Visualize: Insights that power innovation

Visualize: Insights that power innovation

Pre-existing and linked conditions: How insurers can bring more clarity to the customer

By Paola Farrugia  |  March 8, 2021

Pet insurance customers are not always aware of the restrictions on their policies, and a lack of clarity around limits, copayments, and pre-existing medical conditions can often be the source of much contention during the claims process.

Pre-existing conditions are often excluded from cover, leading to the rejection of claims. Furthermore, linked conditions are injuries, illnesses, or any change in a pet’s health that are considered by the vet to be linked to another previously insured injury or illness.  Unbeknown to the customer, insurers often treat these as one condition, and any payments for vet treatment will stop once they have paid up to the limits set on the policy.

For example, a dog that has been diagnosed with lameness in one of its legs – whether that be due to ligament damage or fracture – may also develop issues with another leg, which will be classed as one condition by the insurer if a vet states they are linked. Similarly, diabetes in dogs can also lead to weakness in the legs, kidney failure, urinary tract infections, and cataracts. A recent survey carried out by Verisk and OnePoll found that diabetes is one of the most expensive conditions for vets to treat, and customers may find they exceed the limits on their policy when making a claim for that along with any other linked conditions.

Customers who then find their insurance is not fit for purpose in terms of limits and the treatment of pre-existing and linked conditions may find themselves trapped when searching for more adequate coverage, as many insurers are unwilling to take on such pets.

Ideally, pre-existing conditions shouldn’t inhibit customers’ ability to find coverage more suitable for their pet’s needs or be the reason they lose faith in the product altogether.

Providing more clarity to customers

Verisk’s Pet Black Box automates the assessment of pre-existing conditions and makes it easier for insurers to underwrite more inclusively while providing policy terms that are clearer and more precise.

The tool guides customers through a series of simple questions about their pet’s condition. The tool then generates risk scores that insurers can use to efficiently underwrite policies at point of sale and provide much-needed clarity around policy terms and coverages, including any exclusions.

Insurers can analyse our risk scores and set their own threshold for the risk they wish to accept. If a customer declares their pet’s conditions and it falls outside of the insurer’s threshold, the insurer can use the tool to write on the endorsement documents that the conditions declared are declined and cover will not be available for them.

With the Pet Black Box’s ‘Linked Condition’ feature, can also detail conditions which are related to the conditions declared and declined, giving further clarity to what is and isn’t covered. They can then offer appropriate limits for the risk they take on and provide full transparency for the conditions which would not be covered by the policy.

The Pet Black Box allows you to make better, faster, and more focused underwriting decisions regarding rejections, exclusions, loadings, and excesses. It can help you broaden your customer base by facilitating more coverage options for pets with pre-existing conditions.

To find out more about customer attitudes towards pet insurance, you can access our report, ‘Changing expectations of UK pet insurance customers’.


Paola Farrugia is business development manager for Verisk’s Pet Risk Rating. She can be contacted at Paola.Farrugia@verisk.com.