Skip to content

Are Pet Insurance Companies Regulated In The US

↯ Key takeaway points

  • The National Association of Insurance Commissioners (NAIC) has enacted a model law that regulates pet insurance companies and provides consumer protections.
  • The NAIC's model law includes regulations on preexisting conditions, training requirements, consumer protections, and distinguishing between pet insurance and wellness programs.
  • Prominent pet insurance companies in the US include Lemonade, Healthy Paws, Trupanion, and Fetch by The Dodo.
  • The pet insurance industry is growing in the United States, with 4.4 million pets insured in 2021.
A pet lover passionate about educating readers about animal health and care. Love reading studies and recent research.
Practicing small pets and equine veterinarian and junior teaching assistant in Veterinary Medicine.
Published on
Thursday 2 February 2023
Last updated on
Friday 13 October 2023
Are Pet Insurance Companies Regulated In The US
This page may contain affiliate links. We may receive a commission if you make a purchase using these links.

The pet insurance industry is booming in the United States despite being a newly passed model law. In fact, the North American Pet Health Insurance Association estimates 4.4 million pets in North America had insurance in 2021.

At that time, the pet insurance market statistics in the United States were already developing. This growth continues to rise to this day. 

Are Pet Insurance Companies Regulated In The US

The National Association of Insurance Commissioners (NAIC) enacted the Pet Insurance Model Act. It is a model law that shows precise regulations regarding pet insurance deals and demands disclosures for pet owners. In addition, this model law provides extra protections for consumers who buy insurance for their pets.

The Pet Insurance Model Act concentrates on policy limits and renewal standards. It also focuses on policy benefits and conditions and disclosure of waiting periods for insurance coverage. Furthermore, pet insurance agents must distinguish between pet insurance policies and pet wellness programs.

In addition, it restricts the extent to which insurers can deny coverage due to prior conditions of covered pets. This establishes the basis on which the preexisting condition limits shall apply. 

This new model law is also comparable to human health insurance. It includes various levels of coverage for pet owners to choose from, exclusions, deductibles, and payment limits. Additionally, rates follow the animal’s age and care levels. This means broader protections have pricier policies. 

The pet insurance law is currently on the heels of impressive growth in its industry. As a matter of fact, NAIC reports pet insurance statistics of a 30.5% growth in annual premiums from 2020 until 2021. Aside from that, there was a 27.7% increase in insured pets. 

Above all, an increasing pet population and owners willing to invest more in pets’ wellness could create market and industry opportunities. This could expand insurance and technology in the pet insurance market.

Pet Insurance Companies That Started In The US

Pet insurance has the potential to increase spending, particularly on veterinary services. Currently, the ordinance of pet health insurance differs widely by state.

The United States is a pet-loving nation. There are millions of pet owners from across the country, which means they are willing to spend a lot of money on their furry friends. It is no surprise that the United States has several pet insurance companies that started there.

For instance, in California, a decree passed in 2015 mandates policies to contain precise language on coverage waiting periods, deductibles, and lifetime limits. While pet insurance has existed since the early 1900s, North America’s pet insurance market is still booming, with over 25 companies.

Here is a quick look at the most prominent names in the pet insurance industry right now:

Lemonade

Lemonade is a pet insurance company launched in the US in 2016. It is a fully licensed pet insurance firm that underwrites its own policies. Interestingly, this company dumped the conventional insurance model and created a new one that shares its proceeds with multiple charities

Healthy Paws

Healthy Paws is a US-based pet insurance company founded in 2009 focusing on animal illness and injuries. Furthermore, they offer no lifetime, yearly, or per-incident cap on their claim payouts. Their plans have a waiting duration of 15 days. After that, pet owners can submit claims.

Trupanion

Trupanion is a medical and health insurance provider for dogs and cats throughout Canada and the United States. They provide pet parents with extra benefits on an availed policy, but with an additional cost. 

Fetch by The Dodo

Fetch by The Dodo, formerly PetPlan, transitioned its name in March 2022. It is a pet medical insurance provider that covers advertising costs and rewards when pets get stolen or lost. Additionally, they handle boarding and vacation cancellation expenditures.

NAIC Regulations For Pet Insurance Companies

The National Association of Insurance Commissioners, or NAIC, is a regulatory support association supervised by chief insurance regulators from all fifty states. They provide model laws that individual states can determine whether to adopt, modify, or ignore. 

On top of that, the pet insurance model act supplies a comprehensive legal framework. This includes consumer protections and disclosure requirements, wherein insurers may sell pet insurance in states that adopt the act.  

As pet insurance in the US continues to increase, NAIC ensures to include four key elements to the law. The special provisions of the pet insurance model act include consumer protections, wellness programs, training requirements, and preexisting conditions.

Preexisting Conditions

It restricts how insurance companies can deny pet insurance claims associated with preexisting conditions of covered animals. Aside from that, it puts the responsibility for proof on the insurance provider to verify that a preexisting circumstances limitation applies.

According to the NAIC Pet Insurance Model Act, a preexisting condition means any situation is valid before the policy’s effective date or during the waiting period. It includes the following:

  • Veterinarian’s medical advice
  • Prior treatments of pets
  • Signs or symptoms related to the condition on the claim

Training Requirements

Producers need the training to ensure they are adequately prepared and equipped to provide necessary information to pet owners. This model act clarifies the licensing requirements for producers who vend pet insurance.

In addition, it allows insurance providers who have completed their licensing in a different country to get covered by the same model act in the US. The training in this subsection must include the following matters:

  • Preexisting conditions and waiting periods
  • Dissimilarities between pet insurance and non-insurance wellness programs
  • Hereditary diseases, congenital disorders, and chronic ailments, and how the insurance policies interact with such conditions and disorders
  • Administrative topics, such as rating, underwriting, and renewal of the health insurance policies

Customer Protections

The protections included are policy limits, renewals, disclosures of waiting periods, conditions, benefit schedules, and the like. In addition, it requires disclosures that let consumers affirmatively pick the best insurance policy for them and their pets.

Pet insurers’ top priority must be to help pet owners to understand what pet insurance types they are getting into. The NAIC also says this new model law could deliver consistency with a version that allows pet insurers to remain competitive.

Wellness Program

The Pet Insurance Model Act requires pet insurance carriers and producers to contrast pet wellness programs with insurance policies. This helps eliminate confusion for pet consumers wanting to buy one or the other.

A pet insurer must not sell a wellness program as pet insurance. They should refrain from marketing the program during the solicitation, sale, and negotiation.

It is also the responsibility of the insurer to disclose the following details to the consumers:

  • Purchasing the wellness program is not a requirement for the pet insurance
  • Fees of the wellness program must be separate from the availed pet insurance policy
  • Terms on the wellness program must not duplicate the products available on the pet insurance policy
  • Advertising of the wellness program must not be misleading
  • Insurers should disclose their address and customer service number

Every pet insurance policy is different, and every pet guardian is, too. Breeders may require specific policies, for instance. The owner must ensure that their chosen policy matches their pet’s needs. Also, one of the pet insurance facts is that they provide peace of mind knowing insurers can financially cover furry friends’ illnesses.

Leave a Reply

Your email address will not be published. Required fields are marked *