State Insurance Commissioner Highlights New Rules Under State Pet Insurance Law [The Chronicle, Centralia, Wash.]
May 24—After Gov.
According to the news release, Senate Bill 5319 was based on model legislation from the
SB 5319 establishes uniform definitions for terms frequently used in pet insurance policies, including chronic conditions, congenital anomalies, hereditary disorders, orthopedics, preexisting conditions, renewals, veterinarians, veterinary expenses, waiting periods and wellness programs. If an insurance policy includes any of those terms, the company is required to use the definition provided in SB 5319 and make that definition available on its website.
For those purchasing pet insurance, the insurance company is now required to let purchasers know if the policy excludes coverage based on preexisting conditions, hereditary disorders, congenital anomalies or disorders, or a chronic condition. If there are any other exclusions, the policy must include specific language to that effect.
The insurer must also let policyholders know if their policy has any limitations, such as a waiting period, deductible, coinsurance or policy limit. Insurance companies must also inform customers if their coverage reduces or premiums increase based on their claims history, their pet's age or a change in their location.
Under the new law, people who purchase a policy and haven't filed a claim will have 15 days to change their minds and get their money back.
While policies may have exclusions for preexisting conditions, the burden to show a condition already existed falls to the insurance company rather than the pet owner.
Waiting periods will not be allowed for accident coverage. Policies can impose waiting periods of up to 30 days for coverage of illness or orthopedic conditions, but they can be waived with a medical examination.
An insurance company will also not be allowed to require a medical examination for a policy renewal.
Wellness programs are usually subscription based and help spread out costs for vet check-ups, vaccinations, and, in some cases, necessary speciality foods. Wellness programs differ from insurance policies. A pet's eligibility for insurance can't be tied to participation in a wellness program, and insurers are not allowed to market a wellness program as pet insurance or market a wellness program while selling pet insurance.
Anyone who sells pet insurance will also be required to complete training and become licensed by the
SB 5319 goes into effect on
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