CAT & DOGSURE POLICY WORDING
Cat & Dog Sure is an insurance product designed to cover the unexpected veterinary cost that cats and dogs may incur as the result of illness or injury. Cat & Dog Sure is underwritten by Renasa Insurance Company (Pty) Limited (Renasa) and administered by Pet Underwriting Managing Agency (Pty) Limited (P.UMA). In return for paying your premium, Renasa will cover the pet CAT/DOG named in the policy schedule for the cost of fees incurred as the result of veterinary treatments for illness and injury.
All cats and dogs from 8 weeks to 8 years can join the Cat & Dog Sure policy. We do offer Accidental Cover for pets older than 8 years (Accidental cover is offered on a different policy). The Cat/Dog must be a household pet in the RSA. There is a waiting period of 30 days from the inception of the policy, however, accidental injuries are immediately covered once the policy has incepted.
All vaccinations must be up to date at the time of joining and remain up to date.
POLICY WORDING FOR PETS – PLEASE READ THIS CAREFULLY
1.1. Cat & DogSure cover the cost of veterinary treatments required to appropriately treat illness or injuries that the insured pet may suffer. The treatments covered include, but are not limited to:
1.1.1. Consultations, acute medication, initial diagnostics, x-rays, biopsies and tests
1.1.2. Post-Operative rehabilitation treatments, referral to Specialists consultations and treatments, further diagnostic workups, blood tests, MRI / CT scans, radiology, radiation/chemotherapy, surgeries and prosthesis require pre-approval and are subject to case management and clinical protocols. P.uma will require a detailed treatment plan or quote from the treating Vet. In order to qualify for cover, rehabilitation treatment MUST commence WITHIN 2 weeks from orthopaedic surgery and will be limited to a maximum of 6 treatment sessions, not extending beyond 2 months after the surgery date.
There is a 60-day waiting period, after the first day of inception of the policy, during which you cannot claim for the Pet Care benefits, thereafter the benefits will become available.
Cat & DogSure’s Pet Care benefit can be utilised for:
- Chronic treatment and medication
- Vaccination
- Dental scale and polish
- Sterilization
- Microchipping
- Deworming
- Tick and flea prevention and treatment
- Treatments listed under sections 8.9, 8.10 and 8.11
- Socialisation Classes/Training
There is an annual limit of R1,250.00 for these benefits, inclusively, per cat or dog per policy year.
This benefit will be calculated on a pro-rata basis from date of inception until the end of the policy year where the policy incepts after the start of the policy year being 01 October.
Please note that the benefit is subject to the excess structure detailed under section 4.3.
You agree to disclose all information relating to the pet’s health and condition at the time of signing up for cover and thereafter. This includes all examinations and/or treatments as well as signs and symptoms your pet received or displayed prior to applying for the insurance. Failure to do so could result in claims being repudiated and the cancellation of your policy due to non-disclosure. Please note, new underwriting terms might be offered, and should you not accept the new underwriting terms, your policy will be cancelled.
4.1. All claims within the first 6 months will carry a 25% or minimum of R450 excess per claim;
4.2. From month 7 onwards, the excess will change to 15% or a minimum of R450 per claim; except for the conditions specified as per the excess in 4.3 below.
4.3. All claims for Spinal Conditions, Hindlimb Conditions and Gastro Intestinal System Conditions will carry a 25% or minimum R450 excess per claim.
4.4. Pet Care Benefits will carry a flat excess of 15%.
4.5. Voluntary excess: if elected at inception or at the renewal of your policy (any change requests during the policy year will be at the sole discretion of Renasa and previous claims paid will have bearing), all claims in terms of 4.1 will carry an excess of 25% or minimum R1000 and all claims in terms of 4.2 will carry an excess of 15% or minimum R1000 per claim.
4.6. If pre-authorisation is not obtained from Puma in respect of 1.1.2, there is an ADDITIONAL excess of 20%, minimum R500.00 per claim.
4.7. MRI/CT Scans will carry an excess of R1000.00 per Scan.
4.8. There is a 50% co-insurance period for the first six months from inception of the policy for all pets over four years of age for all treatments, diagnostics and surgeries for conditions affecting the:
4.8.1. Hips, knees, elbows, shoulders and spine.
4.8.2. Eyes and nictitating membranes
4.8.3. Urinary bladder system
The Cat and Dogsure policy carries NO ANNUAL LIMIT. Your pet enjoys unlimited cover, however, there is a maximum claim limit of R25 000 per event.
In addition to excess detailed in section 4, there will be an additional 25% co-payment for the subsequent, follow up or further surgery for the same peril (condition) within the same policy year.
7.1. This policy will incept on the first day of the next calendar month following the acceptance of the application. The policy terms and premiums payable will be reviewed on the 01 October each year. The premiums are subject to inflationary increases.
7.2. A premium discount is applied to multi-pet households where two or more pets are placed on the cover. The most expensive pet will be charged the full premium and each additional pet, whether on Cat or Dogsure, will have a discount on the premium payable.
7.3. All non-emergency treatments (in terms of 1.1.2 “what we cover”) must be pre-authorised by P.UMA. (if not pre-authorised the additional excess will be applied).
7.4. P.UMA reserves the right to contact your Vet(s) to obtain a full history for your pet. This information is utilized for our underwriting decisions
7.5. You must notify P.UMA of any emergency treatments within 72 hours of the event
(authorisations@p-uma.co.za).
7.6. All claims must be submitted to P.UMA within 60 days of the date of treatment (claims@p-uma.co.za). If your claim is older than 60 days, it will be repudiated [due to late submission].
7.7. P.UMA reserves the right to request a second opinion from a vet of their choice regarding treatment and fees charged. If the fees are deemed excessive or the treatment deemed inappropriate, we will pay the lesser amount with the balance being for your account.
7.8. As the person responsible for the pet you are expected to take all reasonable steps to prevent injury and illness. Failure to do so may result in rejection of claims and/or the cancellation of this policy.
7.9. If there is another insurance policy covering the same claim, only the rateable proportion of that claim will be paid in terms of this policy.
8.1. The treatment of pre-existing conditions, including any condition that manifests during any waiting period (If your pet is diagnosed with any illness/condition or a pre-existing injury is noted within the waiting period, these will become full exclusions on the policy).
8.2. P.UMA reserves the right to refuse payment for repeated treatments if they are, under advice, deemed as ineffective, excessive or likely to cause the pet undue distress.
8.3. Any costs other than the costs of veterinary treatments for the pet listed on the policy.
8.4. The costs for the treatment of any illness within the first 30 days of joining Cat or DogSure. (The costs of treatments for trauma resulting from accidental injury are covered in this period).
8.5. Any invoices submitted more than 60 days after the date of treatment.
8.6. The costs for any treatments for injuries and illness incurred outside of the Republic of South Africa.
8.7. Any injury caused by abuse or negligence. We will report all abuse to the relevant authorities.
8.8. Any treatment that continues for longer than 3 months unless approved by P.UMA and subject to clinical protocols. Chronic conditions can be claimed from the Pet Care Benefit.
8.9. Any complementary treatments, experimental treatments or any treatments not forming part of mainstream veterinary science, including but not limited to acupuncture, physiotherapy, homoeopathy, hydrotherapy, rehabilitation care (if not post-surgery and pre-approved), this treatment can be claimed for under the Pet Care Benefit.
8.10. The treatment of behavioural disorders. This can be claimed for under the Pet Care Benefit.
8.11. Any routine care such as anal gland expression, grooming or any prescription food costs, this can be claimed under the Pet Care Benefit.
8.12. Any elective or cosmetic treatments.
8.13. Any treatments in connection with pregnancy, birthing and fertility and breeding (any complications suffered as a result of one of these), sterilization, artificial insemination and injuries resulting from breeding.
8.14. House calls, travel costs, after-hours consultation or hospitalisation unless a vet confirms it as necessary in terms of the pet’s health.
8.15. Any surgical items that can be used more than once. These are non-chargeable items.
8.16. The costs of any prosthesis, implants or transplantation unless explicitly approved by P.UMA.
8.17. Any costs after death and/or cremation (post-mortem examinations).
8.18. Any treatment by person/s not registered with the South African Veterinary Council.
8.19. We do not under any circumstance cover euthanasia unless recommended by a veterinarian.
8.20. Any costs where the treatment or fees charged is deemed excessive in relation to accepted clinical protocol and industry norms and standards.
8.21. Any costs relating to the treatment of Pyometra and Cryptorchid, as these conditions are preventable by spaying/neutering your pet.
This policy may be terminated upon giving one months’ written notice of cancellation and the cancellation shall be effective from the first day of the calendar month following the notice.
ACCIDENT ONLY POLICY
WHAT IS A CAT or DOGSURE ACCIDENT ONLY POLICY
Cat & Dog Sure Accident Only is an insurance product designed to cover the unexpected veterinary costs that pet cats and dogs may incur as the result of accidental injury. Cat & Dog Sure is underwritten by Renasa Insurance Company (Pty) Limited (Renasa) and administered by Pet Underwriting Managing Agency (Pty) Ltd (P.uma). In return for paying your premium, Renasa will cover the pet Cat/Dog named in the overleaf policy schedule for the cost of fees incurred as the result of veterinary treatments for injuries resulting from an accident up to a limit of R20,000.00 or R10 000.00 (whichever has been elected) per policy year.
This policy covers any Cat/Dog older than 8 years. The Cat/Dog must be a household pet in the RSA. All vaccinations must be up to date at the time of joining and must be kept up to date. Your Cat/Dog is immediately covered for accidental injuries, as long as the policy has incepted.
1. A motor vehicle accident
2. A burn or electrocution
3. A fall from an elevated position
4. A near drowning
5. The actions of another animal
6. A swallowed or embedded foreign object requiring surgical or endoscopic removal
7. A snake bite
8. An allergic reaction to an insect bite other than tick or flea bites.
9. Biliary (tick bite fever) is covered as an accident
10. Accidental poisoning
OR OTHERWISE RESULT IN
11. A fractured bone
12. A puncture wound
13. A traumatic ligament or tendon injury
14. Lacerations, abrasions or wounds
15. A Gastric torsion (Gastric dilation volvulus)
1. To be covered as an accidental injury, any diagnosis must be made within 48 hours of the time of the accident.
2. The cover under this policy will only apply to the treatment of the pet cat or dog named on the policy schedule.
3. This policy will incept on the first day of the next calendar month following the acceptance of the application. The policy terms and premiums payable will be reviewed on 1 October each year. The premiums are subject to inflationary increases.
4. There is an excess fee of 15% for every claim with a minimum of R450 per claim that you must pay.
5. All non-emergencies must be pre-authorised by P.uma and emergencies must be notified within 72 hours (authorisations@p-uma.co.za). All claims must be submitted to P.UMA within 60 days of the date of treatment (pumaclaims@p-uma.co.za). If your claim is older than 60 days, it will be repudiated [due to late submission].
6. P.UMA reserves the right to request a second opinion from a vet of our choice regarding treatment and the fees charged. If the fees are deemed excessive or the treatment deemed inappropriate we will pay the lesser amount with the balance being for your account.
7. As the person responsible for the pet you are expected to take all reasonable steps to prevent injury and illness. Failure to do so may result in rejection of claims and/or the cancellation of this policy.
8. If there is another insurance policy covering the same claim, only the rateable proportion of that claim will be paid in terms of this policy.
1. Any sickness, disease, infection or any change in a dog’s health which is not caused by an accidental injury
2. Any invoices submitted more than 60 days after the date of last treatment.
3. The costs for any treatments for injuries incurred outside of the Republic of South Africa.
4. Any treatment by person/s not registered with the South African Veterinary Council.
5. Any allergic reaction to a vaccine or medication.
6. Any surgical items that can be used more than once. These are non-chargeable items.
7. The costs of any prosthesis, implants or transplantation
8. Any injury caused by negligence. P.UMA will report all abuse to the relevant authorities.
This policy may be terminated upon giving one months’ written notice of cancellation and the cancellation shall be effective from the first day of the calendar month following the notice