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What is a pre-existing condition?

Here at Figo, we know how frustrating it is to file a pet insurance claim following an illness or incident, only to have your dog or cat’s coverage denied due to a pre-existing condition. After all, many pet parents don’t even consider pet insurance until a random medical emergency takes them (and their wallets) by surprise, at which point their chances of being covered for that condition is unlikely.

That being said, we believe everyone benefits when our policyholders are equipped with the knowledge to make informed decisions about their dogs or cats’ wellbeing. So, without further ado, here’s the jargon-free lowdown on pre-existing conditions and how they might affect your Figo pet insurance coverage.

What is a pre-existing condition for pets?

A pre-existing condition is any injury or illness whose symptoms were showing before the start of your pet’s policy, or during a relevant waiting period. A condition is considered pre-existing whether or not it’s been officially diagnosed or treated; all that matters is when its symptoms first displayed.

We are unable to determine a specific condition’s eligibility until you submit a claim, but for clarity’s sake, here are two hypothetical-only situations that speak to our general thought process:

  • Your Cocker Spaniel puppy is treated for Giardia pre-policy, and three weeks after you enroll her, she develops a case of some particularly watery runs. Her diarrhea may be considered a pre-existing condition because it’s a clinical symptom of Giardia, an ailment she’d been suffering from before her policy went into effect. Therefore, it won’t be covered. However, if your vet says the watery runs were caused by some other new condition we may cover it.
  • Your senior Maine Coon is diagnosed with cancer during your Figo policy waiting period. A year and a half later, he develops diabetes. His cancer wouldn’t be covered by Figo because it began during a waiting period, but since his diabetes developed well into your policy, it’s not considered a pre-existing condition. Therefore, it could be covered.

What pet insurance covers pre-existing conditions?

Pre-existing conditions aren’t covered by any pet insurance providers, including Figo. Think of it this way: If your car is damaged or starts showing signs of engine failure, you wouldn’t buy an insurance policy after-the-fact on that vehicle and expect the provider to pay for repairs. The purpose of insurance is to protect you from unknowns: You can’t protect yourself against something that already happened or is happening.

How does Figo determine whether my pet has a pre-existing condition?

For questions regarding the determination of pre-existing conditions, review the Pre-ex FAQ.

Can I still insure my pet if (s)he has a pre-existing condition?

Of course! Pets with a pre-existing condition (or two, or even three) aren’t prohibited from enrolling in our policies; their coverage will just exclude those specific ailments.

Is there anything I can do to avoid pre-existing condition exclusions?

Yes, and it’s by enrolling your pet in a policy while they’re still healthy. Taking this sort of precaution improves their chances of being fully covered if something happens down the road.

Figo denied my claim because it deemed my pet’s ailment a pre-existing condition. Can I appeal this decision?

The number of days to appeal a claim varies by the state in which your policy was issued. Please contact Customer Experience regarding your claim.

Note: If you have specific questions about your pet’s possible pre-existing conditions, just drop us a line to discuss yours further. We will not be able to guarantee coverage.

Last updated: Jul 24, 2019 / 11: 47am CDT

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