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Pet insurance pre-existing conditions are health problems your pet showed signs of, was treated for, or got veterinary advice about before the policy started or during its waiting period, and most policies won't cover them. The North American Pet Health Insurance Association (NAPHIA) describes a pre-existing condition as anything relating in any way to your pet's medical history before the policy began.
"In any way" is doing a lot of work there. If your dog already has a diagnosis, or even one line in the chart about limping after a long walk in High Park, it's worth knowing exactly how an insurer will read it. We'll go through the common definitions, how chronic and curable conditions are handled, why switching insurers can reset the clock, and what to ask. In the end, each policy's own wording decides what's covered, so read it before you sign.
What counts as a pre-existing condition?
A pre-existing condition is usually any condition that showed up before cover began, diagnosed or not. The clearest written version comes from the US National Association of Insurance Commissioners (NAIC), which drafted a model pet insurance law in 2022. It counts a condition as pre-existing if, before the policy's effective date or during a waiting period:
- a veterinarian provided medical advice about it;
- the pet received treatment for it; or
- verifiable sources show the pet had signs or symptoms directly related to it.
To be clear, the NAIC model is a template for US states, not Canadian law. Canadian insurers write their own definitions, and NAPHIA's buying guide notes that insurance rules vary by jurisdiction, so your policy's wording is what counts. Most definitions still land in the same place, though. If it was in the chart, or visible, before cover started, expect it to be excluded.
A symptom noted in your pet's record before the policy starts can be enough for an insurer to call a condition pre-existing, even without a diagnosis.
Pet insurance pre-existing conditions: chronic, hereditary and curable
Pet insurance pre-existing conditions get sorted into types, and the type changes how an exclusion works. The NAIC model defines several:
| Type | NAIC definition | What to ask the insurer |
|---|---|---|
| Chronic condition | Can be treated or managed, but not cured | Is it excluded for life if it started before cover? |
| Hereditary disorder | An abnormality genetically passed from parent to offspring | Is it covered if no signs appeared before cover? |
| Congenital anomaly or disorder | Present from birth, inherited or environmental | Is it covered, and from what age? |
| Orthopedic condition | Affects bones, muscles, cartilage, tendons, ligaments and joints, such as hip dysplasia or a ruptured cruciate ligament | Is there a separate waiting period or limit? |
Some policies also split conditions that have fully cleared up, sometimes called curable, from ones that haven't. If yours does, the wording will say how long your pet has to go without signs, treatment or medication before that condition can be covered again.
Chronic conditions are where plans differ most; NAPHIA notes that cover for them varies by plan. So don't ask in general terms. Ask each insurer about the specific thing your pet has actually had.
Switching insurers and renewing a policy
Switching insurers can turn a covered condition into an excluded one. NAPHIA warns that the pre-existing condition exclusion applies again when you change providers, whether or not you ever made a claim. So the ear infection your old policy happily paid for may count as pre-existing to the new one.
Renewing with the same insurer usually works differently. The NAIC model says a condition the policy covered can't be treated as pre-existing on renewal, and that a renewal can't require a new vet exam. Check whether your Canadian policy says the same thing, and ask what happens if you move up or down a plan level with the same company.
Waiting periods and how they connect
A waiting period is the stretch after you buy a policy before some or all of the cover kicks in, and signs that appear during it are often treated as pre-existing. NAPHIA says waiting periods typically last about 10 to 30 days.
The NAIC model caps illness and orthopedic waiting periods at 30 days, bans waiting periods for accidents, and lets owners waive them with a vet exam. Those limits only apply where a US state has adopted the model, though.
What you can do is book a vet checkup close to the day cover starts, so your pet's health on that date is on record. Ask whether an exam can shorten or waive the waiting period. And if something does come up during it, write it down and ask the insurer how they'll treat it.
How insurers check your pet's history
Insurers typically go through your pet's veterinary records when you apply or make your first claim. The NAIC model puts the burden of proving a pre-existing exclusion applies on the insurer. It also requires any required exam to be disclosed before purchase, along with the fact that what the exam finds may lead to an exclusion. NAPHIA's advice is to answer application questions honestly, since a wrong answer can lead to a denied claim.
Before you apply, collect your pet's full records from every clinic they've been to, so you see what the insurer will see. Our guide on how to get your pet's vet records shows how, and who owns your pet's medical records explains your right to copies. For the basics on cover types, deductibles and limits, read pet insurance in Canada.
Questions to ask about pre-existing conditions
The questions to ask about pre-existing conditions are the ones that make an insurer commit to specifics before you pay anything.
- How exactly does your policy define a pre-existing condition, and how far back do you look?
- Do you separate curable conditions from chronic ones? After how long without signs or treatment?
- Are hereditary and congenital conditions covered if no signs appeared before cover?
- Would a related condition in another part of the body, such as the other knee, be excluded too?
- Can a vet exam shorten the waiting period?
- Will you review my pet's records before I buy, so I know what is excluded up front?
Get the answers in writing. An insurer that will tell you before purchase which conditions it plans to exclude has taken most of the surprise out of your first claim.
Questions fréquentes
Can I get pet insurance if my pet already has a condition?
Usually yes, but that condition will normally be excluded. New accidents and illnesses can still be covered under the policy's terms.
What is a curable pre-existing condition?
It's a past condition that has fully resolved, which some insurers may cover again after a set period without signs or treatment. Not every policy has this, and each policy's wording sets the period.
Does a vet note about a symptom make it pre-existing?
It can. Many definitions, the NAIC model included, count signs or symptoms recorded before cover started, even with no diagnosis.
If I switch pet insurance, will my pet's conditions be covered?
Probably not. NAPHIA says the pre-existing condition exclusion applies again when you change providers, whether or not you claimed for that condition before.
Is hip dysplasia a pre-existing condition?
It is if signs or treatment were recorded before cover started or during the waiting period. If not, it comes down to how the policy treats hereditary and orthopedic conditions, so check the wording.
En bref
Pet insurance pre-existing conditions are anything in your pet's history, or visible, before cover begins. Read how each policy defines them, get answers on curable and chronic conditions in writing, and think hard before switching insurers once your pet has a history.
All of those conversations go better with complete records. The free PetGrid app keeps your pet's health records and vet papers in one place, and you can download them whenever an insurer asks.
Gardez les dossiers, les vaccins et les visites de votre animal dans un seul endroit sûr. L'application PetGrid est gratuite pour les propriétaires d'animaux, avec ou sans clinique.
Get the free PetGrid appSources
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