Pet insurance claim FAQs
When it comes time to file a pet insurance claim, you may have lots of questions. We want to provide the answers up front so that you know what to do if the time comes.
When you take your pet to the veterinarian due to an illness or injury, simply complete the one-page claim form. Submit the completed claim form with itemized invoices within 90 days of the treatment date. You can submit your claim by fax, email, or postal mail.
Email: [email protected]
Submit your claim via smartphone: Simply snap a high-quality photo of your claim form and invoice(s) and email them to us!
6100 4th Ave South
Seattle, WA 98108
201 – 185 Forester Street
North Vancouver, BC V7H 0A6
Note: For your pet's first claim, we need your pet's complete medical records from both current and previous veterinary and emergency hospitals. We may request additional information from your veterinarian(s) and the claim process will begin once we have all of the requested information.
To complete your first claim we need:
A completed claim form.
An itemized invoice from the claimed visit.
For your first claim, we need medical records for your pet dating back 18 months prior to enrollment and through waiting periods. This includes complete exam notes, test results, vaccines, and spay/neuter history from all hospitals your pet visited during this time frame.
If you do not have these records, we request them from all hospitals listed on the claim form. Once we have your pet’s medical records on file, you don't need to submit those records again.
For any future claims, all we need is the claim form and invoice. If we need updated records to process your claim, we request them from your vet hospital.
Every time you take your pet to a veterinarian for an illness or injury.
Deductibles at Trupanion are applied per condition, not annually like some insurance plans. Once you meet your deductible for a certain condition, you've met it for the lifetime of the policy on that condition. If your vet bill is less than the deductible, please still file a claim so that it counts toward your deductible. We apply related claims for the same condition until you meet your deductible. After that, coverage applies to any further claims for that condition.
*Please note that filing claims does not directly affect your premium, regardless of how many claims you submit, when you insure your pet with Trupanion.
To submit a claim for an online purchase, please send us a claim form filled out by you and your veterinarian along with the invoice.
If you submit an invoice from a pharmacy, please send us the pharmacy stub along with a completed claim form. The pharmacy stub will include the cost of the prescription, name of the pet, name of the medication, and the date filled.
Trupanion may need to confirm the condition being treated with your veterinarian.
Trupanion offers an appeals process if you feel your claim has been denied in error, an invoice item has been denied in error, or if the deductible was applied incorrectly. There are several ways to start the appeals process:
Bring a copy of the Explanation of Benefit letter for the claim to your veterinarian. The veterinarian can write a letter on your behalf explaining why they feel the claim is eligible for coverage. Once they write the letter and reference the claim number, they can submit it to Trupanion via fax or email.
Email: [email protected]
Your veterinarian can call our Hospital Experience Team at: 877-589-1862
You may send in your own appeal letter if you wish, but appeal letters written by your veterinarian may be more helpful. Your veterinarian can provide more detail about the medical aspect of your pet’s condition that is helpful to re-review the claim.
Once we receive an appeal, it typically takes 2-3 weeks for the appeals team to review the claim and make their decision. You have 6 months to appeal a claim.
If Trupanion maintains the denial of your claim, you may request that your claim be reviewed by an Independent Third Party Veterinarian* (ITPV) no later than two months after receiving Trupanion’s decision.
*Independent Third Party Veterinarian: Trupanion contracts with independent veterinarians who are board certified specialists/experts in the field of your claim. For example, a claim relating to cancer would be reviewed by a board certified oncologist. These doctors are selected purely on the basis of their degree of expertise and have no other relationship or affiliation with Trupanion.
Please contact us for more information on how to submit a claim to ITPV.
If a claim was denied due to the pet’s medical history, it may be submitted to ITPV. For example, Trupanion gets medical records for a pet that suggest the disease process or potential evidence of a condition existed before enrollment or during the waiting periods. ITPV will be able to assess whether or not the medical reasoning provided in the denial is supportive of denying coverage for that condition.
Any claim that was denied due to a direct policy exclusion will NOT be eligible for ITPV review. For example, Trupanion does not cover dental prophylaxis for any reason at any time. An ITPV will not be able to provide further advice, since dental cleanings are not eligible for coverage in any way under your policy.
Once we receive the claim form and invoice, we will open your claim and send you a confirmation email with a claim number. If you do not receive an email after three business days, please call us. If you submit multiple invoices for different dates of treatment, we open a new claim for each separate date of treatment, which means you will likely receive more than one email from us.
We want to keep you updated on the status of your claim as we work to get it completed. You may receive an email that says the claim is pending information. This means we need more information in order to process your claim, such as updated medical records. Updated medical records can help us clarify whether a current medical issue is different from a medical issue that was noted prior to enrollment. If we cannot determine that the current medical issue is different from a medical issue noted prior to enrollment, your claim may not be eligible for coverage.
You may also receive an email that your claim is pending review. This means that we believe we have complete information in order to process your claim and it is under review by a claims specialist. Sometimes claims are placed back into a ‘pending information’ status if the Claims Specialist needs more information to complete your claim. Once we complete the claim, we will notify you by email and mail.
We have two payment options to provide claim reimbursement. We can mail a check to you, or we can submit an electronic payment to your bank account. If we do not have your bank account on file and you would like electronic payments, please call us and we will be happy to set it up for you.
Paying your vet bill and filing a claim for reimbursement is standard. However, we have an option called Vet Direct Pay where we can pay your veterinary hospital directly for all eligible charges! You would still have to pay for the following:
Sales tax where applicable
Any items not eligible for coverage under your policy
The amount of your deductible (if you choose to have one)
A coinsurance payment of 10% of the charges eligible for coverage
Some hospitals would rather receive payment from you at your visit. Whether or not they would like to use Vet Direct Pay is up to the individual vet hospital. Please ask your vet if they offer Vet Direct Pay and if they are not familiar with it, please ask them to contact us for more information.
If your pet is also insured with another provider, that is completely fine! This just means that the claim will need to go through the other company first. After they have processed the claim, please send us their Explanation of Benefits, a completed Trupanion claim form, and a copy of the invoice, and we will evaluate the remainder of the charges.
Disclaimer: All statements above are general in nature and intended to be educational. They are not intended to be used for individual approval. Each situation and claim will be reviewed on an individual basis. For the answer above, we assume that the pet and pet owner comply with our policy wording. Coverage is based on our policy wording.