{"id":77832,"date":"2025-06-01T00:00:13","date_gmt":"2025-06-01T04:00:13","guid":{"rendered":"https:\/\/todaysveterinarybusiness.com\/?p=77832"},"modified":"2025-11-14T15:02:31","modified_gmt":"2025-11-14T20:02:31","slug":"reassessing-how-pet-insurance-works","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarybusiness.com\/reassessing-how-pet-insurance-works\/","title":{"rendered":"Reassessing How Pet Insurance Works (And How It Can Be Improved)"},"content":{"rendered":"

I recently went to an urgent care facility in my neighborhood after suffering from gastrointestinal issues for four days. A few hours later, a physician assistant said I had tested positive for Campylobacter<\/em>, an infectious organism that causes diarrhea, GI upset and vomiting. He prescribed the anti-nausea medication Zofran and three days of the antibiotic azithromycin.<\/p>\n

Throughout my Campylobacter<\/em> experience, I paid nothing out of pocket except $2 and change at the pharmacy. And the entire time, I couldn\u2019t help but wonder: What if human health insurance were like pet health insurance? What if I had to pay out of pocket for all the medical care I received that day and then had to file a claim with my insurance company and wait for reimbursement? How many hundreds of dollars \u2014 thousands? \u2014 would I have needed upfront? Would those costs have dissuaded me from seeking medical care in the first place?<\/p>\n

Pet health insurance helps people budget for veterinary care and is supposed to prevent them from having to make difficult financial choices about what they can afford for their cats and dogs. But since most policyholders must pay upfront, is insurance achieving everything it was intended to solve?<\/p>\n

The reimbursement model is an issue in the United States, where the percentage of enrolled pets hovers in the low single digits. It\u2019s closer to 20% to 30% in the United Kingdom and as high as 90% in countries like Sweden.<\/p>\n

Pet insurance isn\u2019t new here. Veterinarian Dr. Jack Stephens founded the first North American pet insurer \u2014 Veterinary Pet Insurance \u2014 in 1980. Nationwide acquired VPI in 2009.<\/p>\n

After more than 40 years, why is U.S. pet insurance still struggling to take off? Or is it doing just fine?<\/p>\n

\u201cThe industry has grown in North America \u2014 more than 20% compounded annually in the last five years,\u201d said Bob Capobianco, vice president of the North American Pet Health Insurance Association, a trade group. \u201cAny mature line of business would love to be able to do that. And to be fair, after COVID, we moved all those shelter pets into the denominator, which caused it to rise as our insured pets rose. So, we\u2019re not comparing apples to apples, but we are a healthy and growing industry.\u201d<\/p>\n

Dr. Kent Kruse<\/a>, a former chief operating officer at VPI and a self-proclaimed pet insurance provocateur, agreed that moving adopted shelter pets into the denominator cut into the percentage of insured pets.<\/p>\n

\u201cBut that doesn\u2019t alter the fact that there are still only about 3% of pets insured in the U.S.,\u201d Dr. Kruse said. (A newly released NAPHIA report says 5.5% of dogs and 2% of cats.) \u201cConsidering the total number of pet insurance carriers and the increase in the number of pet insurance aggregators that are flooding social media with advertisements, the percentage remains stubbornly low. In my mind, pet owners just aren\u2019t impressed.\u201d<\/p>\n

Industry professionals interviewed for this article addressed five issues potentially holding back pet health insurance.<\/p>\n

1. Not Enough Awareness and Education<\/h3>\n

\u201cIt\u2019s crazy to say this after 40 years, but people in the U.S. do not know that pet insurance exists,\u201d said Dr. Ricky Walther<\/a>, the chief medical officer for the online pet insurance marketplace Pawlicy Advisor. \u201cAnd when people hear \u2018pet insurance,\u2019 the closest thing they hear is \u2018human health insurance.\u2019 The reality is those two things couldn\u2019t be further from similar products. They\u2019re totally different. I\u2019m always shocked at how many people don\u2019t know that pet insurance is property and casualty insurance.\u201d<\/p>\n

Why not market pet insurance as similar to homeowners or auto policies?<\/p>\n

\u201cA wise veterinarian once told me that pet insurance is misnamed,\u201d Dr. Kruse said. \u201cIt should be called \u2018asset protection insurance\u2019 for those who are wealthy enough to be able to pay the entire veterinary bill upfront and wait to be reimbursed.\u201d<\/p>\n

The industry might be getting more than just the name wrong. Dr. Jennifer Sperry, the medical director at Independence Pet Group, the parent company of insurance brands such as Hartville and Figo, said insurers should rethink how they market to and educate pet owners and veterinary professionals.<\/p>\n

\u201cWe need to change the way we talk about insurance,\u201d Dr. Sperry said. \u201cWe tend to talk about it when the pet is adopted, when it\u2019s young and healthy. However, when we think of this as a puppy or kitten discussion and never a discussion for any other time, we\u2019re missing an opportunity to present that tool at a time when people are well aware of the total cost of care.\u201d<\/p>\n

Some veterinarians avoid discussing insurance with clients because they don\u2019t want to recommend a specific brand \u2014 \u201csell\u201d insurance \u2014 or face a client\u2019s anger after a lousy insurance experience. The conversation can also be daunting to veterinarians who don\u2019t have the time to tackle the topic.<\/p>\n

Practitioners don\u2019t have to be insurance experts or recommend a provider. The conversation could be as simple as explaining a few high-level benefits and sending the client online to compare policies.<\/p>\n

\u201cThey don\u2019t want to get in the middle of it,\u201d said Dr. Jules Benson, a consultant and the former chief veterinary officer at Nationwide Pet. \u201cBut they can push it off to a third party like Pawlicy Advisor and tell the client to find out what\u2019s best for them and their pet.\u201d<\/p>\n

Initiating the conversation is possible without being forceful or salesy. Dr. Kruse recommends asking whether the pet owner needs assistance with an insurance claim form after an illness or injury visit. If the pet isn\u2019t insured, the veterinarian can remind the client that the visit\u2019s medical services likely would have been covered.<\/p>\n

Dr. Sperry said client objections about the cost of care can easily be turned into insurance discussions.<\/p>\n

\u201cWhen a sick pet comes in and the owner is faced with a big bill, they\u2019ll ask about pet insurance. And it\u2019s too late in that instance, but that doesn\u2019t mean it\u2019s too late for future issues,\u201d she said. \u201cWe have to get out of the mentality that once there is one preexisting condition, insurance has no value moving forward. Just because a pet has been diagnosed with arthritis doesn\u2019t mean other things won\u2019t come up in the future.\u201d<\/p>\n

Whether or not veterinarians talk about pet insurance, they should, at a minimum, post educational information on their website, blog and social media channels. They also can display brochures and fliers in the lobby and arm the staff with basic pet insurance knowledge. Selecting a team member \u2014 an \u201cinsurance champion\u201d or \u201cclaims coordinator\u201d at larger practices \u2014 to educate clients and help process claims is another idea.<\/p>\n

Experts recommend that in addition to not calling pet insurance \u201chealth\u201d or \u201cmedical\u201d coverage, the industry should set realistic expectations in pet owners\u2019 minds and educate them about what pet insurance is and isn\u2019t.<\/p>\n

\u201cMany consumers don\u2019t necessarily buy pet insurance as a risk-protection product. They often view it as an investment product,\u201d Dr. Benson said. \u201cThey think it\u2019s a waste of their time and money if they\u2019re not getting their money back. But that\u2019s not what insurance is.\u201d<\/p>\n

Insurance companies could use a collaborative, brand-agnostic approach when communicating with veterinary practices. Multiple players could cohost lunch-and-learns in the hospital and lectures at veterinary conferences.<\/p>\n

\u201cWe aren\u2019t talking about it the right way with practices,\u201d Dr. Sperry said. \u201cWe go into clinics and say, \u2018Look at this $30,000 bill we covered.\u2019 What\u2019s more powerful is saying, \u2018Look at this $600 problem that we solved for somebody who didn\u2019t have $600 in their back pocket.\u2019 Those are the real heartbreakers for me as a vet and the most common situations I ran into as a practicing veterinarian.\u201d<\/p>\n

Dr. Kruse said the industry has failed to educate veterinarians about the advantages of pet insurance.<\/p>\n

\u201cThree percent enrollment can only mean one thing, and that is the industry as a whole has failed,\u201d he said. \u201cThere are so many statistics on how the human medical profession and the dental profession and the individuals who work in them have benefited financially, and, more importantly, how their patients are well taken care of because of insurance. Pet insurance could do the same thing for the veterinary profession.\u201d<\/p>\n

According to Capobianco, NAPHIA is working on initiatives to help improve the visibility and perception of pet insurance.<\/p>\n

\u201cMisconceptions can create problems, whether for veterinarians, pet owners or others,\u201d he said. \u201cSo, part of this is lifting the veil and educating everybody, which we believe can be a necessary ingredient to growing the line of business.\u201d<\/p>\n

2. Not Giving Clients What They Want and Need<\/h3>\n

\u201cThere\u2019s a huge opportunity for us to be more creative,\u201d said Pawlicy Advisor\u2019s Dr. Walther. \u201cWe need to be innovative and build products that meet pet owners where they are and give them what they\u2019re looking for.\u201d<\/p>\n

Is a better reimbursement model what pet owners want and need? Today, one U.S. pet insurance company\u2014 Trupanion<\/a> \u2014 pays veterinary practices directly at the time of service. The company\u2019s 2018 software patent prevents competitors from developing a direct-pay solution.<\/p>\n

Dr. Kruse is a vocal opponent of Trupanion\u2019s patent. In 2023, he sent a six-page report to the Federal Trade Commission outlining why he believes the patent restricts access to veterinary care \u201cby preventing multiple members of the pet insurance industry from providing a pet insurance product which is affordable for pet owners.\u201d<\/p>\n

According to his report: \u201cApparently, Trupanion\u2019s latest patent not only protects the design of the software, but also the function. In this instance, the patent-protected function is for the real-time adjudication of the claim, which, in turn, provides for the direct payment of the policy benefit to the veterinarian providing the pet medical services<\/a>. Several years ago, a second pet insurance carrier was reported to have developed claims adjudication software which had a similar function to the Trupanion product. Trupanion reportedly contacted that carrier and advised them that if they provided that software for use in veterinary offices, the carrier would face legal action for patent infringement.\u201d<\/p>\n

Dr. Kruse has not received a response from the FTC.<\/p>\n

Not everyone agrees that direct reimbursement is the U.S. pet insurance industry\u2019s biggest hurdle.<\/p>\n

\u201cIf the reimbursement model was the reason that penetration wasn\u2019t higher, then Trupanion would be more wildly successful than they are already,\u201d Dr. Benson said. \u201cI fundamentally disagree that direct pay is the cure.\u201d<\/p>\n

Either way, Capobianco said, NAPHIA members are studying the issue. (Trupanion is no longer a NAPHIA member.)<\/p>\n

\u201cFrom a technology perspective, the industry, our members, are working on ways to better align the payment to the veterinarian with the out-of-pocket responsibilities of the individual,\u201d Capobianco said.<\/p>\n

In the meantime, experts say insurance should be only one tool in a practice\u2019s financial solutions toolbelt. Other options include payment, financing and wellness plans from companies like VetBilling, CareCredit and Snout.<\/p>\n

Snout, for example, manages wellness plans for veterinary practices, charging pet owners monthly (an average of $40) and paying the practices directly at the time of service. Participating hospitals get multiple benefits in exchange for a small fee, chief operating officer David Nietzke said.<\/p>\n

\u201cWe\u2019re seeing a 44% increase in average client transaction and a 72% increase in visit frequency,\u201d Nietzke said. \u201cOur average member comes in 5.7 times a year. With veterinary inflation as high as it is, clinics that adapt and help their pet owners combat this will do well. Those that don\u2019t will continue to experience a decrease in visits year over year.\u201d<\/p>\n

Another area where pet insurance is falling short of consumer expectations and needs is customer service.<\/p>\n

\u201cMost emergency and specialty veterinary hospitals require the pet owner to pay half of the estimated medical fees before treatment can begin,\u201d Dr. Kruse said. \u201cThere are too many dramatic stories of insured pets being euthanized because the pet owner couldn\u2019t come up with 50% of the estimated cash required to treat their pet\u2019s medical emergency.\u201d<\/p>\n

He said more pet insurers should offer around-the-clock customer service and preauthorize claims for emergency care. To his knowledge, only one company does it.<\/p>\n

Capobianco and Dr. Walther said the issue comes down to innovation and creativity.<\/p>\n

\u201cHow do we, as insurance companies, better understand the position that vets find themselves in?\u201d Capobianco asked. \u201cAnd how do we collaborate to help create a win for the pet owner and a win for the veterinarian while keeping rates reasonable and still generating a profit for the insurance companies?\u201d<\/p>\n

3. Inconsistent State Regulations<\/h3>\n

Aside from cultural differences between the United States and Europe, the U.S. regulatory environment makes insuring pets more difficult for providers.<\/p>\n

\u201cIt\u2019s like opening an insurance company in 51 different countries,\u201d said Nationwide\u2019s ex-CVO, Dr. Benson. \u201cIt\u2019s unbelievably challenging to write an insurance policy in the U.S. from a logistics point of view, and I don\u2019t think there\u2019s any way to fix that.\u201d<\/p>\n

He said that while pet insurance is unlike human medical insurance, it\u2019s also not home or automobile insurance.<\/p>\n

\u201cThere are differences between those things, not just from a coverage level, but from an emotional level. You can\u2019t necessarily expect the same things to work,\u201d he said.<\/p>\n

NAPHIA is pursuing a legislative solution: model law.<\/p>\n

\u201cHaving a model law, which every state in their own time is considering, codifies disclosures and the ways things are seen so that we can be treated on an equal footing,\u201d Capobianco said. \u201cIt\u2019s a lot of work, but it\u2019s also an opportunity for us to be legitimized in the world of insurance. I think it\u2019s a necessary step forward.\u201d<\/p>\n

4. Inconsistent and Nonstandardized Coding<\/h3>\n

Part of the reason direct payment to veterinarians at the time of service is difficult is that pet insurers can\u2019t access enough data to facilitate quick claims decisions. And even if they have access \u2014 as with Trupanion\u2019s patented software \u2014 the data is often not standardized or coded consistently.<\/p>\n

\u201cIn the States, we have 97 different flavors of what we call things, from diagnoses to treatments,\u201d Capobianco said. \u201cWe\u2019re working with technology to recognize the text, turn it into artificial intelligence that helps us more quickly assess those kinds of issues, and then facilitate the claims payments.\u201d<\/p>\n

He said pet insurance should be part of the veterinary profession\u2019s discussions about data standardization.<\/p>\n

\u201cThe Association for Veterinary Informatics is talking about data standards,\u201d he said. \u201cHow does insurance get a seat at that table? How do we find a path forward with the ambition of standardizing everything?\u201d<\/p>\n

5. Not Enough Collaboration<\/h3>\n

\u201cWe all want happier, healthier, longer-living pets,\u201d Capobianco said. \u201cWe want to stop economic euthanasia. We also want to find solutions for pet owners of different socioeconomic backgrounds. For someone who owns a pet, loves their pet and lets their pet sleep in their bed at night but makes $50,000 a year, how do we make insurance protection approachable for them? We have to partner with other interested parties and make that happen.\u201d<\/p>\n

Pawlicy Advisor\u2019s Dr. Walther thinks those partners are all the financial solutions companies.<\/p>\n

\u201cVeterinarians are recommending pet insurance as a tool for financially taking care of pets. They\u2019re trying to increase access to care and the affordability of care, but pet insurance cannot accomplish that alone,\u201d he said. \u201cThere are a lot of ways for the various pet insurance brands and the other financial tools that exist in the space to work synergistically for everyone\u2019s benefit.\u201d<\/p>\n

\n

THE ELEPHANT IN THE ROOM<\/span><\/h3>\n

In 2018, Trupanion secured a utility patent titled \u201cPet Insurance System and Method\u201d for the company\u2019s proprietary software, then called Trupanion Express. The software integrates directly with practice management systems, enabling direct payment to a veterinary practice at the time of service and eliminating the need for policyholders to pay upfront and wait for reimbursement.<\/p>\n

In April 2013, Dr. Kerri Marshall, serving as Trupanion\u2019s chief veterinary officer, appeared on Dr. Doug Kenney\u2019s Pet Insurance Guide Podcast<\/em>. The two veterinarians had this exchange about the company\u2019s new payment software:<\/p>\n

Dr. Kenney:<\/strong> \u201cIt seems to me that a significant number of pet owners and pets can be insured that wouldn\u2019t have been eligible for pet insurance before because they weren\u2019t able to pay thousands of dollars on the front end and then wait for reimbursement.\u201d<\/p>\n

Dr. Marshall:<\/strong> \u201cI think the reimbursement model is dead, and I think you\u2019re right, that\u2019s the game changer. That\u2019s what\u2019s really different about Trupanion Express. \u2026 Hopefully, the other insurance companies will follow suit. I think that this is a good move for veterinarians and will dramatically change the whole environment, not just for pet insurance but veterinary medicine.\u201d<\/p>\n

Sarah Rumple contacted Trupanion with questions and received this emailed statement, attributed to CEO Margi Tooth: \u201cAside from transparency, a key part of the Trupanion product is our ability to pay veterinarians directly at checkout. Pet parents no longer have to wait for reimbursement, making it easier to say yes to care without financial stress. This creates a better experience not just for pet parents but for the entire veterinary industry, reinforcing the value of insurance and helping rebuild the trust that has been eroded by legacy products and companies that entered the market with a bang, only to disappear. By making insurance easier, more transparent and more trustworthy, we are helping to drive overall adoption and penetration rates. There is still work to be done to reach the type of acceptance we have seen in the U.K., but every pet we add to the Trupanion family is a step forward for the pet insurance industry and a step toward a future where cost isn\u2019t a barrier to care.\u201d<\/p>\n

Rumple later asked Trupanion: \u201cThe patent has been a common thread in the interviews I\u2019ve conducted. Many feel that Trupanion\u2019s patent stifles innovation and prevents the pet health insurance industry in the U.S. from advancing and attracting more pet owners. What is Trupanion\u2019s stance on that?\u201d<\/p>\n

Trupanion responded: \u201cWe think this is categorically not true. Trupanion\u2019s software benefits the entire pet industry by reinforcing the value of pet insurance and providing a product both customers and veterinarians can trust.<\/p>\n

\u201cWe can share that in markets where we see a higher adoption of our direct-pay software, we then see a higher adoption of pet insurance as a whole. For example, we have a market in Canada where penetration of our software exceeds 80%, and penetration is double that of Canada overall.<\/p>\n

\u201cWe also see higher penetration (and, in some cases, much higher penetration) in markets where direct payment was not, or still is not, an option. These markets benefited from the early introduction of high-quality products and veterinary support.<\/p>\n

\u201cThe broader pet insurance industry in North America has struggled due to poor legacy products and a breakdown of trust between pet parents and veterinarians. Even today, the industry remains vulnerable to other providers choosing to cancel policies without reason. Trupanion, meanwhile, continues to stand by pet parents \u2014 recently surpassing $3 billion in paid claims. By making pet insurance easier, more transparent and more trustworthy, we help drive overall adoption and penetration rates.\u201d<\/p>\n

\n

WHERE THE SUPPORT LIES<\/span><\/h3>\n

Pawlicy Advisor and the American Animal Hospital Association surveyed 536 veterinary professionals in 2025. Among the takeaways:<\/p>\n

    \n
  • 79% believe that when a client has the right pet insurance policy, the client, pet and veterinary team are better off.<\/li>\n
  • 87% say pet insurance helps clients say \u201cyes\u201d to more care and provides patients with the best possible care.<\/li>\n
  • 48% think pet insurance is \u201cimportant\u201d for their clinic and clients, while 22% believe it is \u201cvitally important\u201d \u2014 a game changer for their practice.<\/li>\n
  • 73% have difficulty talking to clients about pet insurance. About 1 in 5 aren\u2019t sure which company to recommend, and 15% said they don\u2019t have the time to discuss insurance.<\/li>\n<\/ul>\n
    \n

    PET INSURANCE AT A GLANCE<\/span><\/h3>\n

    About three dozen pet insurance brands operate in the United States. According to the North American Pet Health Insurance Association\u2019s 2025 State of the Industry Report:<\/p>\n

      \n
    • As of Dec. 31, 2024, 6.4 million U.S. pets were insured, a 12.7% year-over-year increase.<\/li>\n
    • U.S. gross written premiums in 2024 amounted to $4.74 billion, a year-over-year jump of 21.4%.<\/li>\n
    • The average accident and illness premium for a U.S. dog in 2024 was $749.29.<\/li>\n
    • The average accident and illness premium for a U.S. cat in 2024 was $386.47.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

      Solving five key issues could revitalize the decades-old U.<\/p>\n","protected":false},"author":23,"featured_media":77834,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":0,"footnotes":""},"categories":[529],"tags":[],"class_list":["post-77832","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-june-july-2025","column-features","clinical_topics-pet-insurance"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"\nReassessing How Pet Insurance Works (And How It Can Be Improved) | Today's Veterinary Business<\/title>\n<meta name=\"description\" content=\"After more than 40 years, why is the U.S. pet insurance industry still struggling to take off? 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