Maximum benefit pet insurance explained

The last thing any pet owner needs is to find their pet in need of veterinary treatment. Around 1 in 3 cats and dogs will require vet treatment each year and with the average cost of medical treatment rising each year. Insurance could prove to be a good choice to protect against unexpected bills. There are plenty of pet insurance options, maximum benefit cover offers cover for each condition up to a limit so it can help to protect pets who haven’t developed chronic conditions. Find out more in our guide to maximum benefit pet insurance.

Contents of this guide

• What is maximum benefit pet insurance?
• What does it cover?
• Advantages of maximum benefit pet insurance?
• Disadvantages of maximum benefit pet insurance?
• How much does maximum benefit pet insurance cost?
• How can I influence the price of maximum benefit cover
• Common exclusions to maximum benefit pet insurance
• Alternatives to maximum benefit pet insurance
• Maximum benefit pet insurance FAQs

What is maximum benefit pet insurance?

Maximum benefit pet insurance – sometimes known as per condition cover – covers your pet for accidents and illnesses up to a given limit. Unlike time-limited cover there’s no time limit on how long you can make claims for. This allows you to continue claiming for the same condition year after year as long as you choose to renew the policy each year.

Whilst maximum benefit policies allow you to claim for conditions without the time limit, they aren’t the most comprehensive policies you can get. If your pet has pre-existing conditions – those that existed before you take out the policy – then these won’t be covered. Also bilateral conditions tend to be excluded from cover as well. So for example if a claim is made for elbow dysplasia in the left elbow, then the same elbow dysplasia occurs in the right elbow then this usually won’t be covered.

Maximum benefit policies tend to be more popular policy types for younger pets where chronic, long term conditions are less likely.

All maximum benefit products in the market currently (as of the 7/11/2021) work in the same way. Where there are per condition limits but no annual limit to claims, so you can make an unlimited number of claims in the policy year, but each claim will have a limit. These per condition limits range from £1,000 – with EveryPaw – up to £7,500 with The Insurance Emporium.

What is covered by a maximum benefit policy?

Vet fees

Maximum benefit pet insurance allows you to claim the cost of veterinary treatments needed by your pet during the plan year. It aims to cover new conditions or accidents your pet has up to the per condition limits set by the policy wording.

Once you use up the limit on the condition the cover stops and the condition is classed as pre-existing, meaning you can no longer claim for it. Any further treatment for the condition will need to be funded by you.

Generally speaking most policies will offer cover for: 

• Accidental injury
• Conditions that aren’t pre-existing
• Behavioural treatment
• Physiotherapy
• MRI and CT scans

Inner limits

Whilst the general per condition limits apply for most conditions, it is worth knowing that some providers impose stricter limits on specific conditions. So if your pet needs treatment for one of those conditions you may find that the claim limit is much smaller.

Typically this can be the case with cruciate ligament treatment, but there may be others.

Other areas of the policy will have similar limits. Claims under the following policy sections might also have other lower limits: 

• Dental cover
• Complementary treatments
• Diet food prescriptions
• Cruciate ligament treatment

Death of pet 

If your pet passes away then there are elements of cover to cater for this eventuality. The coverage tends to be split into 3 categories:

• If the pet is euthanised
• If the pet dies from an illness
• If the pet dies from an accident or injury

Depending upon the age of your pet you might find that certain elements no longer apply in the event of your pets death. Senior pets may not receive cover for death in the case of illness. Older cats tend to be 10 years old or over, whilst older dogs are generally classed as 8 and older.

Lost and found cover

If you pet goes missing, strays or is stolen this section of the cover offers support in advertising costs and rewards to recover your furry friend.

To be able to claim under this section of the policy you’ll need to ensure that you have reported your pet’s disappearance to the police and inform your insurer as soon as possible. After 30 days of them being missing the insurer will consider claims.

As with the death of pet benefits, this part of the policy changes depending upon the age of your pet. Percentage contributions decrease the older your pet is.

Find out more about lost and found pet cover.

Third party liability 

Third party liability applies only to dogs and provide cover in the event that they cause damage someone else’s property or causes someone to be injured or even killed.

If this occurs and a court case ensues from there, costs can escalate into hundreds of thousands of pounds. Most policies offer cover into the millions of pounds so there tends to be enough protection there in the very rare event that this occurs.

Advantages of maximum benefit pet insurance

• Provides you with a fixed cover amount for each accident, injury and illness.
• There’s no time limit on the condition, so whether it lasts for days or years you can continue to claim until the condition limit is reached.
• Can cover the costs of regular medication such as steriods.
• When the cap for one condition is reached, you can continue to claim up the same limit for other conditions.

Disadvantages of maximum benefit pet insurance

• If your pet needs expensive treatment like an operation then you can max out the per condition limit quite quickly.
• Pre-existing conditions will not be covered
• Bilateral conditions will not usually be covered.
• Once you reach the limit cover for that condition stops and is then classed as pre-existing.
• Once the limit is reached, if your pet needs further treatment then you will need to pay for this yourself
• The per condition limit is not reset each year – like it is with Lifetime cover. So if you use 50% in year 1, then you only have 50% left of the allocation in future years.

How much does maximum benefit pet insurance cost?

Maximum benefit cover tends to be the second most comprehensive cover you can find, and the price reflects this.

Our most recent price check shows the following costs of maximum benefit cover for the following pets.

Pet Details	Monthly Price
Cat: 3 year old female Moggie	£5.33/month
Cat: 3 year old female Persian	£10.68/month
Dog: 3 year old medium size female Mixed Breed	£14.96/month
Dog: 3 year old female German Shepherd	£26.13/month

*based on a maximum benefit policy with a minimum of £4,000 with a pet living in Loughton, Essex  

What affects the cost?

Maximum benefit pet insurance is the second most comprehensive cover you can get for your pet and due to this tend to be slightly cheaper than lifetime pet insurance but more expensive that time limited plans.  

It is not always easy to find the right balance between cover and cost, so it can be helpful to understand the different factors that go into determining the price of maximum benefit cover.

• Pet type – whether you’re looking to insure a dog, cat, rabbit, horse or exotic animal the range of pricing will be different. Rabbits and cats tend to be cheaper to insure than dogs and horses. 
• Pet age – the age of your pet will be a big factor. The older your pet the more expensive cover will be. This is due to older pets being more likely we are to get ill and require treatment. It is generally recommended that insurance is taken out when your pet is young as the premiums will be much cheaper and cover will be easier to find. Learn more about senior cat insurance and senior dog insurance.
• Pedigree or non-pedigree – different breeds are naturally more prone to illness than others. For example, pedigree breeds by their nature will be more risky than crossbreed pets because the likelihood of congenital and hereditary conditions. Find out how insurance works for pedigree cats and pedigree dogs.
• Pet breed – within pedigree pets there’ll be variation in risk and price too, for example French Bulldogs tend to be much more expensive to insure than Shih Tzus. This is because of known conditions which affect French Bulldogs and the price that treatment of these conditions cost. 
• Postcode –  where you live in the country also affects your price. The same Lurcher in Leicester (£12.49/month) will receive a different price than if it were in Llandudno (£11.75/month) in the case of our latest test (7/11/2021). The reason for this is mainly 3 fold. Firstly, the cost of vet treatment in different areas change, in a built up city the same condition can be much more expensive than it would in a more rural location. Secondly, the likelihood of injury goes up in a more build up area, so if you live in a busy area the risk of a cat or dog being injured is heightened. Thirdly, you’ll be affected by the number of other claims in your area. So if you’re in an area where the insurance company sees a lot of high value claims, they are likely to increase the price based on the postcode performance.
• Vet fee inflation – this is the cost of vet fee treatment across the country. This typically is something that most people don’t consider but – alongside pet age – it is the primary reason why your renewal price increases every year. The cost of treating a dog with a broken leg will be more expensive now than it would have been last year, due to vet fee inflation. The effect of this is seen in the average claim cost which in 2021 was £848 according to the ABI (Association of British Insurers), if we row back to 2012 the average claim was just £300. So that’s a huge increase in pay outs, which the insurers need to cover, and the main way of doing that is by increasing premiums. Find out more about how vet fee inflation affects your price.

At renewal these factors will be re-assessed alongside any claims you may have made through the policy year. At renewal, whether you’ve had to make a claim – and the cost of the claim – will be the single biggest factor determining your renewal quote. 

Now let’s look at how you can influence these factors for cheaper pet insurance premiums.

How can I impact the price?

Some things in the list above you are not going to be able to impact – vet fee inflation, pet age, pet breed for example.

But there are things that you can do to impact the price of your renewal quote or if you’re thinking about bringing a new pet into your family and considering pet insurance for the first time.

• Coinsurance and excesses – when your are buying your policy you’ll likely come across excesses which work in the same way as they do for home and car insurance. It is a fixed amount that you need to pay for each claim you make, and is usually deducted from the claim payment you receive once settled.

  The second thing you may come across is called co-insurance (aka. co-payment). These work alongside your excess and in the even of a claim you pay the excess and a percentage of the claim value – usually up to 20%.

  So for example if you made a claim of £500 – there may be a compulsory excess of, for example, £99 – then you would also be required to pay 20% of the remaining claim value which would equal £80.20. In total, you would be liable for £179.20 and the insurer would pay the remaining £320.80. The benefit to a coinsurance is that because you are taking on more of the risk the initial premium price will reduce. Just be conscious that if your pet required complex treatment running into thousands of pounds your payment could be quite significant.

  Co-insurances are usually optional on pet insurance policies until a certain age at which point they become compulsory, although there are some providers who don’t offer a co-insurance at all.

  Find out more about how excess and coinsurance payments work by using our coinsurance calculator.

• Cover level – the simplest way of saving cost is to consider other cover levels or vet fee limits. The higher the cover the more expensive it will be. You will likely find that annual limit lifetime cover is cheaper than per condition lifetime cover so that may be one option, or you could look at lower annual or per condition limits, or even different cover types such as time limited polices.

  It is worth understanding the types of conditions that your pet may be more prone to and researching typical treatment costs in your area as well as whether the condition would require ongoing treatment or a one off illness. 

• Optional extras – some policies load your policy with lots of features and benefits, which on the face of it sounds great. However, these benefits come with a price which bumps up your premium. It is worth reviewing the cover and whether you’ll need things like legal advice, lost and found cover and overseas cover.

  You can find providers who offer these as add-ons should you want them or not. If you choose not to have them then it will reduce your premium.

• Shop around for vet treatment – many people don’t realise you can do this. Just because you have a local vet doesn’t mean you can’t visit others for comparison prices.

  Because claims are one of the biggest drivers of your renewal price, doing what you can to reduce the cost of treatment will have benefits when the renewal invite lands in your inbox.

  In some cases, insurers have recommended vet practices for which they have negotiated specific rates for their customers, so check this with them and make your own assessment.

  Of course it’s not always possible to shop around in emergencies, but if you have the time it could be beneficial. 

• Medicines online – if your pet requires ongoing prescription for medication, this can be the case for skin allergies for example, then there’s nothing dictating that you need to go to your vet each time you need a top up.

  Instead there are a number of reputable online veterinary retailers where you can opt to purchase instead. You’ll probably find this is less expensive, as the vet won’t be putting their mark-up on it.

• Prevention rather than cure – the best way to reduce your cost is not to claim.

  It is important that if your pet needs medical treatment you should seek it, but taking a preventative approach to the health of your pet is the best way to make sure they don’t fall ill. Appropriate exercise, healthy diets, monitoring weight and even tracking activity through smart devices are all great ways to keep the risk of illness down.

Common exclusions with maximum benefit pet insurance?

Each provider will have their own lists of exclusions so to be completely sure you should check the policy wording which will be publicly available on their websites prior to purchasing. 

The most common exclusions surround the following: 

• Pre-existing conditions – this is any condition where the pet has shown signs of having before starting the policy. There are specific policies available where you can look to cover pre-existing conditions but by default on normal policies these will be excluded.  
• Waiting period – most providers impose a 14-day period in which claims for illnesses cannot be made. This is to protect against pet owners taking out coverage knowing that their pet needs treatment. It also allows customers a cooling off period where they can cancel their insurance policy at no cost. Find out more about how pet insurance waiting periods work.
• Preventative treatment – this relates to regular treatment such as vaccinations, flea and worming treatment, grooming and other activities which are an element of general healthy pet ownership. In regards to vaccinations, you might find that cover will not be offered if your pet is not up to date with vaccinations and then they become ill with a condition that could have been avoided by an inoculation. Take a look at the important vaccinations for cats and dogs.
• Pregnancy – usually anything related to pregnancy or complications arising from giving birth are not covered. 
• Dangerous Dogs Act – there are a number of dogs listed in the UK governments Dangerous Dogs Act, insurers will not cover these. In the case of crossbreeds where the cross is one of the dogs in the Dangerous Dogs Act you’ll likely find that claims will be rejected and cover cancelled. There may also be other breeds that aren’t on the list that some insurers won’t cover. These lists are determined by the underwriter of the insurance policy and it is all dependent upon what type of insurance risks they wish to write. This is why you’ll find some providers covering certain breeds that others do not.

Alternatives to maximum benefit pet insurance?

The main alternatives to maximum benefit pet insurance are the other cover levels available, but be sure to understand their limitations too. 

Accident only policies: Covering your pet against vet fees arising from accidental injury. Learn about accident only pet insurance.

Time-limited policies: You can claim up to a fixed amount per illness or injury within a certain time period, usually 12 months. When you reach the financial or time limit – whichever comes first – your pet will no longer be covered for that condition and it will be classed as pre-existing. Any further treatment your pet needs for the condition you will need to pay for yourself. Explore time limited pet insurance.

Lifetime policies: This covers your pet for illnesses and accidents throughout your pet’s life – as long as you renew the policy each year. Find out how lifetime pet insurance works.

If you choose not to opt for pet insurance then you’ll be choosing to self-insure which involves having a savings pot set aside yourself for use if your pet falls ill.

In some extreme cases you might be able to find assistance from animal charities like Blue Cross which may offer help if you are struggling to cover the costs of vet fee treatment.

Maximum benefit pet insurance FAQs?

What if my pet needs treatment after I’ve reached the condition limit?

Once you’ve reached the maximum limit, you’ll have to pay for any further treatment costs yourself.