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

If your reimbursement came in lower than your total bill, it's usually because of how a claim is calculated. We'll 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 aren't covered under pet insurance, so they're 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's left is your eligible amount.

Step 2: Your reimbursement rate (co-pay) is applied. You chose a co-pay level when you signed up. Most furkids are on the default 10% co-pay (90% reimbursed). The other options are 30% co-pay (70% reimbursed) and 50% co-pay (50% reimbursed).

Step 3: Your deductible is applied (if any). If your plan has a deductible (RM100 or RM200), it's applied per bill, after the co-pay.

Worked example 🐾

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

So on an RM800 eligible bill, RM620 is reimbursed ✅

Want to see exactly what wasn't covered? The exact items not covered are usually listed inside your claims history, so you can check there. If an item doesn't show up, or you're unsure about a particular item, just reach out by email or WhatsApp and we'll gladly explain it line by line 💛

Note: RM100 or RM200 deductible only applies if it's printed on your schedule.