Pre-Existing Condition Exclusion Review Form for Pets
This form is used to request a review of a pre-existing condition excluded from a pet insurance policy. It requires details from both the policy owner and a veterinarian. All supporting documentation must be provided for the review to be completed.
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How do I fill this out?
To fill out this form, you need to provide detailed information about your policy, your pet, and the pre-existing condition you want reviewed. Ensure both you and your veterinarian complete the respective sections. Submit the required supporting documentation along with the completed form.
How to fill out the Pre-Existing Condition Exclusion Review Form for Pets?
1
Provide your policy details.
2
Enter your pet's details.
3
Specify the pre-existing condition to be reviewed.
4
Have your veterinarian complete their section and provide supporting documents.
5
Submit the completed form and documentation via mail or fax.
Who needs the Pre-Existing Condition Exclusion Review Form for Pets?
1
Pet owners who want to request a review of a pre-existing condition excluded from their insurance policy.
2
Veterinarians who need to provide information and documentation about the pet's condition.
3
Insurance companies that need a standardized form for processing exclusion reviews.
4
Policyholders seeking to waive the exclusion of a condition considered pre-existing.
5
Pet insurance administrators handling policy and claims management.
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What are the instructions for submitting this form?
Submit the completed form and all supporting documentation via mail to Guardian Pet Insurance, Locked Bag 9021, Castle Hill NSW 1765, or fax both sides to 1300 367 229. For any questions, call 1300 709 431 between 8am - 8pm (AEST) Monday to Friday. Ensure all sections are completed and documentation is provided to avoid delays.
What are the important dates for this form in 2024 and 2025?
Ensure the form is submitted with the necessary documents within 30 days of the request. Continuous 18-month symptom-free period required for review eligibility.
What is the purpose of this form?
The purpose of this form is to request a review of a pre-existing condition that has been excluded from a pet's insurance policy. By submitting this form, pet owners can provide evidence that their pet has been symptom-free for the required period and request the removal of the exclusion. This ensures that pets with resolved health issues can receive full coverage under their insurance policy.
Tell me about this form and its components and fields line-by-line.
- 1. Policy details: Includes policy number, title, first name, surname, address, suburb/city, state, and postcode.
- 2. Pet's details: Includes pet's name, species, breed, age/date of birth.
- 3. Pre-existing condition exclusion: Details of the condition to be reviewed.
- 4. Policy owner declaration: Questions about the pet's condition over the past 18 months and any treatments received.
- 5. Vet's instructions: Instructions for the vet to provide examination details and supporting documentation.
- 6. Declaration: Signatures from both the policy owner and vet, certifying the accuracy and completeness of the information provided.
- 7. Registration number and state: Vet's registration details.
What happens if I fail to submit this form?
If you fail to submit this form, the pre-existing condition exclusion will remain on your policy, and your pet will not be covered for treatments related to that condition.
- Continued exclusion: The pre-existing condition exclusion will continue to apply to your policy.
- No coverage: You will not receive coverage for treatments related to the excluded condition.
- Delayed review: Submission delays can result in a prolonged review process when you eventually submit the form.
How do I know when to use this form?
- 1. Symptom-free period: Your pet has been symptom-free for the required continuous period.
- 2. Veterinary support: Your veterinarian can provide supporting documentation for the review.
- 3. Insurance policy update: You want to update your insurance policy to remove the pre-existing condition exclusion.
- 4. Formal request: You need a formal way to request a review from your insurer.
- 5. Policy eligibility: To ensure your pet remains eligible for full coverage under your insurance policy.
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