Pet Insurance

Pet insurance terminology explained

Indirect claim

You pay our fees upfront and your insurance provider reimburses you.

Direct claim

Your insurance provider reimburses our fees directly and you have the benefit of not having to pay us the full cost of treatment upfront whilst waiting for reimbursement from your insurance company.

Excess

A pre-agreed amount of money that you will need to pay your insurer in the event of a claim. Some policies charge a percentage excess as well as a fixed excess and some policies do not cover certain items or have a limit on the amount that they will pay for certain treatments.

Pre-authorisation

Your insurance provider agrees in advance that they will pay for a proposed course of treatment. Some insurers insist on this before commencing treatment especially if our fees exceed a certain amount.

General advice

We encourage you to contact your insurance provider before your appointment to find out about your level of cover, any exclusions on your policy and the amount of excess you will need to pay. We are happy to assist you with this process, however most insurance companies prefer to speak to the policyholder.

We are only able to give very general advice about your pet insurance. There are nearly a hundred pet insurance providers in the UK and their policies are all different.

We are happy to help you submit your claim but please bear in mind that we do not have a contract with your insurance company and there is no obligation for them to deal with us.

In most cases the claim that you submit will be a continuation of the initial treatment undertaken by your own vet. To expedite the claims process it is essential to claim for this initial treatment prior to your first visit to us.

How to make an indirect claim

After you have settled our account your insurer will need a completed and signed claim form, together with the receipt from Wessex Veterinary Orthopaedics. After they have processed your claim your insurance provider will refund you the cost of treatment minus any excess and non-insured amounts.

What to expect from Wessex Veterinary Orthopaedics:

If you choose we will process your claim for you free of charge. For us to be able to do this you will need to provide us with a completed and signed claim form.

Once our account is settled we will complete and sign our section of your claim form and send copies of your clinical notes and any other information your insurance company requires for the claim to proceed.

We will send your claim to your insurance company within 3 working days, provided you have settled your account in full.

We will liaise with you insurance company to ensure that they have received your claim and have all of the information that they need to process the claim.

Please note that it may take up to 5 working days for your insurance company to log your claim following submission before you will be able to discuss anything with them.

How to make a direct claim

If you are concerned about the cost of referral, but have adequate insurance cover, you may want to consider making a direct claim. Please note that we do not permit direct claims unless our fees exceed £1000. Direct claims involve a significant amount of administrative work by our team so we charge an administration fee of £50 for the first claim. We will process any subsequent insurance claims for the same condition free of charge.

Even for direct claims we request that you pay a minimum of £500 upfront to cover our insurance administration fee and any additional costs that are not covered by your insurance policy. Once we receive payment from your insurance provider any surplus funds will be returned to you.

Pre-authorisation:

  • To make a direct claim we will usually pre-authorise treatment to ensure that the insurance company will cover our fees. Pre-authorisation cannot be arranged if treatment has already commenced.
  • Pre-authorisation usually takes several working days but in some cases it may take much longer for your claim to be approved by your insurance provider.
  • Some insurance companies do not allow pre-authorisation of insurance claims.

What you will need to do for us to make a direct claim:

  • Before your visit to us contact your insurer to give permission for Wessex Veterinary Orthopaedics to speak to them about your policy.
  • Please call us on 01202 022994 to confirm that you have contacted your insurer to give this permission.
  • Please bring a completed claims submission form to your appointment. The form should be signed and dated and must state that payment is to be made direct to Wessex Veterinary Orthopaedics.

What to expect from Wessex Veterinary Orthopaedics:

  • We will provide an estimate of any insurance shortfall that exceeds your deposit.
  • We will complete and sign our section of your claim form and send copies of your clinical notes and any other information your insurer requires for the claim to proceed.
  • We will send your claim to your insurer within 3 working days, provided you have paid our administration fee and any estimated insurance shortfall in full.
  • We will liaise with you insurer to ensure that they have received your claim and have all of the information that they require.
  • We will inform you if your insurer has not paid us within 6 weeks of sending your claim.

Important points to note:

  • Payment of our fees remains your responsibility; by offering a direct claim we are not creating a contract between Wessex Veterinary Orthopaedics and your insurance provider.
  • Direct claims can only be submitted by Wessex Veterinary Orthopaedics, not by you as the policyholder.
  • When we undertake a direct claim this does not guarantee that your insurance provider will settle your claim in full. If there is an additional shortfall then you are personally liable to pay the outstanding amount.
  • If your insurance provider declines to pay Wessex Veterinary Orthopaedics within 8 weeks of sending your claim, for whatever reason, you are personally liable to pay the full cost of treatment.

Royal and Sun Alliance (RSA) insured pets

If your pet is insured with a company underwritten by the RSA insurance group, your insurance company may direct you towards a clinic that is a member of their “preferred referral network”, many of which are not specialist veterinary facilities. RSA has decided to impose a penalty of £200 on insured pet owners who choose not to use their network.

We have elected to remain independent of the RSA “preferred network”. We believe that your choice of treatment centre should be based on what is best for you and your pet rather than what is most convenient or profitable for your insurance company. We will gladly refund the £200 penalty for our clients if they are affected by this commercial decision by the RSA underwriters.

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