Policy Wording
SECTION 1 – DEFINITIONS
When interpreting this
policy:
•
references to the singular include the plural and vice versa, and to the masculine include the feminine and vice versa
•
monetary references are to UK pounds sterling.
•
certain words and expressions used in this policy have a specific meaning.
The following words will have the meanings described below wherever they appear in this document.
Accident means a sudden, unforeseen, and unintended event causing Injury to Your Pet.
An Accident must be a direct
consequence of at least one of the following:
1.
motor vehicle or boating incident;
2.
burn or electrocution;
3.
fall from an elevated position;
4.
near drowning;
5.
the actions of another animal;
6.
swallowing a foreign object requiring surgical or
endoscopic removal;
7.
snake bite;
8.
allergic reaction to an insect bite, other than
tick and flea bites;
9.
Drug, Alcohol and/or Plant poisoning;
or otherwise result in:
10.
a fracture;
11.
a puncture;
12.
a broken bone;
13.
a traumatic ligament or tendon Injury;
14.
lacerations, abrasions or wounds.
Benefit Limits means the total
amounts payable under this policy per each section of coverage. The maximum Benefit Limit that We will pay for a
single Condition, a Recurring Condition or a Chronic Condition suffered by Your Pet
is the Benefit Limit that was current
in the Policy Period when the Condition first manifested, as stated in
Your Policy Schedule.
If You
transfer Your Pet to a plan with additional or higher Benefit Limits, the additional or higher Benefit Limits will not apply if the Condition being claimed first manifested itself during a previous Policy Period.
Annual Benefit Limits means the
maximum Benefit Limit We will pay for
all claims as detailed in Your Policy
Schedule
Bilateral Condition means any Condition affecting body parts of which Your Pet
has two, one each side of the body (e.g. ears, eyes, knees, cruciate
ligaments). When applying a Benefit Limit or exclusion, bilateral
conditions are considered as one Condition
Chronic Condition means a Condition which, once developed, is
deemed incurable or is likely to continue for the remainder of Your Pet’s
life
Clinical Signs means
changes in Your Pet’s normal healthy state, its bodily functions or behaviour
Complementary Medicine means physiotherapy, hydrotherapy, acupuncture, homeopathic or herbal
medicines administered by a suitably qualified practitioner following a
recommendation from a qualified vet. The
following practitioners are considered to be suitably qualified: Association of
Chartered Physiotherapists in Animal Therapy/ National Association of
Veterinary Physiotherapists, The International Association of Animal
Therapists, Canine Hydrotherapy Association International Veterinary
Acupuncture Society (IVAS) and the Association of British Veterinary
Acupuncturists (ABVA).
Commencement Date means the date
and time when cover first starts as noted in the Schedule
Condition means any Injury sustained during, or resulting
from, a single Accident or any
manifestation of an Illness having
the same diagnostic classification or resulting from the same disease process
regardless of the number of incidents or areas of Your Pet’s body affected
End Date means the date on which this policy ends, which
will be the earliest of the following:
•
the date Your Pet dies; or
•
the expiry of the current policy
period:
o
if You fail to renew this policy;
and/or
o
We choose not
to renew this policy for whatever reason;
or
•
the date You fail to pay the premium;
or
•
the date You cancel this policy; or
•
the date We cancel this policy for whatever reason
Excess means the amount shown in the Schedule that is deducted from Your
benefit for each Illness or
Accidental Injury Condition treated during each 12 month Period starting on the Commencement date
and that is not related to any other Illness
or Accidental Injury Condition treated during the same Policy Year
Injury means damage to
one or more parts of Your Pet’s body as a result of one accidental
cause
Illness means sickness, disease, infection or any change in
Your Pet’s normal healthy state which is not caused by Injury
Market value means the price
usually paid for a Pet of the same
age, breed, pedigree sex and breeding ability at the time a claim is made under
this insurance
Pet means a dog or
cat covered under this policy and named and described in the Schedule
Pre-existing Condition means:
•
any Condition,
symptom or sign of a Condition
occurring or existing in any form prior to the Commencement Date; or
•
any Illness,
symptom or sign of an Illness occurring
or existing in any form during the Waiting
Period
Policy Period means:
•
All our policies are monthly
policies – they run for and premiums are collected each calendar month and
automatically renews every calendar month.
Automatic renewal is subject to receipt of premium.
Policy Year means the first full 12 calendar
months with effect from Your Policy Commencement Date.
Recurring Condition means a Condition that is curable but may recur
Schedule means the document which contains important information
about You and this policy and forms
part of the policy document
Skin Condition means any
diagnosed Condition regardless of the
cause or origin presenting in or affecting the skin (as an organ) in any way
whatsoever
Treatment means any examination, consultation, advice, tests,
x-rays, medication, surgery or nursing care provided by a veterinary practice
or member of a professional organisation acting under their direction
Ultimate means Ultimate Pet Partners, who on behalf of Computer Quote is the administrator
for all sections of this policy and whose registered office is situated at 5th
Floor, The Connect Centre, Kingston Crescent, North End, Portsmouth, PO2 8DE
Company Registration number 06740793. Ultimate Pet
Partners Limited is an appointed representative of Correlation Risk Partners
Limited, which is authorised and regulated by the Financial Services Authority.
Veterinary Fees means reasonable, customary and essential fees typically
charged by a vet in the provision of Treatment
Waiting Period means a period
of 14 days starting from the Commencement
Date of the initial Policy Period
during which a Condition that occurs
or shows Clinical Signs will be
excluded from cover unless otherwise stated on the Schedule
We, Our, Us means Red Sands Insurance Company (Europe) Limited
whose registered office is situated at Suite 912c Europort, Gibraltar and is
registered in Gibraltar under company registration number 87598
You, Your means the person named as the policy owner on the Schedule
From this point on, all defined terms appear in
italics throughout this document
SECTION 2 – VETERINARY FEES
2.1 Cover
We will pay up to the Benefit
Limit shown in the Schedule for Treatment and/or for Complementary Medicine. The Benefit
Limit is applied separately to every unrelated Injury, Illness or Condition claimed for.
The maximum Benefit Limit that We
will pay for a single Condition, a
Recurring Condition or a Chronic Condition suffered by Your Pet
is the Benefit Limit that was current
in the Policy Period when the Condition first manifested. If You
stop making premium payments to us then cover for any ongoing conditions will
cease
If
total Veterinary Fees appear likely to exceed £1,000 You must notify Ultimate
immediately for pre-authorisation as We
may wish to obtain a second opinion from Our
veterinary advisor.
2.2 Level of Veterinary Fees allowed
We reserve the right to obtain a second opinion from Our veterinary advisor where We consider:
•
Veterinary Fees
charged appear greater than conventional fees charged by an attending/referral
practice; and/or
•
Treatment
received may not have been required or may have been excessive when compared
with Treatment conventionally
undertaken by an attending/referral practice
Where there is a dispute We will pay only those Veterinary
Fees deemed reasonable and essential by Our
veterinary advisor.
2.3 Special Diet
We will contribute to the cost of Your
Pet’s prescription food up to a
maximum of £100 per Policy Year (Benefit Limit) as long as it is
prescribed by Your Vet and can only
be brought from a veterinary surgery or online pharmacy and it is to dissolve
bladder stones or crystals in urine and for no other purpose. We will deduct 53p a tin and £1.00 per
kilo as Your normal feeding costs for
Your Pet. We will not be liable for any other dietary costs under this policy
2.4 Advice Line
We are delighted to include an Advice Line service, provided by Vetfone,
for those times when taking Your Pet to
your normal Vet is not possible or
practical - You may contact Vetfone’s
veterinary nurses at any time, who will give You advice about Your Pet’s health
and welfare. This service is available 24 hours a day, 365 days a year and is a
free service.
Vetfone’s telephone number
is 0844 445 7453
2.5 Exclusions
The following are excluded
from cover:
2.5.1 Costs
resulting from an Injury or Illness that:
2.5.1.1 first showed Clinical Signs before the Commencement Date or within the Waiting
Period of the Commencement Date;
2.5.1.2 is the same as or has the same diagnosis or Clinical Signs as
an Injury, Illness or Clinical signs Your
Pet had before the Commencement Date;
2.5.1.3 is caused by, relates to or results from an Injury, Illness or Clinical Signs Your
Pet had before Commencement Date.
2.5.2 Costs
resulting from or related to any excluded Condition
as shown in the Schedule.
2.5.3 Conditions
resulting from an Illness where only Accident cover has been selected by You.
2.5.4 Costs
for cosmetic Treatment, elective Treatment,
routine Treatment or preventative Treatment recommended by a Vet to
prevent an Injury or Illness. This is not limited to but
includes vaccination, spaying, castration, Cryptorchidism (retained testes), grooming, nail clipping,
breeding, whelping, kittening, bathing, dematting, killing and controlling
fleas and worms, spaying to prevent the re-occurrence of false pregnancy and
any claims as a result of these procedures unless specifically noted on the Schedule;
2.5.5 Any
dental or gum Treatment unless
required as a direct result of an Accident
or Injury to Your Pet where We shall cover the costs of extraction
only.
2.5.6 Treatment received by Your Pet
after the End Date.
2.5.7 The
cost of any Treatment if a claim has
not been submitted within 90 days of the first date Your Pet received Treatment.
2.5.8 The
cost of any Treatment for behavioural
problems or for any conditions arising as a result of the same
2.5.9 Any
costs for house calls/out-of-hours calls/non essential hospitalisation and
ambulance costs (where covered) unless a Vet confirms that Your Pet was suffering from a life-endangering Condition. Your personal
circumstances will not be covered.
2.5.10 Costs
of putting Your Pet to sleep, cremation and disposal, including post mortem costs,
coffins or caskets.
2.5.11 Costs
which are not supported by an original receipt or invoice itemising the Treatment costs incurred.
2.5.12 Costs
for Treatment of conditions arising
from Your Pet being overweight, except weight gain as a result of a diagnosed
Illness.
2.5.13 The
cost of any diet food, even if prescribed, other than those detailed at 2.3.
2
2.4
2.5.14 Any
costs associated with routine or investigative laboratory tests or procedures
unless the clinical signs /symptoms
exist and the tests and procedures are to diagnose a specific Condition
2.5.15 Extra
fees on external laboratory fees. We
will only pay the external fee plus up to £20 for post and packaging and
interpretation
2.5.16 Any
charges made by Your vet for a
prescription charge for obtaining medication elsewhere.
2.5.17 Continuation
claims unless You have paid the
required premiums to keep Your policy
in force.
2.5.18 The
Excess applicable to this section of
cover.
SECTION
3 - DEATH OF DOG OR CAT FROM ACCIDENT OR ILLNESS
3.1 Cover
We will pay the market value, the price paid or the
amount shown in the Schedule
(whichever is less) if Your Pet dies during the Policy Period or is put down for humane reasons because of Injury or Illness that happened or started during the Policy Period. The death
must occur during the same Policy Year
as the Accident or Illness.
You must advise Ultimate as soon as possible in writing
of the Accident or Illness, but not later than 30 days
after Your Pet is put down.
3.2 Exclusions
The following are excluded
from cover:
3.2.1 Euthanasia
due to any act of any legal or legislative authority for any reason whatsoever,
including any order made in respect of a 'notifiable' disease.
3.2.2 Euthanasia
due to behavioural problems or for fiscal reasons.
3.2.3 Death
during or after a surgical operation or a general anaesthetic unless a
qualified Vet certifies that it was necessary because of Injury or Illness
3.2.4 Death
due to Illness of any dog or cat aged
8 years or over at the Commencement Date
or any renewal period.
3.2.5 Any
death resulting from breeding, pregnancy or giving birth.
3.2.6 Any
claim if the death has been a result of preventative, routine or elective Treatment / procedure. See Vets fees
3.2.7 Any
death caused by an Illness/Clinical Signs first noticed before or
within the first 14 days of the policy.
3.3 Specific Conditions Applicable
to Sections 2 and 3
3.3.1 If
Your Pet dies, You must
arrange and pay for a qualified Vet to certify the cause of death and, at Your own expense, to conduct a
post-mortem examination if We require
one.
SECTION
4 – EMERGENCY BOARDING KENNEL/CATTERY FEES
4.1 Cover
We will pay, up to the Benefit Limit as noted in the Schedule,
for the cost of boarding Your Pet for the duration that You are registered as an in-patient of a
hospital provided You suffer:
4.1.1 any
bodily Injury, sickness or disease
and You are in hospital for longer
than 4 days during a Policy Period; and
4.1.2 there
is no other responsible person who can care for Your Pet. You
must board Your Pet at a licensed kennel or cattery or place it in the care of a
professional home carer.
4.2 Exclusions
The following are excluded
from cover:
4.2.1 Any
claims by You for:
4.2.1.1 any hospitalisation that could reasonably have been expected
or foreseen when you took out or renewed this policy and any potentially
recurring medical Condition You or Your partner already have.
4.2.2 Any
claim by you for:-
4.2.2.1 costs as a result of any hospital stay that was not on the
advice of a doctor, specialist or consultant;
4.2.2.2 costs
as a result of nursing-home care or convalescence care that You do not receive in hospital.
4.2.2.3 costs as a result of you being hospitalised for alcoholism,
drug abuse, attempted suicide or self inflicted injuries
4.2.2.4 Any
amount if the boarding kennels/cattery/ Pet
minding business are not licensed.
4.2.3 Any
claim if:
4.2.3.1 We do not receive
original receipts from the boarding kennel or cattery identifying the name of Your Pet,
the owner's name and address, the date Your
Pet was cared for by the kennel or
cattery and the amounts charged for each day;
4.2.3.2 We do not receive a
medical certificate from the hospital You
attended showing Your name and
address.
SECTION
5 - HOLIDAY CANCELLATION COVER
5.1 Cover
We will pay up to a maximum amount of the Benefit Limit specified in the Schedule for reasonable travel and
accommodation expenses incurred by You
if You have to cancel or cut short Your holiday because Your Pet
needs immediate life saving surgery while You
are away or up to 14 days before You
leave. You must, at Your own expense, provide Us with receipts showing the dates and
costs You had to pay because of
cancelling or cutting short Your
holiday from the travel company, tour operator or other similar party.
5.2 Exclusions
The following are excluded
from cover:
5.2.1 any
holiday costs where the holiday was booked less than 28 days before You leave;
5.2.2 the
amount you can claim back from anywhere else.
5.2.3 any
extra costs incurred because you delayed
letting the company providing Your transport and accommodation
know you had to cancel
5.2.4 any
costs for anyone else that is on holiday with you
5.2.5 surgery
for non life-saving operations
SECTION
6 - LOSS BY THEFT OR STRAYING
6.1 Cover
We will pay, up to the Benefit Limit as noted in the Schedule,
the market value or the purchase price paid by You, whichever is lesser, if Your
Pet is not found within 28 days of
straying or being stolen. Your Pet
must have disappeared from Your
address or any other place as may be noted in the proposal form or in any endorsement. You
must report the loss of Your Pet to at least one rescue centre in the
case of a cat and in the case of a dog, a dog warden.
We will pay an additional amount up to a maximum amount
of £500, to cover the cost of advertising for Your lost or stolen Pet
or paying a reward which leads to getting Your
Pet back, provided that You first obtain Ultimate’s written agreement.
6.2 Exclusions
6.2.1 Any
claim where You or the person looking
after Your Pet has voluntarily parted with it or in circumstances where the Pet’s loss would not be deemed “theft”
in law.
6.2.2 Any
reward to a member of Your family, to
any person known to you, or to the person who was caring for Your Pet
at the time of the incident.
SECTION
7 - ACCIDENTAL DAMAGE
7.1 Cover
We will pay up to the Benefit
Limit for any costs incurred following accidental damage to personal
property that is not owned by You, a
member of Your immediate family, a
relative, employee, guest or other person who is responsible for or in control
of Your Pet, such damage being caused directly by Your Pet. You
are covered while Your Pet is visiting someone else's property,
whether or not You are legally liable
for the damage. You must give Us
independent proof of value at Your
cost. The damaged item must not be
disposed of without Our written
consent.
7.2 Exclusions
The following are excluded
from cover:
7.2.1 damage
to any motor vehicle or its contents;
7.2.2 damage
caused by Your Pet vomiting, defecating (fouling) or urinating; and
7.2.3 damage
while Your Pet is left unattended.
SECTION
8 - PUBLIC LIABILITY
8.1 Cover
Where property is damaged or someone is killed, injured
or becomes ill as a result of an incident involving Your Pet and you are
legally responsible We shall pay up
to the Benefit Limit in respect of:
8.1.1 Compensation
and the Claimant’s costs and expenses;
8.1.2 The
legal cost and expenses of defending a claim made against You under this Section
We shall also cover You
up to the Benefit Limit in respect of
legal costs You incur defending
criminal proceedings under the Dogs Act
1871, Dogs (Protection of Livestock) Act 1953, Dangerous Dogs Act 1991 or
Dangerous Dogs (Northern Ireland) Order 1991.
8.2 Specific Conditions
8.2.1 You must not admit responsibility, agree
to pay any claim or negotiate with any other persons following an incident.
8.2.2 You must provide us with any information
relating to the claim We reasonably
ask for including detail of Your Pet’s history, including medical,
behavioural and history of ownership.
8.2.3 You agree for us to take charge of Your claim and allow us to prosecute,
defend or settle the same on terms We
are advised are reasonable in Your
name for Our benefit.
8.2.4 You agree to help us ascertain all the
circumstances of an incident leading to a claim, provide written statements and
go to court if We require it.
8.2.5 You must immediately send us any writ,
summons or legal documents of whatever nature relating to a claim made against You and You must never send any replies to such documents.
8.3 Exclusions
This policy shall not apply to liability in respect of:
8.3.1 any
compensation, costs or expenses:-
8.3.1.1 for
defending You which We have not agreed to in writing
beforehand
8.3.1.2 if You are legally liable because of a
contract You have entered into
8.3.1.3 if the Claimant is a person who lives with You, is a member of Your immediate family or is employed by You
8.3.1.4 which
involves Your employment, profession,
occupation or business
8.3.1.5 if You, a member of
Your immediate family or any person
who lives with You or is employed by You is responsible for or is looking
after the property damaged
8.3.1.6 where You have not
followed advice given to You by
previous owners of Your Pet or by any rehoming organisation
about Your Pet’s behavioural traits
8.3.1.7 for an incident at Your
workplace
8.3.2 any
claims:-
8.3..2.1 if You are
responsible for air, water or soil pollution unless You can prove the same took place as a direct consequence of an Accident involving Your Pet;
8.3.2.2 arising as a result of any deliberate act on Your part or for any other act or
omission which could reasonably have been foreseen as causing the loss, damage
or Injury complained of;
8.3.2.3 as
a result of Your Pet's interaction with other animals;
8.3.2.4 as
a result of any person handling Your Pet without Your permission or consent;
8.3.3 any
fines, compensation and prosecution costs following Your prosecution under the provisions of the Dogs Act 1871, Dogs
(Protection of Livestock) Act 1953, Dangerous Dogs Act 1991 or Dangerous Dogs
(Northern Ireland) Order 1991.
8.3.4 the
matters referred to in the General Exclusions, Section 16.
SECTION
9 - PERSONAL ACCIDENT
9.1 Cover
We will pay up to the Benefit Limit to cover income lost if You are bitten by Your Pet while You are caring for it and You
miss work as a result of the Injury.
9.2 Exclusions
9.2.1 Any
losses incurred without a doctor's report (to be prepared by your doctor at
your cost) to confirm the incapacity suffered and the reasons you have been
unable to work.
9.2.2 Any
losses incurred without a report from Your
employer stating the period you were off work and confirming the sums by way of
income you did not receive from any source as a result.
9.2.3 Any
sums you may recover from any other source including Statutory Sick Pay
9.2.4 Losses
caused by any Pet that is known to
have vicious tendencies
SECTION 10-
OVERSEAS TRAVEL EXTENSION
10.1 Emergency
Veterinary Treatment Abroad
10.1.1 Cover
If Your Pet needs emergency veterinary Treatment as a result of an Injury or Illness that first shows Clinical Signs during a holiday in the Policy Period, We will pay up to £2,000 (less the Excess) towards the reasonable costs of emergency veterinary Treatment. This cover applies to a maximum trip duration
of no more than 30 days and for up to 3 trips per Policy Year.
10.2 Exclusions
10.2.1 More
than £2,000 for emergency veterinary fees.
10.2.2 Any
costs resulting from a holiday that started before the Commencement Date.
10.2.3 Any costs resulting
from:
10.2.3.1 an
Injury or Illness that first showed Clinical
Signs before Your holiday
started; or
10.2.3.2 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 Your holiday started; or
10.2.3.3 an
Injury or Illness that is caused by, relates to or results from an Injury, Illness or Clinical Sign Your Pet
had before Your holiday started no
matter where the Injury, Illness or Clinical Signs are noticed or happen in or on Your Pet’s body
except that We
shall continue to provide cover under this policy where Your Pet is already
receiving Treatment for an ongoing Condition under an existing policy with Us.
10.2.4 The cost of food.
10.2.5 Any costs if the
holiday was made to get Treatment
abroad.
10.2.6 Any costs to take Your
Pet’s body home if it dies.
10.2.7 Costs of putting Your Pet
to sleep, cremation and disposal, including post mortem costs, coffins or
caskets.
10.2.7 We will not pay for a claim that is caused
by, connected to or resulting from:
10.2.7.1 You not complying with any part of Your Pet
Travel Scheme whether imposed by the UK government, a transport company or
other countries involved in Your Pet Travel Scheme.
10.2.7.2 Any
confiscation, detention, requisition, damage, destruction or any prohibitive
regulations by customs or any government officials or authorities of any
country unless specifically covered by this policy.
10.2.7.3 Travel
outside European Union countries included in Your Pet Travel Scheme.
10.2.7.4 You having to comply with any part of Your Pet
Travel Scheme unless specifically covered by this policy.
10.2.7.5 Currency exchange rate differences.
10.3 Notification of Claim Cost
If total Veterinary Fees appear likely to exceed £1,000
(at the exchange rate prevailing at time of Treatment)
You must notify Ultimate immediately for pre-authorisation as We may wish to obtain a second opinion from Our veterinary advisor.
SECTION
11 - GENERAL CONDITIONS
11.1 General Conditions
11.1.1 If
You pay the premiums by direct debit
and You default on any payment, We reserve the right to charge an
administration fee of £2.99 to Your
next payment.
11.1.2 If
any loss, damage or liability is insured by any other policy (or would be
insured if this policy did not exist) We
will not be liable for the whole claim. We will only pay anything over the
amount which should have been paid under this policy (or policies) if this
policy had not been taken out.
11.1.3 A
dog on a public highway must be on a collar and lead under control. Reasonable
steps must be taken to ensure a dog does not escape or stray and any area in
which a dog is kept must be secure and appropriately fenced or otherwise
secured.
11.1.4 You must notify Ultimate as soon as possible of any change in circumstances
relevant to this policy, including change of address. Failure to do so may invalidate this
policy. We reserve the right to alter the terms of this policy immediately
after We are notified of such
changes.
11.1.5 During
the Policy Period You must take care of Your Pet
including arranging and paying for any Treatment
normally recommended by Your vet to
prevent or reduce the risk of Illness
or Injury.
11.1.6 You must ensure that Your Pet
is vaccinated against distemper, hepatitis, leptospirosis, parvovirus for dogs,
kennel cough when entering a boarding kennel or show, and feline infections
such as enteritis, feline leukaemia and cat flu for cats. You
must also agree to have Your Pet vaccinated against any other disease
a vet feels is necessary.
11.1.7 You must ensure that Your Pet
is wormed regularly and if there is a risk of contagion, to keep Your Pet
isolated from the same.
11.1.8 We reserve the right to cancel or avoid
this policy and to retain the premium where We
believe you have mis-stated, omitted or concealed a fact We consider material to the risk either when taking out a policy
for the first time or renewing it.
11.1.9 If
a dispute arises then if the dispute relates to any sum to be paid under this
policy then it shall be referred to a single arbitrator appointed in default of
agreement by the Chairman of the Association of British Insurers under the
provisions of the Arbitration Act 1979 as amended. The decision of the
arbitrator shall be final and binding. Where a dispute arises due to a
difference of opinion between vets then We
shall appoint an independent vet whose decision shall be binding. The costs of
the independent Vet will be shared equally by You and Us.
11.1.10 When
inviting renewal of this policy We
may, at Our sole discretion, for any
reason and as We deem appropriate
taking into consideration (but not limited to) Your Pet’s age, medical
and/or claims history, change cover, benefits, premium, terms and/or
conditions.
SECTION 12 - HOW TO CLAIM
12.1 In
the event of an Accident, Illness, loss, destruction or damage
giving rise or likely to give rise to a claim under this policy, You must either:
12.1.1 download
a claim form from www.computerquotepetinsurance.com or submit your claim on
line
12.1.2 contact
Computer Quote Pet Insurance by email on
claims@computerquotepetinsurance.com
12.1.3 contact
Computer Quote Pet Insurance by telephone on 0844 561 1625
and request Ultimate to send You a claim form. Full instructions of how to complete the
claim form will be provided. You must co-operate fully and truthfully
to give Ultimate any information Ultimate may need.
SECTION
13 - CONDITIONS OF SETTLING CLAIMS
13.1 If
requested by Ultimate, the Vet
attending Your Pet or the usual or previous Vet must, at Your expense, provide Ultimate
with all information about Your Pet, including its full medical history
or its Treatment as Ultimate may require.
13.2 Advice Line
Remember You can also use the Advice Line service
provided by Vetfone, for those times when taking Your Pet to Your normal
Vet is not possible or practical - You may contact Vetfone’s veterinary
nurses at any time, who will give You
advice about Your Pet’s health and
welfare. This service is available 24 hours a day, 365 days a year and is a
free service.
Vetfone’s number
is 0844 445 7453
13.3 You and Your vet will have to complete all applicable sections on one of
our Claim Forms and submit the same to Ultimate
before a claim can be assessed by Ultimate.
An incomplete Claim Form will be returned and this will delay settlement of
claims. We will not pay any fee
charged by Your vet for completing
the Claim Form and We reserve the
right to refuse a claim where a fully completed Claim Form has not been
returned to us without undue delay and in any event within 90 days of the
incident occurring or Your renewal if
sooner.
13.4 As
to Sections 3 & 6 it is Your
responsibility to prove the value of Your
Pet although We reserve the right to set the relevant Market Value. In any event Market Value will be limited to
a maximum of 75% of the sum insured value for neutered Pets and up to 50% of
the sum insured value for Pets aged 6 years or more. Where a claim is made for
a pedigree Pet You must send Us, at Your cost, the originals of a recognised
Breed Club registration document, Pedigree Certificate and purchase receipt.
SECTION
14 - GENERAL EXCLUSIONS
14.1 Any Pre-existing Conditions.
14.2 Any
claims for Illness and/or disease
and/or Accident displaying Clinical
Signs within 14 days of Commencement Date.
14.3 Any claims arising from Your Pet
being neutered or spayed.
14.4 Any
claim arising as a result of any sexually transmitted disease, rabies,
Aujesky's disease, leishmaniasis, epidemic outbreaks or any 'notifiable' disease.
14.5 We will not pay a claim that is in any
way untrue or fraudulent, or arises from a malicious, wilful or criminal act on
the part of any person
14.6 Any
claims arising as a result of Act of Parliament, by law or central or local
government regulation.
14.7 We will only pay costs which are
incurred as a direct consequence of the event which led to the claim You are making under this Policy.
14.8 Any claims arising as a result of Your Pet
undergoing organ transplants.
14.9 Any
loss as a result of an act of force or violence for religious, ideological or
political reasons, war, riot, civil commotion, revolution or similar event
including any act of terrorism of any kind.
14.10 Any
loss arising as a result of a disease transmitted from animals or birds to
humans
14.11 We
shall not be liable where We have not
received the correct premium before the start of each Policy Period.
14.12 We shall not be liable under this policy
unless You have complied with all the
terms, conditions and endorsements of this policy.
14.13 We shall not pay any claims where Your Pet
has been used in any trade, profession or business, unless We have agreed in writing to cover such use. Show dogs are covered.
14.14 We shall not be liable for any claims of
any kind which are caused by Your Pet straying, escaping, damaging
property, or attacking persons or pets if Your
Pet has done this before.
14.15 Excluded Dogs
14.1.1 Any
dogs used for trade or business.
14.1.2 The
following dogs, as outlined in the Dangerous Dogs Act 1991, are specifically
excluded from cover under any section of this policy:
•
Pit Bull Terrier
•
Japanese Tosa / Tosa Inus
•
Dogo Argentino (also referred to as Argentine Dogo
and Argentinian Mastiff)
•
Fila Brasileiro
Including any “type”, as defined in the Dangerous Dogs Act 1991,
considered to match the description of a prohibited “type”; any breed crossed
with the above; and any other breed or type deemed be dangerous by the
Secretary of State and subsequently added to the Dangerous Dogs Act 1991.
14.1.3 In
addition, the following types/breeds are also excluded from cover under any
section of this policy:
American
Bandogge/Bandogge Mastiff
American/Irish
Staffordshire Bull Terriers
Canary Dogs/Perro De Pressa Canarios/Presa Canarios
Cane Corsos
Czechoslovakian Wolfdogs/Sarlooswolfhounds/ Wolf Hybrids
Korean Jindo
Northern Inuit Dogs
Racing Greyhounds
Shar Peis
Utonagan
SECTION
15 - CANCELLATION RIGHTS
15.1 If,
once You receive Your full policy documents, You
are not happy You have 14 days within
which you can cancel the policy. If you wish to cancel Your policy this must be done in writing by email or post to Ultimate’s offices – details below. Upon
receipt of Your written cancellation We shall cancel Your policy and provided no claims have been made you shall receive
a refund of any premium you have paid.
15.2 If
You wish to cancel after 14 days We may give You a refund of Your
premium for any period of cover falling after the cancellation date less any
reasonable administration expenses. This must be done in writing by email or
post to Ultimate’s offices – details
below. If You have not received an acknowledgement from Ultimate within 14 days, You
must post the details by recorded delivery.
15.3 If
We have paid a claim You may not receive the full return of Your premium.
15.4 We reserve the right to cancel Your policy at any time. If We do then We shall retain such premium as covers the time the policy has been
in force and return any balance to You
in Excess of £5. We then have no further liability to You but Your rights up
until the cancellation date remain unaffected.
15.5 Should
You wish to alter this policy or
cancel it please contact Ultimate’s
office. This can be done by writing to
the postal address or email address noted below, or by phone on.
If You have not received an
acknowledgement from Ultimate within
14 days, You must post the details by
recorded delivery. A reasonable administration charge will be made for any
policy alteration.
Ultimate’s postal address is: 5th Floor, The
Connect Centre, Kingston Crescent, North End, Portsmouth, PO2 8DE
SECTION
16 - Advice Line
16.1 We are delighted to include an Advice Line service, provided by Vetfone,
for those times when taking Your Pet to
your normal Vet is not possible or
practical - You may contact Vetfone’s
veterinary nurses at any time, who will give You advice about Your Pet’s health
and welfare. This service is available 24 hours a day, 365 days a year and is a
free service.
Vetfone’s Pet
Advice Line is available on 0844 445 7453
SECTION
17- COMPLAINT HANDLING PROCEDURE
If
You have a complaint please follow
this procedure.
17.1 If You are unhappy with the level of customer service You have received please write to the
Customer Services Manager at Ultimate Pet Partners at the above address.
17.2 If you remain dissatisfied please
request that Your complaint be passed
to the Managing Director at Ultimate.
17.3 If You remain dissatisfied please write to the Customer Services
Manager at Red Sands Insurance Company (Europe) Limited Suite 912C, Europort,
Gibraltar
17.4 If
You do not receive satisfaction
through Our internal procedures, then
You can refer Your complaint to the Financial Ombudsman Service (FOS). Their address is: South Quay Plaza, 183 Marsh
Wall, London, E14 9SR or they can be contacted on 0845 080 1800.
17.5 Financial Services Compensation
Scheme
We are covered by the
Financial Services Compensation Scheme. You
may be entitled to compensation from the Scheme if We are unable to meet Our obligations to You under
this policy. If You are entitled
to compensation from the Scheme, the level and extent of compensation would
depend on the nature of this policy.
Further information about the Scheme is available from the Financial
Services Compensation Scheme, 7th Floor Lloyd's Chambers, Portsoken
Street, London E1 8BN and on their website at www.fscs.org.uk
17.6 Your legal rights are unaffected.
SECTION 18 – OTHER
INFORMATION
How We
protect Your Privacy
Ultimate is registered under the Data Protection Act,
number: Z5428709
Purpose of Collection
Ultimate collect, store and use Your personal information in order to consider Your application for insurance and to administer insurance services
to You, including claims
investigation and management. Ultimate may also use this information
for secondary purposes related to the purposes listed above, such as offering You additional insurance or
insurance-related products or services that We
believe You might be interested in
considering. This will always be done as
permitted by the relevant privacy legislation.
Disclosure
In conducting business Ultimate may communicate Your
personal information to organisations to whom We may outsource certain functions or to associated companies. Any such communication is performed with
strict adherence to Our privacy
policy.
Language
All communication between You and Us will be
conducted in English
Opt Out
If You
don't want to receive information on any of Our
new products or services You can tell
Ultimate on Your proposal form or by e-mailing service@computerquotepetinsurance.com
Updating Your
Records
If You
think Ultimate’s records are wrong or
out of date, particularly Your
contact details, it is important that You
contact Ultimate and they will correct them.
Material Information
We rely upon the information You provide Us to decide
whether to insure Your Pet and the terms and conditions under
which We will offer cover. English Law requires You to tell Us about all
known factors relating to the health and behaviour of Your Pet that may
influence Our decision. This is known as Duty of Disclosure, if You fail in Your Duty of Disclosure We
may exercise certain remedies that include cancelling this policy or reducing
the benefits due in terms of the policy.
If You are in any doubt as to
whether a fact is or may be material to Us,
You must tell Us about it.
Monthly Policies
A Monthly Policy
runs for and premiums are collected each calendar month. A monthly policy will automatically renew
each month until such time as You
advise Ultimate you wish to cancel Your policy. We
reserve Our rights to change the
terms and conditions of the policy upon renewal. We
require You to notify Ultimate in writing should You decide not to renew Your policy.
During the Policy Period for Monthly Policies We may offer You upgraded benefits, alter the cover or increase premiums. You
will get at least 14 days notice of any alterations in cover or increase in
premium. All premiums include Government
Insurance Premium Tax at 5%.
About the Insurer
Red Sands Insurance Company
(Europe) Limited (“Red Sands”) is
licensed and regulated by the Gibraltar Financial Services Commission under the Insurance Companies Act 1987 of Gibraltar and is a member of the UK’s Financial
Services Compensation Scheme. Red Sands
Insurance Company (Europe) Limited is registered in Gibraltar under company
number 87598 and their registered office is situated at Suite 912C, Europort,
Gibraltar. As the underwriter RSL is responsible for this policy document.
About the Administrator
Ultimate Pet Partner are authorised and regulated
by the Financial Services Authority (FSA No 311368). . If You
have any questions please call our friendly customer service team on 0845 604
2308, Monday to Friday 9:00am to 6.30pm; or visit our website www.computerquotepetinsurance.com ; or email Us at service@computerquotepetinsurance.com . Ultimate provides administration, customer services and claims
services on Red Sand’s behalf.
Governing Law and Courts
Both parties are
entitled to choose the law applicable to this contract of insurance. We
propose English law and in the absence of any agreement to the contrary,
English law will apply. Any disputes
shall be referred to the exclusive jurisdiction of the English Courts.