RS 22:1371

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RS 22:1371

SUBPART G. PET INSURANCE

§1371. Definitions

A. If a pet insurer uses any of the terms defined in this Section in a policy of pet insurance, the pet insurer shall use the definitions of those terms as provided in this Section and include the definitions in Subsection C of this Section in the policy. The pet insurer shall also make the definitions available through a link on the main page of the pet insurer's website or the pet insurer's program administrator's website.

B. Nothing in this Section prohibits or limits the types of exclusions pet insurers may use in their policies, nor requires pet insurers to utilize any of the limitations or exclusions defined in this Section.

C. For the purposes of this Subpart, the following definitions apply:

(1)"Chronic condition" means a condition that can be treated or managed, but not cured.

(2)"Congenital anomaly or disorder" means a condition that is present from birth, whether inherited or caused by the environment, which may cause or contribute to illness or disease.

(3)"Hereditary disorder" means an abnormality that is genetically transmitted from parent to offspring that may cause illness or disease.

(4)(a) "Orthopedic" means conditions affecting the bones, skeletal muscle, cartilage, tendons, ligaments, and joints.

(b)Orthopedic conditions include but are not limited to elbow dysplasia, hip dysplasia, intervertebral disc degeneration, patellar luxation, and ruptured cranial cruciate ligaments.

(c)Orthopedic conditions do not include cancers or metabolic, hemopoietic, or autoimmune diseases.

(5)"Pet insurance" means a property insurance policy that provides coverage for accidents and illnesses of pets.

(6)(a) "Preexisting condition" means any condition for which any of the following are true prior to the effective date of a pet insurance policy or during any waiting period:

(i)A veterinarian provided medical advice.

(ii)The pet received previous treatment.

(iii)Based on information from verifiable sources, the pet had signs or symptoms directly related to the condition for which a claim is being made.

(b)A condition for which coverage is afforded on a policy shall not be considered a preexisting condition on any renewal of the policy.

(7)"Renewal" means to issue and deliver at the end of an insurance policy period a policy which supersedes a policy previously issued and delivered by the same pet insurer or affiliated pet insurer and which provides types and limits of coverage substantially similar to those contained in the policy being superseded.

(8)"Veterinarian" means an individual who holds a valid license to practice veterinary medicine from the appropriate licensing entity in the jurisdiction in which the individual practices.

(9)"Veterinary expenses" means the costs associated with medical advice, diagnosis, care, or treatment provided by a veterinarian, including but not limited to the cost of drugs prescribed by a veterinarian.

(10)"Waiting period" means the period of time specified in a pet insurance policy that is required to transpire before some or all of the coverage in the policy can begin.

(11)(a) "Wellness program" means a subscription or reimbursement based program that is separate from an insurance policy and provides goods and services to promote the general health, safety, or well-being of a pet.

(b)If a wellness program constitutes a contract whereby one undertakes to indemnify another or pay a specified amount upon determinable contingencies, it is transacting in the business of insurance and is subject to the provisions of this Title.

(c)The definition provided in this Paragraph shall not be interpreted to classify a contract directly between a service provider and a pet owner that only involves the two parties as being the business of insurance, unless other indications of insurance also exist.

Acts 2023, No. 94, §1, eff. Jan. 1, 2024.