Veterinarians should be aware of an exclusion included in the policies of several pet insurers in the United States because it affects them specifically.
Some insurers won't reimburse a claim made by a veterinarian whose pet is insured if the veterinarian diagnoses and treats the pet himself or herself.
This first came to my attention a decade ago when a veterinarian posted what happened to her on a veterinary community message board (VIN - Veterinary Information Network). Her pet was insured by Pets Best which denied a claim when she had treated her own pet for an illness.
Needless to say, she was shocked as were other members of the veterinary community, some who had been recommending Pets Best to their own clients.
The reason given by Pets Best's underwriter was the potential for fraud/conflict of interest when the insured pet is treated by the owner of the pet (a veterinarian). To be honest, I don't fully understand all the reasons behind this restriction, and therefore, won't attempt to explain it.
The veterinary community corresponded with Pets Best expressing their shock and displeasure, and to Pets Best's credit, they reversed the policy.
However, in the past week or so, I have read a sample policy of about a dozen companies and half of them have a clause with this exclusion.
It will usually be found in the "Definitions" section of the policy. It will most likely read something like this:
"Veterinarian shall not include you or a member of your immediate family."
Or, it may be included in the "Exclusions" section of the policy and look something like this:
"Professional fees and services performed by Veterinary Provider for his/her own cat or dog."
It is my understanding that this is a holdover exclusion that is included in other types of insurance also.
The pet insurance company's response to objections to this exclusion is that veterinarians should just get another vet in their practice to treat their pets or take their pet to another veterinarian. Really?
Some veterinarians may prefer that other doctors examine, diagnose and treat their pets. However, other's prefer to treat their own pet unless the diagnosis and treatment requires the help of a specialist or emergency center.
Some veterinarians are solo practitioners and don't practice with a group of other doctors. They may or may not even have another veterinarian who practices in close proximity. What if there is an emergency in the middle of the night and nobody else is available to treat their pet?
Regardless, it seems to me to be an unnecessary inconvenience to have to deal with and risks alienating the veterinary community. If this were a real problem, why do half of the insurers in the United States not have this exclusion in their policies?
Every insurance policy lists fraud as a reason for possible claim denial or even cancellation of a policy. Why can't this be used on a case by case basis if needed when fraud is suspected concerning a veterinarian who treats his or her own pet.
IMHO, it is past due for this exclusion to be eliminated from pet insurance policies. Do the right thing. Follow Pets Best lead.
So, if you are a veterinarian who has an insured pet and was unaware of this exclusion, read your policy and/or call your insurer to determine if you are affected.
If you don't have insurance, but decide to insure your pet, and this exclusion matters to you - take precautions to purchase a policy from a company that doesn't have this exclusion.
Here is a video clip of a discussion with Jenna Mahan, the Claims Director at Embrace. She explains the reasoning behind this exclusion.
If you are a veterinarian, were you aware of this exclusion? How do you feel about it?