10 Most Common Pet Insurance Claims: Facts & FAQ

More and more pet owners are realizing the benefits of pet insurance. Owners insured roughly 6.25 million pets in 2023, up 16.7% from the previous year. That makes sense, given the cost of having an animal companion. After all, dog owners can expect to pay between $19,893 and $55,132 over a pet’s lifetime for the privilege of welcoming one into their lives. But when you have pet insurance, it can seriously help to cut costs for unforeseen circumstances or emergency visits. But what kind of claims are actually the most common? Let’s discuss this below.

How Pet Insurance Claims Work

Pet insurance consists of three main types: basic, comprehensive, and wellness. Companies vary in which ones they offer and cover. Generally, most insurers won’t accept claims for pre-existing conditions. However, their definitions differ. Most companies reimburse pet owners, with few paying the veterinary clinic directly. Otherwise, they operate like health insurance, with deductibles and caps.

Wellness protection covers preventive care, and many insurers offer these plans as add-ons. The coverage varies widely on what the companies will reimburse, making shopping around a wise plan. You’ll also see price differences based on breed, age, and the location where you live. The three types are the same. However, the policies may vary based on these parameters.

Our rankings include the most recent claim data from Nationwide Pet Insurance. While some conditions vary between the two sets, we can see an evident pattern in maladies affecting dogs specifically.

The 10 Most Common Pet Insurance Claims

1. Skin Issues

The 2023 data groups skin issues under the umbrella term “dermatitis,” which is simply inflammation of the skin.¹ The Nationwide figures from 2016 separate these conditions into allergic dermatitis, benign skin neoplasia (growth or tumor), and hot spots.² Suffice it to say that these problems figure prominently in pet insurance claims. And many things can cause them, from food allergies to fleas to cancer.

Comprehensive coverage would likely cover most of these issues, with wellness protection providing valuable prevention.

2. Digestive Problems

The 2023 data groups these claims under the term “gastroenteritis,” which is inflammation of the stomach and intestines. Meanwhile, 2016 figures separate an upset stomach from intestinal inflammation-diarrhea. Often, the two signs go hand in hand with many causes, such as accidental poisoning, allergies, and bacterial diseases. So, GI problems are undoubtedly a popular reason why pet owners take their animal companions to the vet in the first place.

3. Ear Infections

Genetics and selective breeding can explain why we see this claim for dogs and not so much for cats. Some canine breeds, like Basset Hounds, for example, are more susceptible to these issues.³ Evidence also suggests the L-shape of some dogs’ ear canals is another culprit.⁴ Complicating these conditions is the need to sedate some animals to clean their ears thoroughly. It can be a chronic problem for some animals.

4. Arthritis

Arthritis is relatively common among dogs, with estimates that up to 20% of the canine population is affected. Other research has shown a possible link between sterilization of pets and the development of joint disease. Interestingly, the data suggests both dogs and cats are equally plagued. Initial costs are undoubtedly higher because of the tests needed to confirm a diagnosis. It is also a chronic condition.

5. Trauma

“Trauma” is a catch-all term covering a broad spectrum of injuries, from falls to accidents. Healthy Pet Paws Insurance lists pain as a factor in 7% of the top canine accidents and illnesses. Cruciate ligament injuries and limping point to other possible trauma causes. Again, we’re dealing with generic reasons behind the insurance claims. So, we can consider trauma one of the main reasons pet owners go to the vet.

6. Dental Disease

Considering how common it is, we’re surprised that dental disease isn’t the reason for more claims. An estimated 80% of pups over 3 years old have this condition. The form that vets see the most is periodontal disease, or inflammation of the tissue around the teeth. Left untreated, it can lead to tooth loss and a heightened risk of bacterial disease, which can impact other organs.

7. Urinary Tract Infections

Urinary tract infections are bacterial conditions targeting this body area. While dogs get them, they are much more common in cats. Female canids are also vulnerable. It can affect other organs like the kidneys and bladder. Vets diagnose these infections with a bacterial culture and urinalysis. Treatment typically involves a course of antibiotics, and getting the sample often adds to the cost.

8. Heart Disease

Nationwide Pet Insurance specifies the condition as valvular heart disease. It involves the progressive deterioration of the heart valves. It can advance slowly in older dogs or more quickly in pups prone to the disease, such as Cavalier King Charles Spaniels. That explains the relatively low initial treatment cost, which simply identified it in the animal. However, the prognosis depends on whether they develop congestive heart failure.

9. Respiratory Infections

Respiratory infections include relatively mild cases of kennel cough and serious issues like pneumonia. Diagnosis often requires sedation, depending on the tests your vet may elect to perform. Treatment varies with the cause. However, it usually involves antibiotics and cough medicines to make breathing easier for your pet. Brachycephalic breeds like Pugs are particularly susceptible.

10. Liver Disease

The 30-day cost figure provided above is conservative for liver disease. Given the organ’s role in the body, it is a serious condition. Early veterinary intervention is imperative to prevent complications that may involve the brain. Preventable issues like heartworm can lead to liver disease. The claims typically include a myriad of diagnostics, including ultrasound, X-rays, and bloodwork.

Frequently Asked Questions (FAQ)

Is Pet Insurance Worth It?

Absolutely. The monthly price of pet insurance is relatively low, depending on the plan, and you’d be surprised how much money one trip to the emergency clinic can cost, meaning your insurance plan can quickly pay for itself.

For example, one of the most common conditions in puppies is gastrointestinal obstruction. They’re like babies in that everything goes in their mouths, and this situation can quickly turn into a medical emergency. According to Care Credit, the surgery alone runs $2,900 to $3,265. That’s not including the diagnostics, medications, and aftercare. Again, a policy that covers this surgery will more than pay for itself.

What Else Can Affect How Much Pet Insurance Will Cost?

The availability of services versus the pet population can affect what you pay. Large animals are usually more expensive to insure than small pets. The breed’s propensity for various health conditions can also influence your monthly premium. However, many companies give you some leeway by opting for varying deductibles and cap amounts to save you some money.

Are Insurers Good About Paying Claims?

The best thing you can do to ensure prompt payment is to fulfill the company’s requirements for processing claims. Know what information you must provide before submitting it. These businesses know that claim issues are a source of customer complaints, and they try to make the process as seamless as possible.

Conclusion

Pet insurance appeared on owners’ radar when Lassie became the recipient of the first US policy in 1982. While it took a while to catch on, more people than ever are getting coverage for their animal companions. It makes sense when you consider the rising costs of care. Insurance ensures you can pay for the services for your pet for the best quality of life.

Featured Image Credit: Rawpixel, Shutterstock