Insurance Policy Wording

DEFINITIONS

Behavioural Illness
Any changes to your pet's normal behaviour, resulting from a mental or emotional disorder which is diagnosed by a vet.

Clinical signs
Changes in your pet’s normal healthy state, its bodily functions or behaviour.

Complementary Treament
Behavioural conditions, physiotherapy, hydrotherapy or Treatment homeopathy and acupuncture.

Excess
The amount stated on your policy document which is currently R250 is the first part of each unrelated claim and the amount you must pay. If your pet is 9 years and over (7 years or over for selected breeds) this excess may be subject to change dependent upon your previous claims.

Family
Your husband, wife, civil partner, life partner, parents, grandparents, brothers, sisters, sons, daughters, grandsons and granddaughters.

Home
The place in the Republic of South Africa where you normally reside.

Illness
Any changes to a normal healthy state for example sickness, disease,congenital and hereditary conditions.

Injury
A physical injury caused immediately by an accident. Not an injury that occurs over time.

Market value
The price generally paid for an animal of the same age, breed, pedigree, sex and breeding ability at the time you purchased your pet.

Maximum benefit
The most we will pay during the policy year as set out in the policy document. Maximum amount of R25 000.

Policy year The time during which we give cover as set out in your policy document. This is normally 12 months but may be less if your pet has been added to your insurance or it has been cancelled.

Selected Breeds Beauceron, Bernese Mountain Dog, Bulldog, Boer Bull, Deerhound, Dogue de Bordeaux, Estrela Mountain Dog, Great Dane, Irish Wolf Dog, Leonburger, Mastiff, Newfoundlands, Old English Sheep Dog, Pyrenean Mountain Dog, Rottweiler, Shar Pei, and St Bernard.

RSA Republic of South Africa.

Vet Registered Veterinary Surgeon.

Veterinary Costs The amount vets in general or referral practice usually charge.

Veterinary treatment Any examination, consultation, advice, tests, X-rays, legally prescribed medication, surgery and nursing required to treat an illness or injury, provided by a vet, a veterinary nurse or another member of the veterinary practice under the supervision of the vet. This includes physiotherapy and treatment of a behavioural illness provided it is carried out by a veterinary practice.

We, us, our Renasa Insurance Company Pty Ltd.

You, your The person named on the policy document.

Your pet Any dog or cat named on the policy document.

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GENERAL CONDITIONS

1. Throughout the policy year you must take all reasonable steps to maintain your pet’s health and to prevent injury, illness and loss. You must arrange and pay for your pet to have a yearly dental check up and any treatment normally recommended by a vet to prevent illness or injury.
   
2. You must arrange for your pet to be kept vaccinated against the following.
   Dogs: Distemper, hepatitis, bordetella, parainfluenza, leptospirosis, parvovirus and rabies.
   Cats: Feline infectious enteritis (panleukopaenia), calicivirus, Chlamydia, cat flu and rabies.
   
3. If, when you claim, there is any other insurance under which you are entitled to an indemnity, we will only pay our share of the claim. You must tell us the name and address of the other insurance company and your policy number with them.
   
4. If you have any legal rights against another person in relation to your claim, we may take legal action against them in your name at our expense. You must assist us all you can and provide any documents requested.
   
5. If you provided false information. Or make a false or exaggerated claim, or any claim involving your dishonesty, this policy will end and we will not make any further payments.
   
6. Your pet is only covered under this policy if you pay the premium. If you pay the yearly premium in instalments and miss an instalment you must pay the outstanding amount within 10 days of the date the instalment was due to be paid. If we do not receive your payment within 10 days of the date the premium was due your insurance will automatically stop, and we will make no further payments.
   
7. When we settle your claim, we will deduct from the claim, any amount due to us.
   
8. You agree that any vet has your permission to release any information we ask for about your pet. If the vet makes a charge for this, you must pay the charge.
   
9. If the veterinary fees you are charged are higher than the fees usually charged by a general or referral practice, we reserve the right to request a second opinion from a vet that we choose. If the vet we choose does not agree with the veterinary fees charged we may decide to pay only the veterinary fees usually charged by a general or referral practice in a similar area.
   
10. If we consider the veterinary treatment or complementary treatment your pet receives may not be required or may be excessive when compared with the treatment that is normally recommended to treat the same illness or injury by general or referral practices, we reserve the right to request a second opinion from a vet of our choice. If the vet that we choose does not agree with the veterinary treatment or complementary treatment provided that we may decide to pay only the cost of the veterinary treatment or complementary treatment that was necessary to treat the injury or illness, as advised by the vet from whom we have requested the second opinion.
    
11. When we offer further periods of insurance, we may change the premium, and the policy Terms and Conditions.
    
12. We will not guarantee verbally on the phone if we cover a claim. You must send us a fully completed claim form. We will then let you have our decision in writing.
    
13. When you claim you agree to give us any information we reasonably ask for.
    
14. You must arrange for a vet to examine and treat your pet as soon as possible after it shows clinical signs of an injury or an illness. And, if we decide, we will refer the case to a vet that we choose.
    
15. All veterinary fees are to be settled directly with your vet before any claim is submitted.
    
16. We strongly advise that you have your pet microchipped and it is the owner’s responsibility to keep their information up to date with the microchip company.
    
17. Dogs over 9 years (7 years for selected breeds) will be limited to accidental injury and third party liability cover.
18. A letter will be sent to the attending veterinarian requesting more information if hereditary and or congenital conditions are present. This may limit your cover.
19. Other Insurance. If any loss, damage or liability is covered by any other insurance we will not pay more than our rateable proportion of claim.

ADDED BENEFITS
10 % Discount will be granted for every additional pet added to the policy.

COVER
In return for the correct premium, we will provide cover for the following sections if they are shown on your Certificates of Insurance Animal Details.

SECTION 1 A – VETERINARY FEES

WHAT WE WILL PAY
The cost of any veterinary fees for veterinary treatment your pet has received during the policy year to treat an illness or injury.
We will pay up to R100 per month for a veterinary prescription diet if needed to treat an illness for a period of 6 months with advice from a veterinary surgeon.

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WHAT WE WILL NOT PAY

1. More than the maximum benefit of R25 000
   
2. The cost of any treatment for:
   - an injury that happened or an illness that first showed clinical signs before your pet’s cover started; or
   - an injury or illness that is the same as, or has the same diagnosis or clinical signs as an injury, illness or clinical sign your pet had before its cover started; or
   - an injury or illness that is caused by, relates to or results from an injury, illness or clinical sign your pet had before its cover started,
   no matter where the injury, illness or clinical signs are noticed or happen in, or on your pet’s body.
   
3. The cost of any treatment for:
   - an illness that first showed clinical signs within 14 days of your
   pet’s cover starting; or,
   - an illness which is the same as, or has the same diagnosis or clinical signs as an illness that first showed clinical signs within 14 days of your pet’s cover starting; or,
   - an injury or illness that is caused by, relates to or results from a clinical sign that was first noticed, or an illness that first showed clinical signs, within 14 days of your pet’s cover starting,
   no matter where the illness or clinical signs are noticed or happen in, or on your pet’s body
   
4. The cost of any treatment a vet normally recommends to prevent injury or illness.
   
5. The cost of any treatment, or complications arising from treatment, that you choose to have carried out that is not directly related to an injury or illness, including cosmetic dentistry.
   
6. the cost of killing and controlling fleas, general health improvers and any treatment in connection with pregnancy or giving birth.
   
7. The cost of pheromone products, including DAP diffusers and Feliway.
   
8. The cost of vaccinations, spaying and castration except the cost of treating any complications arising from these procedures.
   
9. The cost of treating any injury or illness deliberately caused by you or anyone living with you, or while on your journey anyone travelling with you.
   
10. The cost of house calls unless the vet confirms that moving your pet would further damage its health, regardless of your personal circumstances.
    
11. Extra costs for treating your pet outside usual surgery hours, unless the vet confirms an emergency consultation is necessary.
    
12. The cost of hospitalisation and any associated veterinary treatment, unless the vet confirms it is essential that your pet is hospitalised.
    
13. Costs resulting from an injury or illness specified as excluded on your policy document or generally not covered within these Terms and Conditions.
    
14. The cost of surgical items that can be used more than once.
    
15. The cost of physiotherapy or treatment of a behavioural illness, unless this is carried out by a veterinary practice.
    
16. The cost of treatment for a behavioural illness if your pet’s behaviour is caused by you failing to provide training.
    
17. The cost of any form of housing, including cages, whether hired or purchased.
    
18. The cost of bathing, grooming or de-matting your pet unless
    - you have taken all reasonable steps to maintain your pet’s health;
    - a vet confirms veterinary expertise is needed and therefore only a
    vet or a member of a veterinary practice can carry out these
    activities, regardless of your personal circumstances.
    
19. The cost of dental treatment unless your pet has had its teeth
    checked by a vet no longer than 12 months before the onset date of the claim. If any treatment was recommended as a result of the check this must have been carried out.
    
20. The cost of post mortem examination.
    
21. The cost of transplant surgery, including any pre and post operative care
    
22. The cost of any treatment if a claim has not been submitted within
    60 days of your pet receiving treatment.
    
23. The cost of any treatment while on a journey if a vet believes it can be delayed until your pet returns home.
    
24. The cost of any treatment if the journey was made to get treatment
    in another country.

HOW TO CLAIM
Before your pet is treated, you must make sure that the vet is prepared to fill in our claim form and provide invoices.
You must fully complete a claim form and ask your vet to complete the necessary section required by them.
We will not pay for the vet to do this.
Send us the fully completed claim form together with the detailed invoices setting out the specific costs involved for each procedure.

WHEN TO CLAIM
You should send us your claim at the end of treatment or the end of the policy year if the treatment has not finished by this time.
The claim must be submitted within 60 days of the pet receiving treatment.

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SECTION 1B – COMPLEMENTARY TREATMENT

WHAT WE WILL PAY
If instructed by the vet, the cost of complementary treatment your pet has received during the policy year to treat an illness or injury.

WHAT WE WILL NOT PAY

1. More than the maximum benefit of R25 000.
   
2. The cost of any treatment for;
   - an injury that happened or an illness that first showed clinical signs before your pet’s cover started; or,
   - an injury or illness that is the same as, or has the same diagnosis or clinical signs as an injury, illness or clinical sign your pet had before its cover started; or,
   - an injury or illness that is caused by, relates to or results before its cover started, no matter where the injury, illness or clinical signs are noticed or happen in, or on your pet’s body.
   
3. The cost of any treatment for:
   - an illness that first showed clinical signs within 14 days of your pet’s cover starting; or,
   - an illness which is the same as, or has the same diagnosis or clinical signs within 14 days of your pet’s cover starting; or,
   - an injury or illness that is caused by, relates to or results from a clinical sign that was first noticed, or an illness that first showed clinical signs, within 14 days of your pet’s cover starting, no matter where the illness or clinical signs are noticed or happen in, or on your pet’s body
   
4. The cost of any treatment a vet normally recommends to prevent
   injury or illness.
   
5. The cost of any treatment or complications arising from treatment, that you choose to have carried out that is not directly related to an injury or illness, including cosmetic dentistry.
   
6. The cost of killing and controlling fleas, general health improvers and any treatment in connection with pregnancy or giving birth.
   
7. The cost of pheromone products, including DAP diffusers
   and Feliway.
   
8. The cost of vaccinations, spaying and castration except if the animal is a cryptorchid or any complications arising from these procedures.
   
9. The cost of treating any injury or illness deliberately caused by you or anyone living with you.
   
10. The cost of house calls unless the vet or complementary therapist confirms that moving your pet would further damage its health, regardless of your personal circumstances.
    
11. Extra costs for treating your pet outside usual surgery hours, unless the vet or complementary therapist confirms an emergency consultation necessary.
    
12. The cost of hospitalisation and any associated veterinary treatment, unless the vet or complementary therapist confirms it is essential that your pet is hospitalised.
    
13. Cost resulting from an injury or illness specified as excluded on your Certificates of Insurance or generally not covered within these Terms and Conditions.
    
14. The cost of any form of housing, including cages, whether hired or purchased.
    
15. The cost of bathing, grooming or de-matting your pet unless
    - you have taken all reasonable steps to maintain your
    pet’s health; and
    - the vet or complementary therapist confirm veterinary expertise is needed and therefore only a vet, member of a veterinary practice or the complementary therapist can carry out these activities, regardless of your personal circumstances.
    
16. The cost of treatment for a behavioural illness if your pet’s behaviour is caused by you failing to provide training.
    
17. The cost of dental treatment unless your pet has had its teeth checked by a vet no longer than 12 months before the onset date of the claim. If any treatment was recommended as a result of the check this must have been carried out.
    
18. The cost of any treatment if a claim has not been submitted within 60 days of your pet receiving treatment.

HOW TO CLAIM
Before your pet is treated, you must make sure that the vet and complementary therapist are prepared to complete a claim form and provided the necessary invoices.
You must fully complete a claim form and ask your vet and complementary therapist to complete the necessary section required by them. We will not pay for the vet or complementary therapist to do this.
Send us the fully completed claim form together with the necessary detailed invoices setting out the specific costs involved for each procedure.

WHEN TO CLAIM
You should send us your claim at the end of treatment or the end of the policy year if the treatment has not finished by this time. The claim must be submitted within 60 days of the pet receiving treatment.

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SECTION 2 – ADVERTISING AND REWARDS

WHAT WE WILL PAY
If your pet is stolen or goes missing during the policy year, we will pay:
1. the cost of advertising up to R250 per year.

WHAT WE WILL NOT PAY

1. More than the maximum benefit of R250 per year.
   
2. Any reward we have not agreed to before you advertised it.
   
3. Any reward not supported by a signed receipt giving the full name and address of the person who found your pet.
   
4. Any reward paid to a member of your family, any person living with you or employed by you including anyone travelling with you during your journey.
   
5. Any reward paid to the person who was caring for your pet when it was lost or stolen.
   
6. Any amount if your pet is lost or stolen or goes missing during your journey, unless there is some official documentation to certify the theft or loss was reported to the Police.

SPECIAL CONDITIONS THAT APPLY TO THIS SECTION WHEN YOUR PET IS STOLEN OR GOES MISSING DURING YOUR JOURNEY

1. You must report the loss or theft of your pet within 24 hours of discovering
   it missing, to the police and obtain a police report.
   
2. You must immediately take all reasonable steps to find or recover your pet.

HOW TO CLAIM
Please phone us on 0800 MEDIPET (0800 6334738) for approval on any reward before you advertise it.
Fully complete a claim form and send it to us with the necessary invoices and receipts to show the costs involved, including a receipt for any reward you paid.
If the loss or theft happened during your journey please send us the booking invoice for your journey or any other official documents to show the dates of your journey. (Limited to RSA only).

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SECTION 3 – BOARDING FEES

WHAT WE WILL PAY
If something unexpectedly happens to you that is out of your control and renders you unable to care for your pet, we will pay the cost of boarding your pet at a licensed kennel or cattery or R50 a day towards the cost of someone, who does not live with you looking after your pet. Cover is limited to R1000 per annum. This is in the event that something happens to you that is not in your control

WHAT WE WILL NOT PAY

1. More than the maximum benefit of R1000.
   
2. Any cost resulting from your having to go into a hospital because of an injury or illness first occurring or showing symptoms before your pet was covered.
   
3. Any costs resulting from your being pregnant, giving birth or any treatment that is not related to an injury or illness.
   
4. Any costs resulting from you going into a hospital for the treatment for alcoholism, drug abuse, drug addiction, attempted suicide or self-inflicted injuries.
   
5. Any costs resulting from nursing home care or from convalescence care that you do not receive in a hospital.

SECTION 4 – THEFT

WHAT WE WILL PAY
We will pay R1000 towards your dog if it is stolen or goes missing and is not recovered or does not return.
We will pay R250 per year towards advertising and reward if your cat or dog goes missing.

WHAT WE WILL NOT PAY

1. More than the maximum benefit of R1000.
   
2. Any amount if you or the person looking after your pet has freely parted with it, even if tricked into doing so, unless anyone was looking after or transporting your pet in return for money, goods or services.
   
3. The value of your pet.

SPECIAL CONDITIONS THAT APPLY TO THIS SECTION
If your pet is found or returns, you must repay the full amount we have paid you.

As soon as you discover your pet is missing you must:

1. Tell all vets and local rescue centres within a reasonable distance of the area where your pet was last seen within 5 days of your pet going missing. At least one veterinary practice must be notified;
2. If your pet is a dog you must tell the police and ask for the crime reference number or written confirmation of your report; and
3. If your pet has not been found within 45 days, please fully complete a claim form and return it to us as soon as possible.

HOW TO CLAIM
To claim for theft or straying you must have advertised the loss of your pet, please send proof of this.
We will not pay for this information.

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SECTION 5 – DEATH FROM INJURY

WHAT WE WILL PAY
We will pay up to R500 for cats and R1000 for dogs if it either dies or has to be euthenased by a vet during the policy year as a result of an injury caused by an accident.

WHAT WE WILL NOT PAY

1. More than the maximum benefit of R1 000 for dogs and R500 for cats.
   
2. Any amount if the death results from injury that happened before your pet’s cover started.
   
3. Any amount if the death results from an injury or illness specified as excluded on your policy document or generally not covered within these Terms and Conditions.
   
4. Any amount unless a vet has to euthenase your pet as a result of an injury that cannot be treated and believes it was not humane to keep your pet alive because it was suffering.

HOW TO CLAIM
Please send us:

1. a Death Certificate from your vet;
   
2. your fully completed claim form.
   We will not pay for this information.

SECTION 6 – DEATH FROM ILLNESS

WHAT WE WILL PAY
We will pay up to R500 for cats and R1000 for dogs if it either dies or has to be euthenased by a vet during the policy year as a result of an illness.

WHAT WE WILL NOT PAY

1. More than the maximum benefit of R1000 for dogs and R500 for cats.
   
2. Any amount of your pet’s death results from:
   - an illness that first showed clinical signs before your pets cover started; or,
   - an illness that is the same as, or has the same diagnosis or clinical signs as an illness or clinical sign your pet had before its cover started; or,
   - an injury or illness that is caused by, relates to or results from an illness or clinical sign your pet had before its cover started, no matter where the injury, illness or clinical signs are noticed or happen in or on your pet’s body.
   
3. Any amount if your pets death results from:
   - an illness that first showed clinical signs within 14 days of your pet’s cover starting; or,
   - an illness which is the same as or has the same diagnosis or clinical signs as an illness that first showed clinical signs within 14 days of pets cover starting,
   - an illness that is caused by, relates to or results from a clinical sign that was first noticed, or an illness that first showed clinical signs within 14 days of your pet’s cover starting, no matter where the illness or clinical signs are noticed or happen in or on your pet’s body.
   
4. Any amount if the death results from pregnancy or giving birth.
   
5. Any amount if the death results from an injury or illness specified as excluded on your policy document or generally not covered within these Terms and Conditions.
   
6. The purchase price or market value of your pet if a vet needs to euthenase your pet unless it is because of an incurable illness and the vet believes it was not humane to keep your pet alive because it was suffering.

HOW TO CLAIM
Please send us:

1. a Death Certificate from your vet;
   
2. The pedigree certificate and receipt from when you bought your pet, where applicable; and
   
3. Your fully completed claim form.
   We will not pay for this information.

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SECTION 7 – THIRD PARTY LIABILITY

THIS SECTION APPLIES TO DOGS
In this section, “you and your” mean you or any person looking after or handling your pet with your permission.

WHAT WE WILL PAY
If property is damaged, or someone is killed, injured or falls ill as a result of an incident involving your pet during the policy year, we will pay:

1. compensation and costs awarded against you by a court; and
   
2. the legal cost and expenses for defending a claim against you.
   
3. up to a maximum limit of R1 000 000 per policy year.
4. Please refer to other insurance under general conditions no.19

WHAT YOU PAY
The first R1000 of any compensation, costs or expenses where property has been damaged.

WHAT WE WILL NOT PAY

1. More than the maximum benefit for each incident of R1000 000.
   
2. Any costs or expenses defending you which we have not agreed beforehand.
   
3. Any compensation, costs and expenses resulting from an incident that takes place as a result of your profession, occupation or any business.
   
4. Any compensation, costs and expenses if you are legally responsible only because of a contract you have entered into.
   
5. Any compensation, costs and expenses if the person who is killed, injured or falls ill lives with you or is employed by you.
   
6. Any compensation, costs and expenses if the property damaged belongs to you or any person who lives with you or is employed by you.
   
7. Any compensation, costs and expenses if you, or any person who lives with you, or are employed by you is responsible for or looking after the property that is damaged.
   
8. Any compensation, costs and expenses that result from an incident if you have not followed instructions or advice given to you by previous owners or re-homing organisation about the behaviour of your pet.
   
9. Any compensation, costs and expenses if you are deemed responsible under the laws of any country, other than RSA.
   
10. Any compensation, costs and expenses if you are responsible for air, water or soil pollution, unless it can be proved that the pollution took place immediately after and as a result of an accident involving your pet.
    
11. Any compensation, costs and expenses resulting from an incident that happens where you work.
    
12. If you work from home and your pet has access to your work area, equipment or your clients, any compensation, costs and expenses resulting from an incident that happens where you live.
    
13. 13. Any compensation, costs and expenses if your pet is kept or lives on premises where alcohol is sold.
    
14. 14. Costs resulting from any incident specified as excluded on your policy schedule or generally not covered within these Terms and Conditions.

SPECIAL CONDITIONS THAT APPLY TO THIS SECTION

1. You must not admit responsibility, agree to pay any claim or negotiate with any other person following an incident.
   
2. You agree to provide us with any information connected with the claim we reasonably ask for including details of your pet’s history.
   
3. You agree to tell us or help us find out all the circumstances of an incident that results in an claim, provide written statements and go to court if needed.
   
4. You must allow us to take charge of your claim and allow us to prosecute in your name for our benefit.
   
5. You must immediately send us any writ, summons or legal documents you receive and you must never send any replies to any of these documents.

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HOW TO CLAIM
Send to us the claim form together with all correspondence, writs, summons or any other legal documents. You must not have answered any of these documents. We will not pay for this information.

GENERAL EXCLUSIONS
The following exclusions apply to ALL sections of the policy.

1. Any animal less than 8 weeks old.
   
2. Dogs used for guarding, track racing or coursing.
   
3. Any amount if you break the RSA laws, or regulations, including those relating to animal health or importation.
   
4. Any amount if your pet is confiscated or destroyed by government or public authorities, or under the Animals Act.
   
5. Any loss as a result of an act of force or violence for political, religious or ideological reasons, war, riot, revolution or any similar event, including any chemical or biological terrorism.
   
6. Legal expenses, fines and penalties connected with or resulting from a Criminal Court Case or an Act of Parliament.
   
7. Any amount resulting from a disease transmitted from animals to humans.
   
8. Any amount if your pet lives outside RSA.
   
9. Any dog not vaccinated against rabies, distemper, hepatitis, leptospirosis, bortetella, parainfluenza and parvovirus. And any cat not vaccinated against rabies, feline infectious enteritis (panleukopaenia), calicivirus, Chlamydia and cat flu.
   
10. Any journey you take your pet on against a vet’s advice.

FRAUD
Fraud increases your premium and the premiums of all policy holders. If you

• provide us with false information, or
  
• make a false or exaggerated claim with us, or
  
• make any claim with us which involves your dishonesty,

CANCELLATION RIGHTS
This contract gives you a cooling off period. If after receiving your policy document and full policy Terms and Conditions you are not happy you have 10 days during which you can cancel the policy. In these cases we will cancel your policy from the date it started and you will receive a full refund of any premiums paid. Simply call us on 0800 MEDIPET(0800 6334738) or send written confirmation to:
MedipetSA, PO Box 31596, Tokai, 7966.

If you cancel outside the 14 day cancellation period and the premium becomes due you may not receive a refund of your premium.

You may cancel your policy at any time with a 30 days’ notice period, in writing to us (email, fax and letter acceptable) and we may give you a refund of the money you have paid for the period of cover after the cancellation date. If we have paid a claim you may not receive a full return of your premium.

We reserve the right to cancel this policy on 7 days written notice if you do not abide by the terms of these conditions this will include acting dishonestly or fraudulently.

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