NOTE: §1373 eff. Jan. 1, 2024. See Acts 2023, No. 94.
§1373. Policy conditions
A. A pet insurer may issue policies that exclude coverage based on one or more preexisting conditions if appropriate disclosures are provided to the policyholder. The pet insurer has the burden of proving that a preexisting condition exclusion applies to the condition for which a claim is being made.
B.(1) A pet insurer may issue policies that impose waiting periods upon effectuation of the policy, not to exceed thirty days, for illnesses or orthopedic conditions not resulting from an accident. Waiting periods for accidents are prohibited.
(2) A pet insurer utilizing a waiting period in compliance with this Subsection shall include a provision in the policy that allows the waiting period to be waived upon completion of a medical examination. A pet insurer may require the examination to be conducted by a licensed veterinarian after the purchase of the policy.
(3) A medical examination performed pursuant to Paragraph (2) of this Subsection shall be paid for by the policyholder, unless the policy provides that the pet insurer will pay for the examination.
(4) A pet insurer may specify elements to be included as part of the examination and require documentation thereof if the specifications do not unreasonably restrict a policyholder's option to have the waiting periods waived as provided in Paragraph (2) of this Subsection.
(5) Waiting periods and the requirements applicable thereto shall be disclosed to consumers prior to the policy purchase.
(6) Waiting periods shall not be applied to renewals of existing coverage.
C. A pet insurer shall not require a veterinary examination of a covered pet for a policyholder to have a policy renewed.
D. If a pet insurer includes any prescriptive, wellness, or noninsurance benefits in the policy form, the provisions shall be made part of the policy contract and shall conform to all applicable provisions of this Title and department rules and regulations.
E. Eligibility to purchase a pet insurance policy shall not be based on participation, or lack of participation, in a separate wellness program.
Acts 2023, No. 94, §1, eff. Jan. 1, 2024.