"There's nothing quite as terrifying to me as when an animal that's in my care -- of whom I promised to be its guardian-- goes missing. That's why I've done everything I can think of when it comes to taking care of my newest family member: Ullr ("the wonder dog"). He's been microchipped, wears a PetHub Link tag, and has PetFirst Healthcare's EmergencyFirst medical insurance that reimburses me for any vet bills up to $3,000 (after a $50 deductible). It's impossible to put a price on the life of a companion animal, and with this insurance I won't have to worry about ensuring he gets the care he needs if something does happen if he goes missing." -- Tom Arnold, Founder, PetHub, Inc.
From the PetHub, Inc., and PetFirst Healthcare, LLC, agreement:
"The EmergencyFirst pet insurance shall protect a pet’s health if injured while lost for a period of 12 months. Each EmergencyFirst policy shall cover up to three thousand dollars ($3,000) of emergency medical treatment, reimbursable by PetFirst at one hundred percent (100%) of the actual cost after a deductible in the amount of fifty dollars ($50). The coverage shall include physical injuries (broken bones, lacerations, sprains, bites, etc). A sample policy of the EmergencyFirst pet insurance is attached hereto as Exhibit A. In order to qualify for reimbursement of a claim, a policyholder shall provide to PetFirst a certification from a veterinarian that the pet was injured while lost."
Note: this insurance applies only to dogs and cats.
EXHIBIT A -- SAMPLE POLICY -- EMERGENCYFIRST PLAN POLICY
INSURING AGREEMENT
The “insurer” (PetFirst Healthcare) agrees to reimburse the “insured” (that's you, the pet owner) for "covered services" to the extent set forth in the policy. “We” (PetFirst Healthcare) will pay only for “covered services” rendered during the “policy period”. Benefits are payable subject to any and all policy exclusions and conditions.
Words and phrases in quotations have special meaning and are defined in the Definitions provision below.
DEFINITIONS
“Aggregate Limit” shall mean the maximum amount “we” will pay for all “covered incidents” as shown on the Declarations Page of this policy.
“Application” shall mean “your” statements and representations to “us” provided by “you” in the enrollment process in response to “our” standard questions and data requests to “you” as comprising part of the enrollment process, whether such enrollment is done over the telephone, on paper, or via the Internet.
“Covered incident” shall mean an occurrence wherein “you” (the insured) had to make payment for a “covered service” under this policy.
“Covered Incident Limit” shall mean the maximum amount that “we” will pay per “covered incident”, as shown on the Declarations Page of this policy.
“Covered service” shall mean expenses incurred from necessary veterinary medical service provided to and/or arising from life-threatening accidental injury affecting “your pet” should “your pet” be injured while reported lost by the “insured” or a certification is issued from a licensed “veterinarian” or shelter administrator/executive that “your pet” was injured while lost.
“Insured” shall mean “you”, the pet owner/insured policyholder.
A “lost” pet, for purposes of determining applicability of this policy, is one that has strayed or otherwise disappeared from “your” physical custody and supervision, the location of which is not known to “you” at the time of the accident from which the need for emergency medical services arises or at the time of the transportation of “your pet” to the veterinary facility following such accident.
“Policy period” shall mean twelve (12) months from the inception of this policy.
“Reasonable & Customary” shall refer to published industry guidelines, such as the American Animal Hospital Association’s fee reference guide for “veterinarians”.
“Veterinarian” shall mean a properly licensed veterinarian.
“Veterinary services” shall mean services rendered by a licensed “veterinarian”.
“We”, “our”, or “us” shall mean the insurer (PetFirst Healthcare).
“You” or “your” shall mean the insured policyholder.
“Your pet” shall mean only the pet specified and described by “you” in the “application” for this policy and other applicable “documents of insurance” pertaining to this policy.
EFFECTIVE DATE
“Your” coverage begins on the effective time and date shown on the “documents of insurance”.
BENEFIT PROVISIONS
During the “policy period”, “we” will pay 100% of “reasonable and customary” ”covered services” per “covered incident” claim, subject to the “Covered Incident Limit”, the “Aggregate Limit”, and “your” payment of any applicable deductible.
DEDUCTIBLE
A deductible shall apply to each “covered incident” during the “policy period”, as shown on the Declarations Page.
LIMIT OF LIABILITY
Payments for “covered services” are limited to the “Covered Incident Limit” and the “Aggregate Limit” as shown on the Declarations Page.
GENERAL CONDITIONS
Other Insurance - If at any time a claim is made under this policy for a “covered incident”, and there is other insurance applicable, “we” will pay “our” share of the benefits for covered expenses. “Our” share is the proportion that the “Covered Incident Limit” bears to the total benefits available under all applicable insurance.
Territory - This coverage is valid and only applies to “covered incidents” arising from incidents occurring or services rendered within the United States, its territories and possessions while this policy is in effect.
Condition of “Your Pet” – In the original “application” for this insurance, “you” represented that “your pet described on the Declarations Page was in good health and free of injury as of the effective date of this policy.
Change of ownership – Coverage for “your pet” will cease if ownership of “your pet” is transferred by agreement or law.
Conformity to State Statutes – When this policy’s provisions are in conflict with the statutes of the state in which this policy is issued, the provisions are amended to conform to such statutes.
Cancellation – “You” may cancel this policy at any time by returning it to “us” or by notifying “us” in writing including the future date cancellation is to take effect. “We” may elect to non-renew this policy on the expiration date.
Misrepresentation - The policy shall be terminable if “you” have willfully concealed or misrepresented any material fact concerning this insurance or the subject thereof, or committed any fraud or false swearing relating thereto. Such cancellation will be effected pursuant to written notice to “you”, with the minimum advance notice period allowable under applicable state law for a cancellation due to fraud or material misrepresentation.
Electronic Delivery
By accepting the terms of this insurance as evidenced by the payment of premiums hereunder, it is agreed that this policy and any endorsements may be delivered to “you” by electronic mail via the internet, at “our” option. If “you” choose not to accept electronic delivery of this policy, “you” must immediately notify “us” and arrange for the policy to be mailed or otherwise delivered.
EXCLUSIONS AND LIMITATIONS
This policy will not pay for costs “you” incur for:
1. Injury or illness contracted, manifested or incurred prior to the policy effective date, unless such injury or illness has been cured and there has not been a subsequent recurrence or manifestation of the injury or illness requiring treatment. Support documentation from a licensed “veterinarian” must be submitted to “us” for consideration of removal of any medical exclusion.
2. Elective procedures, cosmetic surgeries, including but not limited to tail docking, dewclaws, skin folds, nail trims, and cropping of ears.
3. Expression or removal of anal glands or anal sacculitis.
4. Breeding or conditions related to breeding.
5. Special diets, pet foods, vitamins, mineral supplements, grooming costs and bathing (including medicated baths).
6. Treatment of external parasites such as fleas, lice and ticks and preventable internal parasites such as heartworms, hookworms, roundworms, tapeworms and whipworms.
7. Orthodontics, endodontics and removal of deciduous teeth.
8. Diagnostic test(s) and treatment(s) for conditions excluded or limited by this policy and complications of conditions excluded or limited by this policy.
9. Time and travel expenses to the “veterinarian’s” premises or hospital.
10. Illness or injury which arises out of racing, coursing, commercial guarding or organized fighting of “your pet”.
11. Congenital or hereditary defects or diseases
12. Continuous coverage of chronic and long-term conditions that manifest in a previous policy year.
13. Behavioral problems, training or therapy.
14. Routine examinations, routine tests or screens, vaccines, teeth cleaning or polishing.
15. Preventive treatments and diagnostics for, or conditions relating to, preventable parasites, including heartworms.
16. Spaying/Neutering.
17. Intentional injury to “your pet” by “you” or a member of “your” household.
18. Illness not directly caused by an injury while “your pet” is lost.
19. Diagnosis, medical management, or surgical correction of anterior cruciate ligament (ACL) or cranial cruciate ligament (CCL) damage or rupture, unless this policy is a renewal of a Pet Insurance Policy issued by “us”.
20. Diagnosis, medical management, or surgical correction of interverterbal disc(s) regardless of the procuring cause (unless otherwise agreed with “you”) during the first six (6) months of the “policy period”.
This policy will not provide payment for expenses related to accidental injury of “your pet” caused directly or indirectly by: 1. An enemy attack by armed forces, with or without a state of war, including actions taken in resisting that attack; 2. insurrection; 3. rebellion; 4. revolution; 5. invasion; 6. civil war; 7. Illegal acts; 8. usurped power; or 9. nuclear radioactive contamination.
LOSS CONDITIONS & “INSURED’S” DUTIES
In cases of illness and/or accident giving rise to a claim under this policy, “you” agree to obtain or release all medical records to support claims upon request; furthermore, “you” authorize “us” to obtain all records to support the claim. Upon request “you” will provide “us” with proof of identity of “your pet” as “we” may require.
A loss is payable within 60 days after “we” receive a fully completed claim form with the attached actual itemized receipts that have been paid in full for “covered services”, or advertising and reward.
All claims must be submitted in writing within 90 days of the treatment date or date of the receipt furnished to “you” in connection with a “covered service”.
DECLARATIONS
By accepting this policy, “you” affirm that all the statements made by “you” to “us” in the “application” and/or enrollment process, and any related declarations or representations by “you” are true and that “you” have not withheld any information regarding “pre-existing condition(s)” or any other material facts.
“You” affirm that the policy and the endorsements are the entire and only agreements between “you” and “us”.
THIS IS A SAMPLE POLICY -- when speaking with a PetFirst Healthcare agent to activate your plan it is up to you to determine if this plan meets your needs. If it does not, do not activate your policy and instead contact us for a refund.
Copyright 2011, PetFirst Healthcare, LLC, and PetHub, Inc. All rights reserved.