Policy Wording - Exotics

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 Maximum Cover and subject to the Co-Pay in providing Medical Treatment for the Pet named in the Policy, with the provision that the Medical Treatment is incurred within the Period of Cover.

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

COVER:

a) 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.
b) The Cover is provided for the Pet/s named in the Policy Schedule only. Proof of identity may be required.
c) The Cover under this Policy is defined in the Policy Plan table set out in your Policy Schedule.

PERIOD OF COVER:

a) The Cover is for a term of twelve months from 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 full premium has been paid to the Company, except where the Company cancels the Policy.
b) The Company reserves the right to terminate this Policy by advising the Owner in writing upon 21 days notice. Where the Company terminates the Policy it will refund any unused premium for the term of the Policy, if any.
c) The Owner can only cancel the Policy at the end of an annual Cover period or any other time as long as the Owner pays the Company the full Annual Premium due during the period of Cover. If the full Annual Premium is not paid, we reserve the right to charge default fees and collection costs to reCover the premium. Any requests by the Owner to cancel the Policy must be made in writing to the Company.

RENEWAL OF COVER:

a) 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") and will be subject to there being no Material changes to the information disclosed by the Owner to the Company.
b) A Renewal Advice will be sent to the Owner at the Owner's last known address prior to the Renewal Date and will include an Updated Policy Schedule (the "Updated Schedule") and Policy Wording.
Wording.
d) Payment of the Premium due on the Renewal and outlined on the Updated Schedule 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.
e) Until further notice, the Owner grants the Company authority to continue any existing Payment Authority given by the Owner to the Company and the Owner's Bank in relation to the Premium payments. This includes any Direct Debit Authority, Automatic Payment Authority or Credit Card Details where the Owner has authorised the Company to debit a nominated bank account and / or credit card for the premium payments due under the Policy or the Renewal.

CONDITIONS:

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

a) The Owner having paid to the Company the premium on or before the due date for payment - In the event that a premium payment is not paid by the due date for payment 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 asking for proof of the Pet's good health, new terms and conditions applying including exclusions being imposed and no claim being assessed or paid for the period that the Policy was lapsed;
b) The Owner ensuring that the Pet is properly cared for and maintained at all times in accordance with the requirements of The Animal Welfare Act 1999 (or as amended) and that the Pet undertakes treatments as prescribed by a Veterinarian at each annual check-up to prevent an illness or sickness occurring and to also ensure that the Pet is taken to a Veterinarian as soon as it shows signs of being unwell so that it can be examined and treated without delay;
c) The Owner ensuring that the Pet whether kept inside or outside must be kept in proper enclosures with adequate heating and ventilation;
d) A maximum Benefit payable under this Policy as specified in the Policy Schedule;
e) The Owner paying the Co-Pay specified in the Policy Schedule on a per Medical Treatment and / or per veterinary visit basis for each and every claim that is submitted under this Policy;
f) The Policy only Covering treatments specified in the Policy Schedule for Treatment received by your Pet in New Zealand only;
g) The Owner ensuring that he/she fully discloses all known Medical conditions 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;
h) None of the exclusions as listed below being applicable;
i) In the event a claim or any information provided to the Company is fraudulent, misleading or untrue this Policy will be cancelled and the Owner will forfeit entitlement to all Benefits which would otherwise have been payable under the Policy and the Company reserves the right to claim all premiums that have been paid to Cover the Company's costs;
j) The Owner ensuring that the Pet is vaccinated in accordance with vet recommendations for the entire period of the Policy;
k) The Owner agreeing for the Pet's veterinarian/s to provide the Company with the Pet's Medical records and supporting information regarding all treatments whether or not Covered by the Policy and the Owner agreeing to meet the costs of obtaining this information;
l) The Company reserves the right to impose a 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 selected treatments and procedures;
m) The Pet always being in the care of the Owner or someone that is a permanent resident at the address of the Owner, or is in the care of a registered and recognised animal care institution.

EXCLUSIONS:

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

a) A claim arises for illness or accident within the Stand down Period specified in the Policy Schedule including any follow up or on going Treatments relating to any Condition or Symptom that occurs within the Stand down Period.
b) Treatment is for a Pre Existing Condition.
c) The claim is for the Treatment of skin and/or allergic conditions that have been 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.
d) The Pet suffers contact skin conditions and/or allergies from contact with but not limited to plants.
e) The Pet has caused damage to any property or people or any other animal.
f) The Pet is being used for commercial purposes or kept on commercial premises for a period exceeding 28 days.
g) The maximum Benefit as specified in the plan table has been exceeded.
h) Treatment is a result of a deliberate act or omission or the negligent behaviour caused by the Owner or anyone at the Owner's premises.
i) Treatment for the Pet is as a result of injury or illness caused by your other Pets, the Pets of anyone living with you, or any other animal in your care, or any animal visiting your premises.
j) A claim is received for a Pet that is under the age of 6 weeks.
k) The claim is for the cost of having the Pet put to sleep (unless directed and carried out by the attending Veterinary Surgeon to alleviate suffering), cremated, buried or otherwise disposed of.
l) A claim is received in relation to a post mortem of the Pet.
m) A claim 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.
n) A claim is received for the cost of any vaccinations, spaying or neutering procedures.
o) A claim received in relation to the travel expenses of the Pet's veterinarian for any Medical or accident callouts and / or any courier costs incurred as a result of any Treatment.
p) A claim relates to the Pet / treatments where the Pet is ordered to be destroyed or quarantined by the courts / relevant legislation or any government agency of New Zealand.
q) The Treatment of the Pet is directly or indirectly caused through hunting, racing or arranged or organised fighting.
r) Treatment that is a result of, or is related to, any breeding / coming into season related procedures or any Treatments including, but not limited to, contraception, contraceptive procedures and pregnancies.
s) The Treatment is required due to or is related to the Pet being overweight or obese.
t) A claim is received for reimbursement of diet food, medication for diet and vitamin deficiencies or medication for a Pet's coat even if it has been prescribed and recommended by the Pet's veterinarian.
u) The Treatment is for the normal health care and maintenance of the Pet including but not limited to, nail clipping, grooming, hydatids dosing, flea treatments or any condition that arises directly or indirectly as a result of fleas or parasites.
v) A claim is received within the first six months of the Pet being imported into New Zealand.
w) The Treatment is for any cosmetic surgery, docking, removal of dew claws and any form of tattooing of a Pet.
x) The Treatment is elective including but not limited to routine health checks, sexing, microchipping, or tagging / I.D. marking.
y) The condition does not affect the Pet's normal healthy lifestyle.
z) A claim is received for dental Treatment including but not limited to, teeth trimming, inflammation of the gums, cleaning and de-scaling of the Pet's teeth, removal of any teeth or any Treatment resulting from overgrown or malocclusion of teeth.
aa) The Treatment is for a condition that is for a preventable disease/illness where a vaccine is available but has not been administered or taken on a regular basis or as directed by the Pet's veterinarian.
bb) The Treatment is a direct or indirect result of Rabbit Calicivirus Disease (RCD).
cc) If a hereditary problem presents itself in the first three years of the Pet's life then any claim relating to the illness will be excluded - the "hereditary exclusion" (Pre-Existing Condition rules will apply).
dd) The claim relates to cataract operations, treatments/medication and routine eye tests (all other eye conditions Covered) - "eye exclusion".
ee) The Treatment is for heartworms.
ff) The claim is for any transplant, replacement or implant of any organs or body parts including pacemakers and prosthetics.
gg) The Treatment is for tetanus or for Treatment to prevent tetanus.
hh) The Treatment and/or death of the Pet is as a result of attack by vermin, including but not limited to rats, possums, stoats and feral cats.
ii) 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 including but not limited to flooding, earthquake, volcanic eruption.

GENERAL

a) It is the Owners responsibility to ensure that all Policy details are correct including all details relating to the Pet, the Medical history of the Pet and the contact details of the Owner.
b) 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

Please note that any unpaid Annual Premiums will be deducted from any approved claim payment (including any Annual Premium amount outstanding on policies that are being paid via agreed instalments). This also applies to claims paid in the event of your pet's death.

The Owner must notify the Company no later than 3 months after treatment has finished. Any claims submitted more than 3 months after treatment will not be accepted. To make a claim for reimbursement of Veterinary fees and other costs Covered under the Policy, the Owner needs to:

a) Telephone Beneficial Insurance Limited on 0800 738 678 (0800 PET N SUR) notifying a claim and to request a claim form; or
b) Fax to Beneficial Insurance Limited on 0800 329 424 requesting a claim form to be sent; or
c) E-mail to claims@beneficial.co.nz and request a claim form to be sent; or
d) Download claim form at www.Petnsur.co.nz

In order for the Company to assess the Pet's claim, the Company will require a duly completed claim form along with copies of all relevant receipts. In the case of a claim occurring, the Owner will be required to produce at their own expense all relevant information from your veterinarian or other parties as requested by the Company in order for the Company to assess the claim and make a decision.

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.

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

DEFINITIONS

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

Annual Premium - the full premium due on a Policy for any given year determined by the Company excluding any premium discounts applied

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

Commencement Date - that date referred to in the Policy Schedule

Company - Beneficial Insurance Limited

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

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

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

Medical / Medical Treatment - 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 - the person(s) referred to in the Policy Schedule as the Pet Owner(s)

Payment Authority - 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 - the period referred to in the Policy Schedule from the Commencement Date to the Renewal Date

Pet - the animal(s) referred to in the Policy Schedule

Policy - Policy Schedule or Updated Schedule and Policy Wording

Policy Schedule - 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 - 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 - the Policy sent to the Owner by the Company at the time of Renewal

Renewal Date - that date referred to in the Policy Schedule

Stand down Period - the period specified in the Policy being the numbers of days from the Commencement Date during which Cover for any Treatment will not apply

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 including X-rays and / or scans that result in a Surgical procedure (subject to the Policy Terms, Conditions and Exclusions)

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

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

Treatment Type - Medical Treatment(s) and Surgical Treatment(s) used to treat the same occurrence of a condition.

Updated Schedule - 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 v010916