Policy Wording - Rhodium 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 (mailto: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
At the time of renewal, the Owner can 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 and 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 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 Premiumdueto 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) before the Renewal Date.
- Any adjustments to the Annual Premiumor 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 by your existing method of payment and frequency as set out in the Policy unless contrary advice is received by us in writingand we agree, before 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 about 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 has 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 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 Type and /or per veterinary visit basis on each claim.
- The Policy only covering Treatment specified in the Policy Schedule for Treatment received by your Pet in New Zealand.
- The Owner fully discloses all known Treatment about the Pet at application, at renewal or any time during the Period of Coverif a Material event or information relating to the Pet arises. If any of this information is withheld, the Company has the right to deem the Policy as void and not meet any claims that may be submitted.
- None of the exclusions listed below under ‘Exclusions’ being applicable.
- If any 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. 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 the time of application or at the time of renewal and 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.
Exclusions
The obligations of the Company and payment of any Benefit will not apply if:
- A claim arises for Treatment within the Stand down Periodincluding any follow up or ongoing Treatments relating to any Condition or Symptom that occurs within the Stand down Period.
- Treatment is for a Pre-Existing Condition.
- Treatment is for skin and/or allergic conditions caused by the chemicals or substances used in products to maintain the cleanliness of the Pet or for the Treatment of ectoparasites on the Pet.
- Treatment is for 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 animals.
- 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.
- Treatment is in relation to a post mortem of the Pet.
- Treatment is for a psychiatric disorder, behavioural problems or costs associated with retraining a Pet due to the suffering such disorders or problems and/or any Treatment for conditions caused by, or results from, psychiatric disorders or behavioural problems.
- A claim for the travel expenses of the Pet’s veterinarian for any Treatmentand/or any courier costs incurred as a result of any Treatment.
- Treatment where the Pet is ordered to be destroyed by the courts, relevant legislation or any government agency of NZ.
- Treatment directly or indirectly caused through hunting, security work, racing or arranged or organised fighting.
- Treatment that is a result of, or is related to, anybreeding related procedures or any Treatments including, but not limited to, contraception, contraceptive procedures and pregnancies.
- Treatment for, or is related to, the Pet being overweight or obese.
- 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.
- Treatment for normal health care and maintenance including but is 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.
- Treatment within six months of the Pet being imported into NZ.
- Treatment for any cosmetic surgery, tail docking, removal of dewclaw and any form of tattooing.
- 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.
- Treatment is for a condition that is for a preventable illness where a vaccine is available but has not been administered or taken regularly 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 Treatment related to a Congenital condition whether known or not.
- Treatment relates to cataract operations or medication and routine eye testing - the “eye exclusion”.
- Treatment is for heartworms.
- Treatment of feline aids (including testing for) or related conditions to do with feline aids or feline infectious peritonitis (FIP) or feline leukemia.
- Treatmentis for any transplant, replacement or implant of any organs or body parts including pacemakers and prosthetics.
- Treatment is for tetanus or tetanus prevention.
- 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.
- Claims received more than 6 months after the Treatment was completed or more than 1 month after Renewal Date.
- Treatmentforor related to Desexing or Microchipping or Vaccinations or Funeral Costs (including cremation and /or burial).
General
The Owner is responsible to ensure all Policy 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 claim 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 a claim form at www.petnsur.co.nz.
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. If the claim is accepted, the payment will be less the Co-Pay as referred to in the Policy Schedule. If 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, the Company will not refund more than the total refundable share of the amount claimable under the Policy. You must also advise the other Company's name permitting us to discuss all details of the relevant claim.
If 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 - acupuncture, chiropractic care, homoeopathy, 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.
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 that is passed down through your pet’s bloodline and which is commonly breed specific.
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 continued 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 before 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 that 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.
Select Breed - the following breeds or a mixed 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 - the period specified in the Policy being the number of days from the Commencement Date during which cover for any Treatment will not apply.
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) - physical or mental evidence that 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 [v210618]