§ 7155.
474 words·~2 min read·
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§ 7155. Policy conditions
(a)A pet insurer may issue policies that exclude coverage on the basis of one or more preexisting conditions with appropriate disclosure to the consumer. The pet insurer has the burden of proving that the preexisting condition exclusion applies to the condition for which a claim is being made.
(b)A pet insurer may issue policies that impose waiting periods that do not exceed 30 days from the effective date of the policy for illnesses or orthopedic conditions not resulting from an accident. Waiting periods for accidents are prohibited. An insurer must issue coverage to be effective not later than 12:01 a.m. on the second calendar day after premium is paid.
(1)A pet insurer using a waiting period permitted under this subsection shall include a provision in its contract that allows the waiting period to be waived upon completion of a medical examination. Pet insurers may require the examination to be conducted by a licensed veterinarian after the purchase of the policy.
(A)A medical examination pursuant to this subdivision
(1)shall be paid for by the policyholder, unless the policy specifies that the pet insurer will pay for the examination.
(B)A pet insurer can specify elements to be included as part of the examination and require documentation thereof, provided the specifications do not unreasonably restrict a consumer’s ability to waive the waiting period under this subsection.
(2)Waiting periods, and the requirements applicable to them, shall be clearly and prominently disclosed to consumers prior to the policy purchase.
(3)If a policy does not include a waiting period, an insurer may set a policy effective date that is up to 15 calendar days after purchase, provided such policy effective date is clearly disclosed and no premium is earned before the policy becomes effective.
(c)A pet insurer must not require a veterinary examination of the covered pet for the insured to have their policy renewed.
(d)If a pet insurer includes any prescriptive, wellness, or noninsurance benefits in the policy form, then it is made part of the policy contract and shall follow all applicable insurance laws and rules.
(e)An insured’s eligibility to purchase a pet insurance policy shall not be based on participation, or lack of participation, in a separate wellness program.
(f)A condition for which coverage is afforded on a policy shall not be considered a preexisting condition on any renewal of the policy.
(g)A policyholder shall be allowed to modify coverage amounts without having the policy cancelled and renewed.
(h)Coverage for new or existing claims shall not be suspended due to nonpayment of premium. The policy is considered effective until renewal, cancellation, or nonrenewal.
(i)Unpaid premiums shall not be deducted from claim payments for a covered loss. (Added 2023, No. 110 (Adj. Sess.), § 28, eff. July 1, 2025.)