Why was only part of my bill reimbursed? Understanding your claim breakdown

If your reimbursement came in lower than your total bill, it is usually because of how a claim is calculated. We will go through it step by step.

Only the eligible portion of your bill is reimbursed, worked out in this order:

Step 1: Excluded items are removed. Some things are not covered under pet insurance, so they are taken out first. These include vaccines, deworming, supplements, grooming, and pet food. Treatment for non-claimable illnesses is also excluded, not just add-on items. What is left is your eligible amount.

Step 2: Your reimbursement rate is based on your schedule. Your reimbursement rate may be 90%, 70%, or 50%, depending on the co-payment shown on your policy schedule. This is not the same for every customer, so always check your schedule.

Step 3: Your deductible is applied, if any. If your plan has a deductible, it is applied after the co-payment. Your deductible only applies if it is printed on your schedule.

Worked example

Your pet has an RM800 eligible diabetes bill, on a 10% co-payment with an RM100 deductible:

So on an RM800 eligible bill, RM620 is reimbursed.

Want to see exactly what was not covered? The exact items are usually listed inside your claims history. If an item does not show up, or you are unsure about a particular item, reach out by email or WhatsApp and we will explain it line by line.