Policy Wording - Cat and Dog

Purpose

Beneficial Insurance Limited (“Company”) will reimburse the Owner, subject to the exclusions, terms and conditions mentioned in the Policy, the reasonable costs and expenses incurred by the Owner up to the Cover Amount as set out in the Policy Schedule and subject to the Co-Pay in providing Treatment for the Pet named in the Policy, with the provision that the Treatment is incurred within the Period of Cover. Refer to Definitions at the end of the Policy Wording for special meanings of words set out in bold in the Policy.

Address for Notices

All written correspondence to the Company must be sent to either PO Box 68548, Newton, Auckland 1145 or admin@petnsur.co.nz or fax 0800 329424

Free Look Period

The Owner has a 7 day “free look” period during which you can read the terms and conditions of the Policy and decide if you wish to continue with it. If you decide not to continue with the Policy, you will need to advise us in writing within seven days of receipt.

Changing your Plan

The Owner can, at time of renewal, apply in writing to increase or decrease the Benefit payable under the Policy by up-grading or down-grading the Cover. In the event of a Benefit increase there will be a 4 month stand down period from the Commencement Date for any new condition that the Pet experiences. Any claim for an existing condition will be assessed and paid on the terms and conditions, including exclusions, of the preceding Cover.

Period of Cover

The Cover is for a term of twelve months from midnight on the Commencement Date. Where we agree that you may pay your premium on an instalment basis, you are required to continue to make instalment payments until the Annual Premium is paid except where the Company cancels the Policy.
The Company reserves the right to terminate this Policy by advising the Owner in writing upon 21 days’ notice. If the Company terminates the Policy it will refund any unused premium for the term of the Policy, if any.
The Owner can only cancel the Policy at the end of a Period of Cover or any other time as long as the Owner pays the Company the Annual Premium due to the Company during the Period of Cover. If the Annual Premium is not paid, we reserve the right to charge a $75 processing fee and default fees and collection costs to recover the Annual Premium. Any requests by the Owner to cancel the Policy must be made in writing to the Company.

Renewal of Cover (“ Renewal”)

The Policy will be renewed for a further 12 month period from the Renewal Date set out in the Policy Schedule at the sole discretion of the Company. The Renewal will be subject to there being no Material changes to the information disclosed by the Owner to the Company.
A Renewal Advice will be sent to the Owner at the Owner’s last known address (postal and / or email) prior to the Renewal Date.
Any adjustments to the Annual Premium or Cover will be advised to the Owner on the Renewal Advice.
Payment of the Annual Premium on the Renewal and outlined on the Renewal Advice is payable in accordance with your existing method of payment and frequency as set out in the Policy unless contrary advice is received by us in writing and we agree, prior to the Renewal Date.
Until further notice, the Owner grants the Company authority to continue any existing Payment Authority given by the Owner to the Company and Owner’s Bank in relation to the payment of the Annual Premium.

Conditions

The obligations of the Company and payment of any Benefit under the Policy is conditional upon:

The Owner having paid to the Company the Annual Premium on or before the due date. In the event payment is not paid by the due date the Policy will lapse 7 days after the due date. No claims will be paid if a claim is received after a Policy has lapsed. In the event the Policy lapses the Owner can apply to have the Policy reinstated subject to the Company’s discretion, which could include proof of the Pet’s good health, new terms and conditions including exclusions being imposed and no claim being assessed or paid for the period that the Policy was lapsed.
The Owner ensuring that the Pet is properly cared for and maintained at all times and undertakes Treatment prescribed by a Veterinarian to prevent illness or sickness and the Pet is immediately taken to a Veterinarian as soon as it shows Symptoms of being unwell to be examined and treated without delay.
A maximum Benefit payable under this Policy as specified in the Policy Schedule.
The Owner paying the Co-Pay specified in the Policy Schedule on a per Treatment and / or per veterinary visit basis for each claim submitted.
The Policy only covering Treatment specified in the Policy Schedule for Treatment received by your Pet in New Zealand only.
The Owner has fully disclosed all known Treatment in relation to the Pet at application time, at the time of renewal or at any time during the Policy if a Material event or information relating to the Pet arises and in the event that it is found that any of this information has been withheld, the Company has the right to deem the Policy as void and not meet any claims that may be lodged.
None of the exclusions as listed below being applicable.
In the event information provided to the Company is fraudulent, misleading or untrue this Policy will be cancelled and the Owner forfeits entitlement to all Benefits which would otherwise have been payable under the Policy. The Company reserves the right to claim premiums paid to offset the Company’s costs.
The Owner ensuring that the Pet’s vaccinations for hepatitis, bordetella, distemper, parvovirus and leptospirosis for dogs and feline infectious enteritis and feline influenza virus for cats are kept up to date for the entire period of the Policy.
The Owner agreeing for the Pet’s veterinarian/s to provide the Company with the Pet’s Medical and Surgical records and information regarding all Treatments of any nature whether or not covered by the Policy and the Owner agreeing to meet the costs of obtaining this information.
The Company reserves the right to impose an additional Co-Pay or loading to the Policy, either at time of application or at the time of renewal and also reserve the right to specify a maximum payment for Treatment.
The Pet always being in the care of the Owner or someone that is a permanent resident at the address of the Owneror a trusted family member or friend or is in the care of a registered and recognised animal care institution i.e. a registered Cattery or Boarding Kennel.

Exclusions

The obligations of the Company and payment of any Benefit will not apply if:

A claim arises for Treatment within the Stand down Period including any follow up or on going Treatments relating to any Condition or Symptom that occurs within the Stand down Period.
Treatment is for a Pre-Existing Condition.
The claim is for the Treatment of skin and/or allergic conditions caused by the chemicals or substance used in products to maintain the cleanliness of the Pet or for the Treatment of ectoparasites on the Pet.
The Pet suffers contact skin conditions and/or allergies from contact with but not limited to plants.
The Pet has caused damage to any property or people or other animal.
The maximum Benefit as specified in the plan table is exceeded.
Treatment is as a result of a deliberate act, omission, negligent behaviour or maltreatment by the Owner or anyone at the Owner’s premises.
A claim is received for a Pet that is under the age of 6 weeks.
A claim is received in relation to a post mortem of the Pet.
A claim is received for Treatment of a psychiatric disorder, behavioural problems or costs associated with retraining a Pet due to them suffering such disorders or problems and / or any claim for Treatment that is caused by, or results from, psychiatric disorders or behavioural problems.
A claim received in relation to the travel expenses of the Pet’s veterinarian for any Treatment and/ or any courier costs incurred as a result of any Treatment.
A claim relates to the Treatment where the Pet is ordered to be destroyed by the courts, relevant legislation or any government agency of NZ.
The Treatment of the Pet is directly or indirectly caused through hunting, security work, racing or arranged or organised fighting.
Treatment that is a result of, or is related to, any breeding related procedures or any Treatments including, but not limited to, contraception, contraceptive procedures and pregnancies.
The Treatment is required due to or is related to the Pet being overweight or obese.
A claim is received for reimbursement of diet and / or prescription food, medication for diet and vitamin deficiencies or medication for a Pet’s coat (including shampoo), even if it has been prescribed and recommended by a Veterinarian.
The Treatment is for the normal health care and maintenance of the Pet including but not limited to, nail clipping, grooming, hydatids dosing, flea Treatment or any condition that arises directly or indirectly as a result of fleas or parasites.
A claim is received within the first six months of the Pet being imported into New Zealand.
The Treatment is for any cosmetic surgery, tail docking, removal of dew claw and any form of tattooing of a Pet.
The Treatment is elective including but not limited to routine health checks, debarking or tagging.
The condition does not affect the Pet’s normal healthy lifestyle.
A claim is received for dental Treatment including but not limited to, inflammation of the gums, cleaning and de-scaling of the Pet’s teeth or the removal of any teeth, except in the instance where the Treatment is required due to the teeth being damaged in an accident.
The Treatment is for a condition that is for a preventable illness where a vaccine is available but has not been administered or taken on a regular basis or as directed by a Veterinarian.
If a Hereditary problem presents itself in the first three years of the Pet’s life, any claim relating to the illness will be excluded - the “Hereditary exclusion”.
All Congenital conditions or any Treatment related to a Congenital condition whether known or not.
The claim relates to cataract operations, Treatments or medication and routine eye testing - the “eye exclusion”.
The Treatment is for heart worms.
The claim is for the testing or Treatment of feline aids or related conditions to do with feline aids or feline infectious peritonitis (FIP) or feline leucemia.
The claim is for any transplant, replacement or implant of any organs or body parts including pacemakers and prosthetics.
The Treatment is for tetanus or for Treatment to prevent tetanus.
The claim is a result of declared or undeclared war or any act thereof, invasion or civil war or any claim that is a result of a natural disaster.
A claim is received for Treatment more than 6 months after the Treatment was completed or more than 1 month after Renewal Date.

General

The Owner is responsible to ensure all Policy details and contact details are correct including details relating to the Pet and the Treatment history.

Premium payments that fall due on a Public Holiday(s) shall be debited on the working day preceding the Public Holiday(s) using any existing Payment Authority given by the Owner to the Company.

Claims Process

To make a claim for reimbursement of a Benefit covered under the Policy (subject to the Terms, Conditions and Exclusions contained in the Policy Schedule), the Owner needs to:

Telephone Beneficial Insurance Limited on 0800 738 678 notifying a claim and to request a claim form; or
Fax to Beneficial Insurance Limited on 0800 329 424 requesting a claim form to be sent; or
E-mail to claims@beneficial.co.nz and request a claim form to be sent; or
Download claim form at www.petnsur.co.nz.

In order for the Company to assess the Pet’s claim, the Company will require the Owner to complete a claim form, provide copies of all relevant receipts and produce (at their own expense) all relevant information from your veterinarian or other parties as requested by the Company. In the event that the claim is accepted, the payment will be less the Co-Pay as referred to in the Policy Schedule. In the event that the Pet is covered with another provider in addition to this Policy from which you are eligible for reimbursement for a claim under their Policy then the Company will not refund more than the total refundable share of the amount claimable under the Policy. You must also advise the name of the other Company giving us permission to discuss all details of the relevant claim. The following will be required to assess claims for:

Lost Pet - Police report, copy of the advertisement and a copy of the receipt of payment for the advertisement.

Replacement Pet - Proof of death of the Pet and a copy of receipt from seller of new Pet.

Boarding fees - Will require evidence of hospitalisation of Owner and a receipt from a recognised boarding place.

Funeral costs - Proof of death of the Pet and a copy of receipt from a recognised Pet funeral organisation.

In the event that there is a disagreement between the Company and the Owner in regards to a claim, the claim may be referred to an independent veterinarian as agreed by both parties who will act as an arbitrator. The cost will be at the expense of the party who is found to be at fault.

Definitions

Alternative Therapy means acupuncture, chiropractic care, homeopathy, hydrotherapy, manipulation, massage therapy, physiotherapy, osteopathy or similar Treatment performed or personally authorised by a Veterinarian.

Annual Premium means the full premium due on a Policy for any given year determined by the Company excluding premium discounts applied (if any).

Benefit means an amount payable under the Policy as a result of a claim assessment by the Company.

Commencement Date means that date referred to in the Policy Schedule.

Company means Beneficial Insurance Limited.

Congenital means a Congenital anomaly or developmental defect which is present at birth but may not manifest symptoms until later in your pet’s life.

Cover means the Cover applying to the Policy and Pet as set out in the Policy Schedule.

Co-Pay means the amount the Owner pays towards the cost of Treatment.

Hereditary means a genetic condition which is passed down through your pet’s bloodline and which is commonly breed specific.

Material means any information that would have influenced the judgment of a prudent provider in fixing the premium or in determining that he/she would have taken or continues the risk upon substantially the same terms.

Medical / Medical Treatment means Veterinary care, hospitalisation, diagnostics, medication, nursing, specialist referral, medical devices, Alternative Therapy and behavioural therapies performed or personally authorised by a Veterinarian (subject to the Policy Terms, Conditions and Exclusions).

Owner means the person(s) that is referred to in the Policy Schedule as the Pet Owner(s).

Payment Authority means any Direct Debit Authority, Automatic Payment Authority or Credit Card where the Owner authorised the Company to debit a nominated bank account and / or credit card for the premium payments due under the Policy.

Period of Cover means the period referred to in the Policy Schedule from the Commencement Date to the Renewal Date.

Pet means the animal(s) referred to in the Policy Schedule.

Policy means the Policy Schedule or Updated Schedule and Policy Wording.

Policy Schedule means the Schedule the Company issues to the Owner outlining the full details of Cover provided under the Policy.

Pre-Existing Condition means any Treatment, Symptom or Chronic condition relating to the Pet that occurs prior to the Commencement Date, regardless of whether or not it is specifically diagnosed, which you are aware of or a reasonable person in your circumstances ought to have been aware of including any Treatment, Symptom or Chronic condition that is related to or is a result of any Pre-Existing Condition.

Recurring / Chronic / Ongoing condition means a condition which continues indefinitely and has no widely accepted cure and / or may require longer than 3 months of monitoring, medication, Treatment, consultations, check-ups, examinations or tests and / or may relapse following Treatment with intervals of remission in between.

Renewal Advice means the Policy sent to the Owner by the Company at the time of Renewal.

Renewal Date means that date referred to in the Policy Schedule.

Select Breed refers to the following breeds or a mix breed containing any of the following breeds: Anatolian Shepherd; Basset Hound; Beauceron; Boxer; Briard; All Bulldog Breeds; Bloodhound; Bouvier des Flanders; Dachshund; Deerhound; Dobermann; Dogue de Bordeaux; English Bull Terrier; Giant Schnauzer; Great Dane; Greyhound; Irish Wolfhound; Leonberger; Lurcher; All Mastiff Breeds; All Mountain Breeds (including Bernese and Pyrenees) ; Munsterlander; Newfoundland; Old English Sheepdog; Rhodesian Ridgeback; Rottweiler; St Bernard; Shar-Pei; Soft Coat Wheaten Terrier; Staffordshire Terrier (including Pit Bull Terrier).

Stand down Period means the period specified in the Policy.

Surgery / Surgical / Surgical Treatment means procedures performed or personally authorised by a Veterinarian involving an incision with instruments performed to repair damage or arrest disease in a Pet (subject to the Policy Terms, Conditions and Exclusions).

Symptom(s) means physical or mental evidence which indicates a disease or disorder.

Treatment means any examination, consultation, surgery, medication, tests, scans, x-rays and diagnostic work by a Veterinarian on the Pet.

Updated Schedule means the Policy Schedule the Company issues to the Owner at the time the Policy is renewed or cover is amended.

Beneficial Insurance Limited has a Full Licence to carry on insurance business in NZ as required by the Insurance (Prudential Supervision) Act 2010 [v210618]