods that Apply

1. 14 days following the Policy Effective Date for any Illnesses and any related Conditions.

2. 30 days following the Policy Effective Date for any Cruciate Ligament Events and any related Conditions.

3. Once met, these Waiting Periods are waived for continuous, uninterrupted policy Renewals, including, at our discretion, uninterrupted policy Renewals from other Pet Insurance providers.

4. The Waiting Periods may be reduced or waived for coverage acquired through pre-approved channels where the health of your Pet is certified by a participating Veterinarian prior to coverage being purchased.


Please refer to your Declaration Page for your Pet’s specific waiting period.

Description of Accident and Illness Plan Coverage

 

Annual Policy Limit

Option 1 $2,500 Option 2 $5K Option 3 $10K Option 4 No Annual Limit

Co-Insurance (Us / You):

50%/50%, 60%/40%, 70%/30%, 80%/20%, or 90%/10% as shown on the policy declarations page

Annual Deductible per Pet:

$50 - $2,000 as shown on the policy declarations page

Supplemental Benefits

 

Office Visits / Exam Fees

Covered or not covered as shown on the declaration page

Take Home Prescription Medications

Covered or not covered as shown on the declaration page

Rehabilitation, Acupuncture, and Chiropractic Care

Covered or not covered as shown on the declaration page

Description of Accident Only Policy

 

Annual Policy Limit

$10,000

Co-Insurance (Us / You):

90%/10%

Annual Deductible per Pet:

$250

Deductible & Coinsurance

DEDUCTIBLE: The Annual amount you pay out-of-pocket for the Actual Cost of Veterinary Treatment for any eligible Condition after the application of your selected Co-Insurance amount.

CO-INSURANCE: This term applies to both parties as described on your declarations page. The larger percentage represents our portion of the Actual Cost of Veterinary Treatment that is paid for any eligible Condition before the application of your chosen Deductible.

Claims Procedures

Payments for Claims are subject to: the terms of the Policy; any coverage limitations; Deductibles; and Coinsurance. We will make all Claims payments directly to you, unless we receive a written notice from you requesting that such payment be made directly to the veterinary provider listed on the Claim. Claim forms can be accessed on-line at the website address below or can be obtained by contacting Pets Best Insurance Services LLC. The most we are obligated to pay for Covered Loss is the lesser of the actual amount incurred for the treatment of an insured Pet, minus Deductible and Coinsurance; or the applicable scheduled Policy maximum benefit. The formula for determining claims reimbursement is as follows: eligible expenses multiplied by reimbursement percentage minus deductible = reimbursement amount.

Premiums

The cost of your policy may change if you change geographic locations or your Pet ages, among other factors. Your cost will not change based on your Pet’s individual claims experience.

Underwriting Company

Pet insurance coverage offered and administered by Pets Best Insurance Services, LLC is underwritten by American Pet Insurance Company, a New York insurance company headquartered at 6100 4th Ave. S. Suite 200 Seattle, WA 98108. Pets Best Insurance Services, LLC (CA agency #0F37530) is a licensed insurance agency located at 10840 Ballantyne Commons Parkway, Charlotte, NC 28277. Terms and conditions apply. See your policy for details.

Definitions

Chronic Condition - A Condition that can be treated or managed, but not cured. This includes, but is not limited to, Cruciate Ligament Event, atopy, renal disease, osteoarthritis, diabetes, inflammatory bowel disease, Cushing’s, heart disease, hyperthyroidism, and hip dysplasia

Insurance Producer - As defined in section 601-A of the act of May 17, 1921 (P.L.789, No.285), known as The Insurance Department Act of 1921.

Insured - A person on whose behalf a Pet Insurer is obligated to pay or reimburse covered Veterinary Expenses under a pet insurance policy.

Pet Insurance Policy - A property insurance policy, certificate or rider that provides coverage for Accidents and Illnesses of Pets.

Pet Insurer - An insurer that issues a Pet Insurance Policy.

Practice of Veterinary Medicine - As defined in section 3 of the act of December 27, 1974 (P.L.995, No.326), known as the Veterinary Medicine Practice Act.

Pre-existing Condition - This policy excludes coverage for Conditions Present prior to the Policy Effective Date. This means that any Condition for which any of the following are true prior to your policy’s effective date or during any Waiting Period, are not eligible for coverage: (1) A Veterinarian provided medical advice regarding the Pet. (2) The Pet received previous treatment (3) Based on information from verifiable sources, the Pet had signs or symptoms directly related to the Condition for which a claim is being made.

Renewal - As defined in section 3 of the act of July 22, 1974 (P.L.589, No.205), known as the Unfair Insurance Practices Act.

Veterinarian - An individual who holds a valid license to engage in the Practice of Veterinary Medicine from the appropriate licensing entity of the jurisdiction in which the individual engages in the Practice of Veterinary Medicine.

Veterinary Expenses - The costs associated with medical advice, diagnosis, care or treatment provided by a Veterinarian, including the cost of drugs prescribed by a Veterinarian.

Waiting Period - As follows: (1) The period of time specified in a Pet Insurance Policy that is required to transpire before some or all of the coverage in the policy can begin. (2) A Waiting Period may not be applied to a Renewal of existing coverage.

Complaint Resolution

Pennsylvania Insurance Department Contact Information:

1326 Strawberry Square
Harrisburg, PA 17120
Toll Free: 877.881.6388
Website: https://www.insurance.pa.gov/Pages/default.aspx

Pets Best Contact Information:

965 Keller Rd.
Altamonte Springs, FL 32714
1-877-738-7237
https://www.petsbest.com

Edited 12/2024