How to make a pet insurance claim

Vet bills can add up fast. If your pet has an accident and needs surgery or develops a chronic condition that requires ongoing treatment, vet fees can quickly run into the thousands. It’s exactly these unpredictable costs that drive so many pet owners to take out pet insurance in the first place. But there’s a catch; you still often need to pay the vet bill upfront, out of your own pocket, and then claim the money back from your insurer afterwards. That gap between paying and being reimbursed can be a real problem if you don’t have the cash sitting there ready to go. 

Electronic options that make claiming easier are becoming more widespread, but the methods available to you depend on both your insurer and your vet. 

If both your vet and your insurer subscribe to the same on-the-spot claims service, you’ll have access to instant claims and just need to pay “the gap”. 

But if on-the-spot claims aren’t available, you’ll need to have the funds available to pay your vet in full. 

How can you avoid having to pay the full cost up front?

To avoid having to make full payment upfront, you need an insurer with an “on-the-spot” claims system, and a vet who’s signed up to that service. That way, your vet can submit the claim while you wait, the insurer pays their portion directly to the vet, leaving you to pay just the gap (what’s left when your insurer’s payout is deducted from the total bill). If you’ve ever used HICAPS to claim on extras insurance, this works in pretty much the same way.

The most common system that facilitates on-the-spot claims is GapOnly which is owned by PetSure, the pet insurance giant behind the majority of pet insurance brands in Australia. All policies underwritten or administered by Petsure (or their parent company Hollard) offer GapOnly including Bow Wow Meow, Bupa, CBA, Medibank, petinsurance.com.au, Guardian and Trupanion. You can go to the GapOnly website and search for your vet to see whether they (or another vet near you) is signed up too. 

On-the-spot claims are also available with Fetch via their system called FetchPay, and with RSCPA via their Direct2Vet portal. Like with GapOnly, you also need to check that your vet has signed up for their service too. Petcover can also pay your vet directly, but you need to make an arrangement with your vet.

Can my vet lodge a claim for me?

The next easiest way to claim is for the vet to submit the claim for you. This is sometimes called a vet e-claim. This way you don’t need to deal with the paperwork yourself, but you do need to pay the whole bill upfront and the insurer will transfer their contribution back to you once the claim has been approved. This is available for all of Petsure’s brands, plus Knose and Coles. Other insurers like RACQ, Budget Direct or CoverMyPet require you to submit the claim yourself.

What are the other options?

All the pet insurance brands we review accept claims via the insurers’ web portal or app, or via email or post. To claim this way, after you have paid the bill in full at the vets, you take your vet’s itemised invoice and upload it via a portal on your insurer’s website or email it to them. Sometimes they’ll require your pet’s clinical notes or medical history as well. Once they’ve received and approved your claim, they’ll transfer their proportion back to you.

Will any insurers pre-approve claims?

Some insurers offer a pre-approval service for large bills. If you know you have a large vet bill coming up, for a planned surgery for example, you can ask your insurer if they can pre-approve the claim ahead of time, and be ready to pay it. That way you’ll know how much money you need to have available. 

All the Petsure brands (including Bow Wow Meow, Bupa, CBA, Medibank, petinsurance.com.au, Guardian and Trupanion) will facilitate a pre-approval, as will Coles pet insurance, for certain procedures. If you know you have a big vet bill coming up it’s worth having a conversation with your insurer so you know where you stand, even if they don’t mention pre-approvals on their website or in their PDS.

Different insurers offer different ways to claim

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Jane Bardell

Jane Bardell is a Content producer in the Insurance and utilities team. She writes about home, car, pet and health insurance. Previously at CHOICE, she checked facts, figures and statistics as a Verifier with the Editorial and investigations team. Jane has a Bachelor of Science from the University of New South Wales.  LinkedIn

Jane Bardell is a Content producer in the Insurance and utilities team. She writes about home, car, pet and health insurance. Previously at CHOICE, she checked facts, figures and statistics as a Verifier with the Editorial and investigations team. Jane has a Bachelor of Science from the University of New South Wales.  LinkedIn