I was writing the script for a training manual on PurinaCare this morning. This manual is for veterinary hospitals to help get them up to speed on the nuts and bolts of PurinaCare Pet Health Insurance. When I got to the part on waiting periods it was a little harder to explain than I thought. I figured that might be a good topic for a post for everyone.
First of all, why do we have waiting periods at all? Basically we are trying to protect ourselves from paying benefits for pre-existing conditions. When you think about it that makes sense.
No insurance company could stay in business for very long if they paid for pre-existing conditions.
It's kind of like your auto insurance company. If you waited until you had an accident to sign up for car insurance it would not be fair to the insurance company. In the same way, if you waited until your dog had torn his
anterior cruciate ligament to apply for insurance and expect to receive benefits, we'd go broke in the process. We'd be unable to provide insurance for other pets and they would not be able to get the care they deserved. It wouldn't be fair, either. In fact there's a legal term for it. Insurance fraud. And believe it or not, some people will try to get away with it.
So that's why we have waiting periods for accidents and illness. We don't have waiting periods for preventive care procedures offered under the PurinaCare Plus Preventive Care policy.
So how do they work and how can I explain them in plain English? The legal definition in the policy is based on defining the Effective Date of the policy. It
reads like this.
"The Effective date is listed on the declaration page (of your policy), however no benefits will be paid for accident if the accident occurs before 12:01 AM on the third day following the effective date and no benefit will be provided for illness if the illness manifests itself before 12:01 on the fifteenth day following the effective date."
Don't you just love lawyers and legalese? I guess this language is precise and it serves a function, but I have to think about it. Here's how I like to think about it.
There's basically a two day waiting period for accidents and a two week waiting period for illness. The effective date is determined by the completion of any underwriting that might be required.
So if you buy a policy for your dog or cat on the 15th of April and all the underwriting is completed, the policy effective date becomes the 16th. In the case of an accident, the 48 hours starts at 12:01 AM on the 16th and ends at 12:01 AM on the 18th. No benefits are paid for accidents that would occur during those 48 hours.
For illness, the waiting period would start at 12:01 AM on the 16th and go until 12:01 on the 30th. The key part to remember is that the waiting period starts at 12:01 on the effective date listed on your policy declaration page. That has to be slightly clearer than mud, right? Again, you can read all the details
here if you are confused.
Hopefully none of this will ever make any difference and you or your dog or cat won't be unlucky enough to have a problem during the waiting period. Just be sure to take extra special care of them until the waiting period is over.