POLICY WORDING FOR PET DOGS – PLEASE READ THIS CAREFULLY
- This policy will incept on the first day of the next calendar month following the acceptance of the application. The policy terms and premiums payable will be reviewed on the 1 June each year. The premiums are subject to inflation.
- There is an excess fee of 10% for every claim with a minimum of R200 per claim that you must pay.
- All non-emergency treatments (in terms of 1 B above “what we cover”) must be pre-authorised by P.uma.
- You agree to disclose all information relating to the pet’s health and condition at the time of signing up for cover and thereafter. This includes all examinations and/or treatments as well as signs and symptoms your pet received or displayed prior to applying for the insurance. Failure to do so could result in the cancellation of your policy due to-non disclosure. Please note, new underwriting terms might be offered, and should you not accept the new underwriting terms, your policy will be cancelled.
- P.uma reserves the right to contact your Vet(s) to obtain a full history for your pet. This information is utilized for our underwriting decisions
- You must notify P.UM A of any emergency treatments within 72 hours of the event (firstname.lastname@example.org).
- All claims must be submitted to P.UM A within 60 days of the date of treatment (email@example.com). If your claim is older than 60 days, it will be repudiated [due to late submission].
- P.UM A pays claims in accordance with the South African Veterinary Councils Guideline of Tariffs and reserves the right to request a second opinion from a vet of our choice regarding treatment and fees charged. If the fees are deemed excessive or the treatment deemed inappropriate we will pay the lesser amount with the balance being for your account.
- As the person responsible for the pet you are expected to take all reasonable steps to prevent injury and illness. Failure to do so may result in rejection of claims and/or the cancellation of this policy.
- If there is another insurance policy covering the same claim, only the rateable proportion of that claim will be paid in terms of this policy.
- Consultation, acute medication, initial diagnostics, x-rays, biopsies and tests.
- Rehabilitation (post-operative only) treatments, specialist referrals, further diagnostic workups, blood tests, MRI / CT scans, radiology, radiation / chemotherapy, surgeries, chronic medication and prosthesis requires pre-approval and is subject to case management and clinical protocols. P.uma will require a detailed treatment plan from the treating Vet.
- Chronic treatment plans may be purchased at an additional premium as a complement to this insurance plan. Chronic treatment plans are subject to treatment protocols (appropriate treatment plans) as determined and approved by P.uma (under the guidance of our Vet). A detailed treatment plan must be submitted by the treating Vet for approval by P.uma.
- DogSure will pay up to a maximum of R 600.00 towards vaccinations for your dog. This amount will only be paid on receipt of a valid invoice from the Vet. This benefit is available once per policy year.
- Your pet is immediately covered for accidental injuries, as long as the policy has incepted
- The treatment of pre-existing conditions, including any condition that manifests during any waiting period (If your pet is diagnosed with any illness/condition or a pre-existing injury is noted within the waiting period, these will become full exclusions on the policy).
- P.UM A reserves the right to refuse payment for repeated treatments if they are, under advice, deemed as ineffective, excessive or likely to cause the pet undue distress.
- Any costs other than the costs of veterinary treatments for the pet listed on the policy.
- The costs for the treatment of any illness within the first 30 days of joining DogSure. (The costs of treatments for trauma resulting from accidental injury are covered in this period).
- Any invoices submitted more than 60 days after the date of treatment.
- The costs for any treatments for injuries and illness incurred outside of the Republic of South Africa.
- Any injury caused by abuse or negligence. We will report all abuse to the relevant authorities.
- Any treatment that continues for longer than 3 months unless approved by P.UMA and subject to clinical protocols.
- Any complementary treatments, experimental treatments or any treatments not forming part of mainstream veterinary science, including but not limited to acupuncture, physiotherapy, homeopathy, hydrotherapy, rehabilitation care (if not post-surgery and pre-approved).
- The treatment of behavioral disorders.
- Any routine care such as dental scale and polish, anal gland expression, de-worming, grooming, tick and flea control or any food costs.
- Any elective or cosmetic treatments.
- Any treatments in connection with pregnancy, birthing and fertility and breeding (any complications suffered as a result as one of these), sterilization, artificial insemination and injuries resulting from breeding.
- House calls, travel costs, after-hours consultation or hospitalisation unless a vet confirms it as necessary in terms of the pet’s health.
- Any surgical items that can be used more than once. These are non-chargeable items.
- The costs of any prosthesis, implants or transplantation unless explicitly approved by P.UMA.
- Any costs after death and/or cremation (post mortem examinations).
- Any treatment by person/s not registered with the South African Veterinary Council.
- We do not under any circumstance cover euthanasia unless recommended by a veterinarian.
- Any non-emergency treatment undertaken without the prior approval of P.UMA.
DO NOT BE PRESSURED INTO BUYING THIS PET INSURANCE POLICY You are entitled to cancel your contract within 14 days after inception should the product not meet your requirements. Thereafter you have the right to cancel this policy by giving 30 days notice.
Do not sign any blank or partially completed application forms and please keep notes of anything said to you regarding your insurance You are entitled to a copy of all documentation relating to this insurance FREE of charge.
You must be informed in writing if any changes are made to this contract and your policy cannot be cancelled unless a written confirmation is sent to you.
You have the right to know all fees and premiums applicable to this insurance contract.
All premiums are collected by debit order to your account, please make sure that you are being debited correctly.
If a claim is rejected, you must be given the reasons in writing.
Please make sure that all the information you supply has been recorded correctly. Any misrepresentation or incorrect information can prejudice you in the event of a claim.