Disclaimer: This article provides general guidance on the pet insurance claims process in Malaysia as of February 2026. Policy terms, conditions, exclusions, and coverage limits apply. Always review your specific policy wording. For the full exclusions list, visit the exclusions page.
Your cat just spent three nights at the vet for a kidney infection. The bill is RM2,800. You have pet insurance, but now what? How do you actually get your money back?
This guide walks you through exactly how to submit a pet insurance claim with Oyen, what documents you need, how your payout is calculated, and what to expect at every stage.
Here's what we'll cover:
- How Oyen's pay-and-claim model works
- What to prepare before submitting
- Step-by-step claim submission
- How your payout is calculated (with examples)
- What happens during the review process
- What to do if your claim is on hold
- The RM1,000 threshold for monthly plans
- Tips for getting paid faster
How Oyen's Claims Process Works
Oyen uses a pay-and-claim (reimbursement) model. You pay your vet bill first, then submit a claim to get reimbursed. There's no cashless card or panel clinic to worry about. You can visit any licensed vet clinic in Malaysia.
| Step | What Happens |
|---|---|
| 1. Your pet gets treated | Visit any licensed vet clinic. No referral or pre-approval needed. |
| 2. You pay the vet bill | Settle the full bill at the clinic. Keep the receipt. |
| 3. You submit your claim online | Log in to your Oyen account and submit your claim with supporting documents. |
| 4. Oyen reviews and validates | The claims team reviews your documents and may contact your vet for validation. |
| 5. Insurer approves and pays | Once approved, the reimbursement is paid into your bank account. |
The whole process typically takes 3 to 4 weeks from submission to payout. It can be faster if your documents are complete, or slower if additional information is needed.
Before You Submit: Get Your Documents Ready
The number one reason claims take longer than expected is missing or incomplete documents. Getting this right from the start saves you weeks of back-and-forth.
Your Claims Checklist
| Document | What It Must Include | Why It Matters |
|---|---|---|
| Paid vet bill / receipt | Fully settled (not a quotation). Must show your pet's name and owner's name. | Proves treatment was received and paid for |
| Itemised bill | Each item named individually. "Medication" is not enough; needs the actual name (e.g., "Amoxicillin", "Danzen"). | Claims are reviewed line by line. Unnamed items can't be assessed. |
| Diagnostic test results | All test results from blood work, x-rays, ultrasound, urinalysis, etc. | If tests were done, the results must be submitted. No exceptions. |
| Diagnosis from your vet | The name of the illness or condition, and what the vet believes caused it. | Needed to confirm the condition is covered under the policy |
Pro tip: Before leaving the vet clinic, check your receipt. Make sure your pet's name, your name (or whoever brought the pet), and every medication and treatment is listed by name with individual pricing. It's much easier to sort this out at the clinic than after you've left.
Step-by-Step: How to Submit Your Claim
Step 1: Log in to Your Oyen Account
Go to oyen.my and log in to your account dashboard. Make sure your profile is up to date: vaccination card uploaded, microchip number updated (for dogs), and bank account details filled in.
Step 2: Click "Claim Your Bills"
From your dashboard, click the claim submission button and select the pet you're claiming for. Choose the claim type that matches your situation.
Step 3: Fill in the Claim Details
You'll need to provide:
| Field | What to Enter |
|---|---|
| Clinic name and vet details | The name of the clinic you visited and the treating vet |
| Date of first symptom | When you first noticed something was wrong with your pet |
| Treatment date | The date(s) your pet was treated |
| Bill amount | The final, fully paid amount |
| What happened | Describe when you first noticed symptoms and what you observed |
| What caused the illness | Your vet's diagnosis and their assessment of the cause |
Step 4: Upload Your Documents
Attach your itemised vet bill (fully paid), all diagnostic test results, and any medical reports. Clear photos or scans work fine. Make sure everything is legible.
Step 5: Submit and Wait
Once submitted, you'll get a confirmation. The review typically takes 3 to 4 weeks. You can track your claim status through your account dashboard, and you'll receive email updates as it progresses. For more details on the submission process, see Oyen's claims guide.
When Should You Submit Your Claim?
| Timing Rule | Details |
|---|---|
| Submit within 30 days | You should submit your claim within 30 days of the vet visit. Submitting sooner (within 7 days) helps with faster processing. |
| After the waiting period | For illness claims: the date of first symptoms must be after your waiting period has ended (30 days for conventional, 14 days for takaful). Even if treatment happens after the waiting period, if symptoms appeared before it ended, the condition is considered pre-existing. Accident claims are covered immediately. |
| While your policy is active | Treatment and claim must happen while your policy is still in force. Treatment after policy expiry without renewal is not covered. |
Why the symptom date matters: It's the date your pet first showed symptoms that counts, not the date of treatment. If your cat started limping on Day 25 of your policy (still within the 30-day waiting period) and you brought her to the vet on Day 35, that's still considered pre-existing. This is why it's always better to get insurance early, while your pet is healthy.
The sooner you submit after your vet visit, the better. Fresh claims are easier to process because all the details are still clear in your mind and your vet's records.
How Your Payout Is Calculated
This is the part most pet parents want to understand. Your reimbursement isn't simply "90% of the total bill." Here's how it actually works.
Step 1: The Illness Is Evaluated First
Before any line item on your bill is reviewed, the claims team evaluates the underlying illness or condition itself. They look at the origin of the condition, your pet's medical history, whether symptoms appeared during the waiting period, and whether the condition is on the exclusions list.
If the illness is not claimable (for example, it's a pre-existing skin condition or a vaccine-preventable disease), then no items on the bill are eligible, regardless of what treatments were given. The illness must be claimable before the individual bill items are assessed.
Every claim is unique because every pet is unique. The same treatment (e.g., antibiotics) could be covered for one illness but not for another, depending on whether the underlying condition qualifies.
Step 2: The Bill Is Reviewed Line by Line
Once the illness is confirmed as claimable, your vet bill is reviewed item by item:
- Items on the exclusions list are removed (e.g., supplements, vaccines, deworming)
- Your reimbursement rate (50%, 70%, or 90%) is applied to the eligible amount only
- If applicable, any deductible is subtracted (see deductible section below)
Example: How a Claim Payout Is Calculated
Say your cat had a fever caused by an infection. The claims team first confirms the infection is a claimable illness (not pre-existing, not within the waiting period, not excluded). Once confirmed, the bill is reviewed. The total vet bill is RM800.
| Bill Item | Amount (RM) | Eligible? |
|---|---|---|
| Consultation | 60 | Yes |
| Blood test (CBC) | 180 | Yes |
| Antibiotics (Amoxicillin) | 120 | Yes |
| IV drip | 150 | Yes |
| Probiotics (Pro-kolin) | 80 | No (supplement) |
| Deworming tablet | 15 | No (preventive care) |
| Vaccine booster | 60 | No (preventive care) |
| Medicated shampoo | 35 | No (excluded) |
| Total bill | RM700 | |
| Eligible amount | RM510 |
Your Payout by Reimbursement Rate
| Your Reimbursement Rate | Calculation | You Receive |
|---|---|---|
| 90% (10% co-payment) | 90% of RM510 | RM459 |
| 70% (30% co-payment) | 70% of RM510 | RM357 |
| 50% (50% co-payment) | 50% of RM510 | RM255 |
This is why your payout might be less than you expected. It's not 90% of the total bill. It's 90% of the eligible amount after excluded items are removed. And remember: the example above only applies because the underlying illness (infection) was confirmed as claimable first. If the same bill items were for a non-claimable condition, the entire claim would be declined.
For a full list of items that are excluded (including specific supplements not covered), check the exclusions list.
How Deductibles Affect Your Payout
Depending on your plan, a deductible may apply before your reimbursement is paid out.
| Plan Type | Deductible | How It Works |
|---|---|---|
| Conventional | Per-bill, if applicable | A deductible may be introduced by the insurer on a case-by-case basis, depending on your pet's unique circumstances. If applicable, the deductible amount is always displayed at checkout when you renew, giving you full visibility before you commit. |
| Takaful | RM100 or 10% of eligible amount, whichever is higher | Applied per condition, not per bill. If you have follow-up visits for the same condition within 60 days, they share a single deductible. See takaful deductible details. |
Takaful Deductible Example
Say your claim has an eligible amount of RM510 on a Takaful plan:
| Calculation | Amount |
|---|---|
| Eligible amount | RM510 |
| 10% of RM510 | RM51 |
| Deductible applied (higher of RM100 or RM51) | RM100 |
| Payout (RM510 - RM100) | RM410 |
If you return for a follow-up visit for the same condition within 60 days, the deductible is not charged again. Only the first visit for that condition carries the deductible.
What Happens After You Submit
Once your claim is in, here's what the review process looks like from your side.
| Stage | What You'll See | What's Happening Behind the Scenes |
|---|---|---|
| Submitted | Claim received confirmation | Your documents are being checked for completeness |
| Reviewing | Status shows "Reviewing" | Claims team is assessing your bill and may contact your vet for validation |
| On Hold | You'll be contacted for more info | Additional information needed from you or your vet (see section below) |
| Approved | Approval notification via email | Claim approved. Payment being processed. |
| Paid | Status shows "Paid" | Money has been sent to your bank. Allow 3-5 working days for it to appear. |
You can check your claim status anytime through your Oyen account dashboard. Email updates are sent as your claim moves through each stage.
Vet Validation: What Is It?
For most claims, the Oyen claims team will contact your vet clinic directly to validate the treatment. This is standard procedure across the insurance industry. Your vet may be asked to confirm the diagnosis, treatment details, and medical history.
You don't need to do anything for this step. The Oyen team handles the communication with your vet. But if your vet is busy and slow to respond, the review may take longer.
What If Your Claim Is On Hold?
A "Hold" status means the claims team needs additional information before they can proceed. This usually happens because:
- Your vet hasn't responded to the validation request yet
- The claims team needs more details from you or your vet
- Some documents are missing or unclear
Information Typically Needed
| Information | Who Provides It |
|---|---|
| Diagnosis (name of illness) | Your vet |
| Possible cause(s) | Your vet |
| Date of first clinical signs | You or your vet |
| Date of first treatment | Your vet |
| Relevant medical history | Your vet |
| Test result findings | Your vet |
| Full treatment breakdown with names and prices | Your vet (if not already on the receipt) |
If your claim is on hold, Oyen's team is also following up with your vet. But vet clinics are often busy, so your help can speed things up. If you can, contact your vet and let them know the insurance team is waiting on information.
The RM1,000 Threshold (Monthly Plan Customers)
If you're on a monthly payment plan, there's one important rule to know: when your total approved claims reach RM1,000 or more (from a single claim or multiple claims combined), you'll need to settle the remaining premium for the full policy year before further reimbursements are processed.
| Scenario | What Happens |
|---|---|
| Claim approved for RM800 | Under RM1,000. Paid out normally. No action needed. |
| Claim approved for RM1,200 | Over RM1,000. You'll be asked to settle remaining annual premium before reimbursement. |
| Two claims totalling RM1,100 | Cumulative total crosses RM1,000. Same rule applies on the second claim. |
Alternatively, you can continue paying monthly as normal and collect the approved reimbursement after the last month's premium has been settled. This is a standard term in the policy that ensures fairness for all policyholders.
If you're on an annual plan, this doesn't apply to you since you've already paid in full.
Tips for Getting Your Claim Paid Faster
- Check your receipt before leaving the clinic. Make sure your pet's name, your name, and every item is listed individually with the actual medication/treatment name and price. "Medication RM50" will slow things down. "Amoxicillin 250mg RM50" won't.
- Submit all test results. If your vet did blood tests, x-rays, ultrasound, or urinalysis, the results must be included. Missing test results is one of the most common causes of delays.
- Write a clear description. When filling in "What happened," include the date you first noticed symptoms and exactly what you observed. For "What caused the illness," include your vet's diagnosis and their assessment of the likely cause.
- Submit within 7 days. While you have up to 30 days, submitting sooner means the details are fresh and the process starts earlier.
- Keep your profile up to date. Make sure your bank account details are correct in your Oyen account. Wrong bank info after approval means delays in getting paid.
- Respond quickly if contacted. If the claims team asks for additional information, providing it promptly keeps things moving.
Writing a Strong Claim Description
The claim form asks you two key questions. Answering them well helps the claims team process your claim faster.
| Question | What to Include | Example |
|---|---|---|
| "What happened?" | Date you first noticed something wrong, and what symptoms you saw | "On 15 Jan 2026, I noticed my cat Milo was not eating and seemed lethargic. By the next day, he was vomiting and hiding under the bed. I brought him to the vet on 17 Jan." |
| "What caused the illness?" | Your vet's diagnosis and their assessment of the cause | "The vet diagnosed Milo with a urinary tract infection. Blood test and urinalysis confirmed bacteria in the urine. The vet said it was likely caused by dehydration and not drinking enough water." |
The more specific you are, the better. Vague descriptions like "my cat was sick" or "don't know what caused it" can slow down the review. If your vet hasn't confirmed the cause yet, say so: "The vet is still running tests. A follow-up appointment is scheduled for [date]."
Common Reasons Claims Are Declined
Nobody wants their claim declined. Understanding the common reasons helps you avoid surprises.
| Reason | Explanation |
|---|---|
| Pre-existing condition | The condition existed or first showed symptoms before your policy started or during the waiting period. Remember: it's the symptom date that matters, not the treatment date. |
| Exclusion applies | The treatment or condition is on the exclusions list (e.g., dental, foreign body ingestion, reproductive) |
| Vaccine-preventable disease | Conditions like parvovirus, tick fever, or rabies that are preventable through vaccination |
| Symptoms during waiting period | The first symptoms appeared within the first 30 days (conventional) or 14 days (takaful) of your policy, even if treatment happened after the waiting period ended |
| Supplements or non-covered items | Supplements, special diets, medicated shampoos, and vitamins are not covered even if prescribed by a vet |
| Below deductible amount | For Takaful plans: the eligible amount doesn't meet the deductible threshold (10% or RM100, whichever is higher) |
If your claim is declined and you believe it shouldn't have been, you can appeal. The Oyen team can help you understand the reason and guide you through the appeal process if applicable.
Burial Claims
If your pet has passed away, burial or cremation costs may be covered under Plus and Champion plans. This is an emotional and difficult time, and the Oyen team handles these claims with care and sensitivity.
The cause of death affects eligibility. Conditions on the exclusions list may not qualify for the burial benefit. If you're unsure, reach out to the Oyen team and they'll guide you through it at your own pace.
"Is This Covered?" How to Check Before Claiming
One of the most common questions pet parents ask is: "Can I claim for this?" Here's how to find out.
| If the Condition Is... | What It Means |
|---|---|
| On the exclusions list | Not covered. The exclusions list is the definitive reference. |
| Not on the exclusions list | Generally covered, but the final outcome depends on review by the claims team after submission. No outcome can be confirmed before a claim is formally submitted and reviewed. |
| Unsure or unclear | Contact Oyen's team via WhatsApp for guidance before your vet visit, or check the Knowledge Base. |
The general rule: Oyen covers 1,000+ illnesses and injuries. If it's not on the exclusions list, it's generally covered, subject to review by the claims team. But no one can confirm the outcome before a claim is formally submitted and assessed.
FAQ
How long does it take to get reimbursed?
Typically 3 to 4 weeks from submission to payout. It can be faster if your documents are complete, or longer if the claims team needs additional information from you or your vet.
Can I claim at any vet clinic?
Yes. Oyen has no panel restriction. You can visit any licensed vet clinic in Malaysia, including specialists and emergency clinics. You pay the bill first, then submit your claim for reimbursement.
Why was my payout less than expected?
Your reimbursement rate (50%, 70%, or 90%) is applied to the eligible amount, not the total bill. Items on the exclusions list (supplements, vaccines, deworming, medicated shampoo) are deducted first. For a full breakdown, check your claim details in your account dashboard or contact the Oyen team.
What documents do I need to submit a claim?
You need a fully paid, itemised vet bill with each treatment and medication named individually (not just "medication"), all diagnostic test results, and a diagnosis from your vet. Your pet's name and owner's name should be on the receipt. See Oyen's claims guide for the full checklist.
What does "On Hold" mean for my claim?
It means the claims team needs more information before proceeding. This is usually because your vet hasn't responded to the validation request or some documents are missing. Oyen is following up on your behalf, but you can help speed things up by contacting your vet too.
What is the RM1,000 threshold?
For monthly plan customers: when your approved claims reach RM1,000 or more cumulatively, you'll need to settle the remaining annual premium before further reimbursement. You can also continue paying monthly and collect reimbursement after the final premium payment. Annual plan customers aren't affected.
Can I check if something is covered before I visit the vet?
Yes. Check the exclusions list. If the condition isn't listed, it's generally covered, subject to claims team review after submission. You can also reach out to Oyen's team via WhatsApp for guidance. But no one can confirm a claim outcome before it's formally submitted and reviewed.
What if my claim is rejected?
You'll receive an explanation of why the claim was declined. Common reasons include pre-existing conditions, exclusions, or treatment during the waiting period. If you believe the decision was wrong, you can appeal. The Oyen team can explain the reason in detail and guide you through the process.
How do I write a good claim description?
For "What happened": include the date you first noticed symptoms and what you observed. For "What caused the illness": include your vet's diagnosis and their view on the cause. Be specific. "My cat stopped eating on 15 Jan and was vomiting" is much better than "my cat was sick."
Does Oyen contact my vet during the claims process?
Yes. For most claims, Oyen's claims team contacts your vet clinic directly for validation. This is standard procedure. They'll verify the diagnosis, treatment details, and medical history. You don't need to arrange this, but it's good to let your vet know a validation request may come through.
Protecting Your Pet Starts Here
The claims process doesn't have to be stressful. With the right documents and a clear description, most claims are processed smoothly within 3 to 4 weeks. Oyen's team is there to help at every step, from preparing your submission to following up with your vet.
Not insured yet? Oyen covers cats and dogs at any licensed vet clinic in Malaysia, with coverage up to RM10,000/year and reimbursement rates up to 90%.
Check your pet's eligibility now - it takes less than 2 minutes.
