Pet Insurance Policy Specimen

THIS IS A SPECIMEN POLICY FOR OUR 12 MONTH VETERINARY FEE PRODUCT

Healthy Pets 12 month Pet Insurance Policy

Terms and Conditions

Written in plain English

1 July 2003

These policy terms and conditions are part of your insurance contract; the other parts are your Certificate of Insurance and your Application form. To know exactly what your insurance contract covers you need to read your Certificate of Insurance and these policy terms and conditions.

Definitions

We, us, our

Allianz Cornhill Insurance plc

You, your
The person named as the policyholder on the Certificate of Insurance.

Your pet
Any dog or cat named as the insured animal on the Certificate of Insurance.

Treatment

Any examination, consultation, advice, tests, X-rays, medication, surgery, nursing and care provided by a veterinary practice or;

if instructed by a vet, consultation and advice provided by a member of one of the following associations.

Association of Pet Behaviour Counsellors

Association of Chartered Physiotherapists in Animal Therapy

McTimoney Chiropractic Association

National Association of Animal Therapists

Canine and Feline Behaviour Association

Period of cover

The time during which we give cover as set out in the Certificate of Insurance Policy Details. This is normally 12 months but may be less if your pet has been added to your insurance or it has been cancelled.

Clinical signs
Changes in the pet's normal healthy state, its bodily functions or behaviour.

Illness
Sickness, disease and any changes to the pet's normal healthy state including mental and emotional disorders.

Sum insured

The amount you chose as the most we will pay.

Home Counties
Berkshire, Essex, Hertfordshire, Kent, Middlesex, Surrey, East Sussex and West Sussex.

12 months

365 days calculated from and including the date an injury happens or the first clinical signs of an illness are noticed.

Market value

The price generally paid for an animal of the same age, breed, sex, pedigree and breeding ability immediately before your pet died.

Maximum benefit

The most we will pay as set out on the Certificate of Insurance.

Home

The place where you usually live.

Veterinary fees
The amount vets in general and referral practice generally charge.

Select breeds

Bernese Mountain Dog
Bulldog
Pyrenean Mountain Dog

Deerhound
Estrela Mountain Dog
Great Dane

Irish Wolfhound
Leonberger
All Mastiff breeds

Newfoundland
Old English Sheep Dog
Dogue de Bordeaux

Rottweiler
St Bernard
Beauceron

General conditions

1 Throughout the period of cover you must take care of your pet and arrange and pay for your pet to have a yearly dental examination and any treatment normally recommended by a vet to prevent illness or injury.

2 You must arrange for your pet to be kept vaccinated against the following.
Dogs : distemper, hepatitis, leptospirosis and parvovirus.
Cats : feline infectious enteritis, feline leukaemia and cat flu.

If you do not keep your pet vaccinated, we will not pay any claims that result from any illness it must be vaccinated against.

3 If, when you claim, there is any other insurance under which you are entitled to payment, we will only pay our share of the claim. You must tell us the name and address of the insurance company and the number of the policy you hold with them.

4 If you have any legal rights against another person in relation to your claim, we may take legal action against them in your name at our expense. You must give us all the help you can and provide any documents we ask for.

5 If you make a false or exaggerated claim, or any claim involving your dishonesty this policy will end and we will not make any further payments.

6 Your pet is only covered under this policy if you pay the premium. If you pay the yearly premium in instalments and you miss an instalment you must pay the outstanding amount within 10 days of the date the instalment was due to be paid. If we do not receive your payment within 10 days of the date the premium was due your insurance will stop.

7 The amount of any instalment payments that you should have paid that you have not paid by the date we settle your claim may be taken from any claim amount we pay you.

8 You agree that any vet has your permission to release any information we ask for about your pet. If the vet makes a charge for this, you must pay the charge.

9 When we offer further periods of insurance, we may change the premium, policy terms and conditions and place exclusions because of your pet's claims history.

10 If, after we have offered a further period of insurance, you make a claim that relates to a period of insurance before the one we have offered, we may, based on the details of the claim, place exclusions back dated to the start of the further period of insurance.

11 We will not guarantee on the phone or by email that we will pay the cost of treatment of an illness or injury. You must send us a claim form that has been properly filled in. We will then write to you with our decision.

12 You are free to choose the law to apply to this insurance contract. We are also free to choose the law to apply. Until there is an agreement between you and us to use a particular law, English law will apply.

13 You must arrange for a vet to examine and treat your pet as soon as possible after it shows clinical signs of an injury or an illness. And, if we decide, you must also take your pet to a vet that we choose.

14 If a vet, who has treated your pet or is about to treat your pet, asks for information about your insurance that relates to a claim or a possible claim we will tell the vet what your insurance covers, how the amount we pay is calculated and if your payments are up to date.

15 When you claim you agree to give us any information we may reasonably ask for.

Cover

In return for the correct premium, we will provide cover in the following sections if they are shown on your Certificate of Insurance. The cover applies in the United Kingdom, the Isle of Man and the Channel Islands.

Section 1 - Veterinary fees
What we will pay

The cost of veterinary fees for treatment your pet receives for an illness or injury during a period of 12 months starting from the date during the period of cover when the injury happened or the clinical signs of an illness were first noticed.

What you pay

For each illness or injury treated, that is not related to any other illness or injury, you must pay an amount (excess) shown in the following table.

Pet
Zone 1
Zone 2
Zone 3

London except E and SE postcodes
The Home Counties and London E and SE postcodes
All other areas

Dogs under the age of 10 years and select breeds under the age of 7 years.
£70
£60
£50

Dogs aged 10 years or over and select breeds aged 7 years or over.

£70+35% of the rest of the cost of the treatment
£60+35% of the rest of the cost of the treatment
£50+35% of the rest of the cost of the treatment

Cats under the age of 10 years.
£65
£55
£45

Cats aged 10 years or over.
£65+35% of the rest of the cost of the treatment
£55+35% of the rest of the cost of the treatment
£45+35% of the rest of the cost of the treatment

What we will not pay

1 More than the maximum benefit for each illness or injury.

2 The cost of any treatment for;

1 an injury that happened or an illness your pet first showed clinical signs of before its cover started, or;
2 an injury or illness that is the same as, or has the same diagnosis or clinical signs as an injury, illness or clinical sign your pet had before its cover started, or;
3 an injury or illness that is caused by, relates to or results from an injury, illness or clinical sign your pet had before its cover started;
no matter where the injury illness or clinical signs are noticed or happen in, or on your pet's body.
3 The cost of any treatment for;
1 an illness that first showed clinical signs, within 14 days of your pet's cover starting, or;
2 an illness which is the same as, or has the same diagnosis or clinical signs as, an illness that first showed clinical signs, within 14 days of your pet's cover starting, or;
3 an injury or illness that is caused by, relates to or results from a clinical sign that was first noticed, or an illness that first showed clinical signs, within 14 days of your pet's cover starting;
no matter where the illness or clinical signs are noticed or happen in, or on your pet's body.

4 The cost of any treatment your pet receives more than 12 months after the date the injury happened or the illness first showed clinical signs.

4 The cost of any treatment resulting from an injury or illness, if the clinical signs are the same as the clinical signs of an injury or illness we have already paid the cost of treatment for 12 months.

6 The cost of any medicines or materials prescribed or supplied to be used after the period of 12 months has finished.

7 The cost of any treatment a vet normally recommends to prevent injury or illness.

8 The cost of any treatment, including cosmetic dentistry that you choose to have carried out that is not directly related to an injury or illness.

9 The cost of killing or controlling fleas, general health improvers and any treatment in connection with pregnancy or giving birth.

10 The cost of food, including food prescribed by a vet, except where it is used to dissolve bladder stones and crystals in urine.

11 The cost of vaccinations, spaying and castration except the cost of treating any complications arising from these procedures.

12 The cost of treating any injury or illness deliberately caused by you or anyone living with you.

13 The costs of having your pet put to sleep, cremated, buried or otherwise disposed of.

14 The cost of house calls unless the vet believes that moving your pet would damage its health.

15 Extra costs for treating your pet outside usual surgery hours, unless the vet believes an emergency consultation is necessary.

16 The cost of hiring a swimming pool, hydrotherapy pool or any other pool
or hydrotherapy equipment.

17 The cost of bathing your pet unless a vet believes only a vet or a member of a veterinary practice can bathe your pet.

18 Costs resulting from an injury or illness specified as excluded on your Certificate of Insurance or generally not covered within these terms and conditions.

Special conditions that apply to this section

1 The maximum amount we will pay for the cost of treatment of each illness or injury is the maximum benefit that applies on the date the injury happened or the date the clinical signs or the illness were first noticed.

2 The period of 12 months or the maximum benefit will always start or be calculated from the date in the policy year
o the injury first happened or the clinical signs or illness were first noticed, or,

o an illness with the same diagnosis or clinical signs as the illness or clinical signs that you have claimed the cost of treatment for was first noticed,

no matter how many times the same injury, illness or clinical signs are noticed or happen in, or on any part of your pet's body.

3 If a number of injuries, illnesses or clinical signs are;

o diagnosed as one injury or illness; or,

o they are caused by, relate to or result from another injury, illness, or clinical sign,

one period of 12 months or one maximum benefit will apply to the treatment received for all the injuries, illnesses or clinical signs.

The period of 12 months or the maximum benefit will start or be calculated from the first date in the policy year

o any of the clinical signs or any of the illnesses were noticed; or;

o any of the injuries happened.

4 After we have paid the cost of treatment for 12 months or the maximum benefit for an illness, injury or clinical signs under this or any other insurance. We will not pay the cost of any more treatment for;

o the same illness or injury; or;

o the same clinical signs; or;

o an illness or injury with the same diagnosis or clinical signs as the illness or clinical signs we have paid the limit for; or

o an injury or illness that is caused by, relates to or results from an injury, illness or clinical sign that we have paid the limit for,

no matter where the clinical signs, illness or injury are noticed or happen in, or on your pet's body.

How to claim

Before your pet is treated, you must make sure that the vet is prepared to fill in our claim form and provide invoices.

Phone 0870 011 6564 or contact us online at www.healthy-pets.co.uk/claim.htm to ask for a claim form.

You must fill in a claim form and ask your vet to fill in their part. We will not pay for the vet to do this.

Send us the claim form together with the invoices setting out the costs involved.

Section 2 - Veterinary Referral
What we will pay
If your pet is injured or shows the first clinical signs of an illness during the period of cover and your usual vet recommends another vet treats your pet, we will pay 20p for each mile you have travelled in between your home and the other veterinary practice.

What we will not pay
1 More than the maximum benefit in each period of cover.

2 Any amount unless the cost of treatment of the illness or injury is covered under Section 1 - Vet's fees.

3 Any amount that results from a complication of pregnancy or giving birth.

4 Any amount to travel to or from your pet's usual veterinary practice. Or to, from or in between any practice or branch practice of a group of veterinary practices your usual veterinary practice belongs to.

How to claim
Phone 0870 011 6564 or contact us online at www.healthy-pets.co.uk/claim.htm to ask for a claim form.

Fill in the section on the Vet's fees claim form when you are sending us your claim for treatment.

Section 3 - Advertising and rewards
What we will pay

The cost of advertising if your pet is stolen or goes missing during the period of cover.

The reward you have offered for the recovery of your pet if it is stolen or goes missing during the period of cover.

What we will not pay

1 More than the maximum benefit.
2 Any reward that we have not agreed to before you advertised it.
3 Any reward not supported by a signed receipt giving the full name and address of the person who found your pet.
4 Any reward paid to any person living with you or employed by you.

How to claim
Please phone us on 0870 011 6564 for approval of any reward before you advertise it. We will then send you a claim form for advertising and rewards.

For a claim form for advertising and rewards phone 0870 011 6564 or contact us online at www.healthy-pets.co.uk/claim.htm.

Fill in the claim form and send it to us with invoices and receipts to show the costs involved, including a receipt for any reward you paid.

Section 4 - Boarding kennel and cattery fees
What we will pay

The cost of boarding your pet at a licensed kennel or cattery or £5 a day towards the cost of someone who does not live with you looking after your pet while you are in hospital during the period of cover.

What we will not pay

1 More than the maximum benefit in any period of cover.

2 Any amount if you are in hospital for less than 4 days.

3 Any costs resulting from you having to go into a hospital because of an injury or illness first occurring or showing symptoms before your pet was covered.

4 Any costs resulting from you being pregnant, giving birth or any treatment that is not related to an injury or illness.

5 Any costs resulting from you having to go into a hospital for the treatment for alcoholism, drug abuse, drug addiction, attempted suicide or self-inflicted injuries.

6 Any costs resulting from nursing home care or from convalescence care that you do not receive in a hospital.

How to claim

For a claim form for boarding kennel and cattery fees, phone 0870 011 6564 or contact us online at www.healthy-pets.co.uk/claim.htm.

Please send us a claim form filled in by your doctor or consultant and by the owner of the boarding kennel or cattery. We will not pay for this information.

We also need an invoice from the kennel or cattery or written confirmation from the person looking after your pet.

Section 5 - Death from Injury
What we will pay

The market value of your pet if it dies or has to be put to sleep by a vet as a result of an injury caused by an accident that happens during the period of cover.

What we will not pay

1 More than the maximum benefit.

2 Any amount if the death results from an injury that happened before your pet's cover started.

3 Any amount if your pet dies or is put to sleep more than 12 months after the date during the period of cover the injury happens.

4 Any amount if the death results from an injury or illness specified as excluded on your Certificate of Insurance or generally not covered within these terms and conditions.

5 Any amount unless a vet has put your pet to sleep as a result of an injury that cannot be treated and believes it was not humane to keep your pet alive because it was suffering.

How to claim

For a claim form for death from injury, phone 0870 011 6564 or contact us online at www.healthy-pets.co.uk/claim.htm.

Please send us:

o a death certificate from your vet;

o the pedigree certificate and receipt from when you bought your pet; and,

o your claim form.

We will not pay for this information.

Section 6 - Third party liability
This section only applies to Dogs
In this section, you and your mean you or any person looking after or handling your pet with your permission.

What we will pay

If property is damaged, or someone is killed, injured or falls ill as a result of an incident involving your pet during the period of cover, we will pay:

1 compensation and costs awarded against you by a court; and

2 the legal cost and expenses for defending a claim against you.

What you pay

The first £250 of any compensation, costs or expenses where property has been damaged.

What we will not pay

1 More than the maximum benefit for each incident.

2 Any costs or expenses for defending you which we have not agreed beforehand.

3 Any compensation, costs and expenses resulting from an incident that takes place as a result of your profession, occupation or any business.

4 Any compensation, costs and expenses resulting from an incident that takes place as a result of the profession, occupation or business of anyone employed by you or works for you in any way.

5 Any compensation, costs and expenses if you are legally responsible only because of a contract you have entered into.

6 Any compensation, costs and expenses if the person who is killed, injured or falls ill lives with you or is employed by you.

7 Any compensation, costs and expenses if the property damaged belongs to you or any person who lives with you or is employed by you.

8 Any compensation, costs and expenses if you, or any person who lives with you, or are employed by you is responsible for or looking after the property that is damaged.

9 Any compensation, costs and expenses if you are deemed responsible under the laws of the USA or Canada.

10 Any compensation, costs and expenses if you are responsible for air, water or soil pollution, unless it can be proved that the pollution took place immediately after and as a result of an accident involving your pet.

Special conditions that apply to this section

1 You must not admit responsibility, agree to pay any claim or negotiate with any other person following an incident.

2 You agree to provide us with any information we reasonably ask for.

3 You must allow us to take charge of your claim and allow us to prosecute in your name for our benefit.

4 You must immediately send us any writ, summons or legal documents you receive and you must never send any replies to any of these documents.

How to claim

For a claim form for third party liability, phone 0870 011 6564 or contact us online at www.healthy-pets.co.uk/claim.htm.

Section 7 - Legal advice helpline

What we will provide

Access to Lawphone, a helpline that gives you legal advice on any personal legal

issue that affects you. It is available 24 hours a day 365 days a year.

What will not provide

Legal advice for public or business issues.

How to get the advice

Phone 0870 241 4140 and quote master policy number 36105. You will be asked about the problem and the details will be passed to an adviser who will call you back.

Section 8 - Vet finder Service

What we will provide

The name, address and telephone number of the nearest veterinary practice or practices to your home address or any address in the United Kingdom, the Isle of Man and the Channel Islands.

What we cannot provide

The name, address and telephone number of:

1. the cheapest veterinary practice.

2. a specialist veterinary practice.

3. an Emergency vet.

4. any veterinary practice if you call between the hours 5pm and 9am.

When we tell you where the nearest vet is we do not accept any responsibility for, or guarantee any treatment or service given by that veterinary practice.

To use Vet finder Service

To use the Vet finder service, phone 0870 011 6564 or contact us online at www.healthy-pets.co.uk.

General Exclusions

All sections in this policy do not cover the following.

1 Any animal less than 8 weeks old.

2 Any amount that results from your dog being used for guarding, racing or used or connected in any way with a business occupation or profession.

3 Any amount if you break the United Kingdom animal health or importation laws or regulations.

4 Any amount if your pet is confiscated or destroyed by government or public authorities, or under the Animals Act 1971 United Kingdom because it was worrying livestock.

5 Any loss, cost or expense caused by any sort of war, riot, invasion, act by a foreign enemy, revolution, terrorism, insurrection, military or civilian take over or any type of hostile act.

.

6 Any loss caused by, connected or resulting from any device failing to recognise, interpret or process any date as its true calendar date.

7 Any amount resulting from an illness that your pet contracted while outside the United Kingdom, the Isle of Man and the Channel Islands that it would not normally have contracted in the United Kingdom, the Isle of Man or the Channel Islands.

8 Any dog that must be registered under the terms of the Dangerous Dogs Act 1991 and the Dangerous Dogs (Amendment) Act 1997.

9 Any costs caused because the Department for Environment, Food and Rural Affairs (DEFRA) have put restrictions on your pet.

Claims procedure

1 Unless you are claiming for vet's fees, you must let us know of any circumstances which are likely to lead to a claim. Please write to:

Healthy Pets
No 6 Ridgeway Office Park
Bedford Road
Petersfield
HAMPSHIRE
GU32 2BN Alternatively, you may phone 0870 011 6564.

2 You must then follow the procedures set out in the section under which you are claiming.

Customer service

Our aim is to get things right, first time, every time. If we make a mistake we will try to put it right straight away. If you have a question about your insurance please call on 0870 011 6564.

Alternatively write to:
Healthy Pets Limited
No 6 Ridgeway Office Park
Bedford Road
Petersfield
HAMPSHIRE
GU32 2BN

e-mail sales@healthy-pets.co.uk

Complaints

If you are not satisfied with the way we have handled your question or you are not happy with the answer and want to complain please write to:

The Chief Executive Officer
Healthy Pets Limited
No 6 Ridgeway Office Park
Bedford Road
Petersfield
HAMPSHIRE
GU32 2BN

e-mail ceo@healthy-pets.co.uk

Phone 0870 011 6564

If you are not satisfied by the Chief Executive Officer's reply please write to:

The Customer Satisfaction Manager
Allianz Cornhill Insurance plc
Animal Health Division
Computer House
Great West Road
Brentford
Middlesex
TW8 9DX

dbi.csm@allianzcornhill.co.uk

Phone 020 8580 8184

We will contact you within 5 days of receiving your complaint to tell you what we are doing. We will try to sort out the problem and give you an answer within 4 weeks. If it will take us longer than 4 weeks we will tell you when you can expect an answer.

If we have not given you an answer in 8 weeks we will tell you how you can take your complaint to the Financial Ombudsman Service.

Allianz Cornhill Insurance plc
Animal Health Division
Computer House
Great West Road
Brentford Middlesex
TW8 9DX
Registered address 57 Ladymead Guildford GU1 1DB

Registered in England No. 84638

Healthy Pets Limited
No 6 Ridgeway Office Park
Bedford Road
Petersfield
HAMPSHIRE
GU32 2BN
Company number 3209135