§ 27-83-4. Policy conditions. [Effective January 1, 2026.]
(a) A pet insurer may issue policies that exclude coverage on the basis of one or more
preexisting conditions with appropriate disclosure to the consumer. The pet insurer
has the burden of proving that the preexisting condition exclusion applies to the
condition for which a claim is being made.
(b) A pet insurer may issue policies that impose waiting periods upon effectuation of
the policy that do not exceed thirty (30) days for illnesses or orthopedic conditions
not resulting from an accident. Waiting periods for accidents are prohibited; provided,
however, an insurer shall issue coverage to be effective at 12:01 a.m. on the second
calendar day after the purchase, subject only to the following exceptions:
(1) If an insurer elects to conduct individualized underwriting on a specific pet, then
coverage shall be effective by 12:01 a.m. on the second calendar day after the insurer
has determined such pet is eligible for coverage;
(2) An insurer may delay coverage from becoming effective to establish a method for the
consumer or group administrator to pay the premium;
(3) For pet insurance coverage acquired by an individual through an employer or organization,
the coverage effective date of such pet insurance may be delayed to align with the
eligibility and effective date requirements of the employer's organization's benefit
plan; or
(4) If a policy does not include a waiting period for an illness or orthopedic condition,
an insurer may set a policy effectuation date that is up to fifteen (15) calendar
days after purchase, as long as such policy effectuation date is clearly disclosed
and no premium is earned before the policy becomes effective.
(c)(1) A pet insurer utilizing a waiting period permitted in subsection (b) of this section
shall include a provision in its contract that allows the waiting periods to be waived
upon completion of a medical examination. Pet insurers may require the examination
to be conducted by a licensed veterinarian after the purchase of the policy.
(i) A medical examination under this subsection shall be paid for by the policyholder,
unless the policy specifies that the pet insurer will pay for the examination.
(ii) A pet insurer can specify elements to be included as part of the examination and require
documentation thereof; provided that, the specifications do not unreasonably restrict
a consumer's ability to waive the waiting periods in subsection (b) of this section.
(2) Waiting periods, and the requirements applicable to them, shall be clearly and prominently
disclosed to consumers prior to the policy purchase.
(3) If a policy does not include a waiting period for an illness or orthopedic condition,
an insurer may set a policy effectuation date that is up to fifteen (15) days after
purchase, as long as such policy effectuation date is clearly disclosed and no premium
is earned before the policy becomes effective.
(d) A pet insurer shall not require a veterinary examination of the covered pet for the
insured to have their policy renewed.
(e) If a pet insurer includes any prescriptive, wellness, or non-insurance benefits in
the policy form, then it is made part of the policy contract and shall follow all
applicable laws and regulations in the insurance code.
(f) An insured's eligibility to purchase a pet insurance policy shall not be based on
participation, or lack of participation, in a separate wellness program.