Thanks for your interest in Toto Pet Health Insurance! Here you’ll find a variety of pet insurance FAQs so you can get answers to your questions about coverage, billing, claims, and more. If you don’t see the pet insurance FAQs that you’re looking for, please don’t hesitate to reach out to us. We’d be happy to help.
- What is pet insurance?
Just like humans, pets can get injured and sick without warning. The good news is that huge strides have been made in veterinary medicine, allowing our pets to often receive the same high level of care as their human companions. But those advancements have also brought higher costs, and like human medical, the need for health insurance. When your pet is covered, you’ll never have to worry about choosing between paying your rent/mortgage and giving the best medical care to the pet member of the family.
- How much does pet insurance cost?
Premiums vary depending on several factors: species, breed, age of your pet and the zip code in which you live. Toto presents you with the flexibility to choose the deductible, reimbursement percentage, coverage limits, and specific features you want to include in your coverage. We make available flexible accident and illness plan selections that you can customize to fit your monthly budget. With just a few clicks, you can get a quote.
- Who is my insurance company?
The policy is issued and underwritten by Independence American Insurance Company. Independence American Insurance Company (IAIC) is licensed to write property and/or casualty insurance in all 50 states and the District of Columbia. IAIC is rated A- (Excellent) for financial strength by A.M. Best, a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet policyholder obligations (an A++ rating from A.M. Best is its highest rating). Our insurance policy is an agreement between you and IAIC, please see your policy for all terms and conditions.
- Can I still go to my current veterinarian?
Yes! You may use any licensed veterinarian in the United States or Canada. This includes emergency and specialty veterinarians, should the need arise.
- Can I get a refund if I am not satisfied with my coverage?
Toto wants you to be completely satisfied and the plans available include a Right to Return policy. You may get 100% premium refund in the first 30 days if not satisfied, as long as no claims have been submitted. Applies to newly issued policies only. This is not available in all states.
- Does Toto offer any discounts?
Yes, Toto offers a Multi-Pet Discount—when you insure two or more pets, you can enjoy a 5% discount for each pet insured.
- Who is eligible for coverage?
Plans are available for dogs and cats of any age that reside within the US. Accident & Illness coverage is available to all dogs and cats under the age of 9 years; and an Accident Only plan is available for all dogs and cats 9 years and older. All breeds of dogs and cats are eligible for coverage.
- Are senior pets eligible for coverage?
Yes, senior pets—ages 9 and older—can enroll in an Accident Only plan. This plan also provides the option to add on Wellness coverage and Exam Fee coverage.
- What are the waiting periods?
A waiting period is the number of days specified in the policy that must pass before coverage begins. These are the coverage waiting periods (per pet): There is a 2-day waiting period for accidents and injuries and a 14-day waiting period for illnesses—except for IVDD (Intervertebral Disc Disease) including slipped or herniated discs secondary to IVDD and cruciate ligament conditions (ex. ACL), where there is a 180-day waiting period for coverage. We will cover a pre-existing condition following a 365-day waiting period.
Waiting Periods are waived for subsequent renewals and add-on coverage from a preceding policy year provided the policy remains active—with no gap in coverage, annually renewed and continuously in-force.
As an example, let’s say you purchase a policy through Toto on June 20, your effective date is June 21. If your dog or cat suffers an injury on June 23 (2 days later), your pet would be eligible for coverage because the waiting period for injuries and accidents has been met. The waiting period applies only to the first year of your policy, or if you decide to increase your coverage, like upgrading your plan at renewal for example. Waiting periods don’t apply to your annual renewal as long as there are no gaps in coverage.
If your pet was previously covered under an Independence American Insurance Company group pet insurance policy that was in effect immediately before the effective date (no gap in coverage) of this policy, credit toward satisfying waiting periods will be applied for the period of time the pet was covered under the prior group pet insurance policy. Submission of the prior policy declarations page and/or the verification of premiums paid through payroll deduction may be required.
- What are pre-existing conditions?
Pre-existing conditions are illnesses or injuries, that occurred or existed before the policy effective date and during specific waiting periods. Pre-existing conditions are typically excluded by all pet insurance companies.
An annual policy renewal will not cause an approved condition to be considered pre-existing, unless there has been a gap in coverage.
- What are deductible and reimbursement percentages?
Pet insurance works very similarly to human health insurance where you and your policy share in the costs of covered services. Toto allows you to select your deductible—the amount you will pay toward the healthcare of your pet per policy year. Toto also allows you to select the reimbursement percentage—the amount the policy reimburses you for the cost of care once your deductible has been met.
- Is there a lifetime maximum?
No, there is only an annual policy maximum, which you are able to choose when you customize your plan or at the time of renewal.
- Is my pet covered while we are traveling?
Yes. As long as you are traveling within the US or Canada, your pet is covered.
- Can I change my coverage later?
Yes. You can either add or subtract coverage at any time, subject to underwriting approval. Coverage changes include annual limit, deductible, reimbursement percentage and all optional benefits, except for wellness which can be added or subtracted at renewal.
- What is Exam Fee coverage?
The cost of exam and office visit fees for your sick or injured pet. You can claim this coverage at your regular veterinarian, specialty clinic, emergency rooms, veterinarian universities and even telemedicine. This does not cover wellness visits. This coverage is included in all plans made available through Toto Pet Insurance™.
- What is Wellness coverage?
Just as with people, regular health checkups become increasingly important as your pet grows older. We offer one comprehensive wellness plan to suit you and your pet’s needs. Reimbursement is not subject to deductibles or coinsurance. Wellness exams include vaccinations, flea/tick meds, teeth cleaning, spay/neuter, and more!
- What is Alternative, Behavioral and Holistic coverage?
Coverage for alternative, holistic and behavioral care including chiropractic treatment, acupuncture, herbal supplements and vitamins. This coverage is included in all plans made available through Toto Pet Insurance™.
- What are Inherited and Congenital conditions?
Congenital condition refers to an illness, disease or condition that was present at or before birth. Inherited condition refers to the presence of an illness or condition that is determined by genetic factors. Some examples are heart disease, hip dysplasia, elbow dysplasia, diabetes, arthritis, and luxating patella. Widely accepted veterinarian research and studies on genetics are used to determine those conditions considered hereditary or congenital. A 30-day waiting period applies to inherited and congenital coverage.
- What is Final Respects coverage?
End of life care including burial, cremation, necropsy (autopsy) and urns are covered up to a maximum benefit of $300. There are no waiting periods and reimbursement is not subject to deductible or coinsurance. Euthanasia, when advised by a veterinarian to alleviate suffering, is covered in the base policy.
- Can I review a sample policy?
Yes! Our sample policies for both Accident and Illness coverage and Accident Only coverage are available here for review.
Claims & Reimbursement Questions
- How is my claim reimbursement calculated?
With a policy from Toto, the deductible is applied to your veterinary bill first, then your chosen reimbursement % is applied to the balance. This should seem familiar as it is how it works in human medical insurance. However, beware of companies that first calculate the reimbursement % and then subtract your deductible—that method saves them money. (We call that a Gotcha! With Toto, we believe you should enjoy insurance without the sting of a Gotcha!)
- How do I file a claim?
Filing a claim is quick and easy. Log on to your Customer Portal and there you can upload your vet’s invoice, a photo of the invoice or, if you prefer. Simply download and complete our claim form. Send us the completed claim form along with the invoice from your veterinarian, and we will take care of the rest. For more detailed instructions, see File Pet Insurance Claims.
- Should I file a claim if my bill was less than my deductible?
Yes. This amount applies towards fulfilling your annual deductible. If another covered incident occurs later in the year, you have less of a deductible to meet.
- How long do I have to file a claim?
We understand that dealing with a sick or injured pet can be stressful, and we want you to be able to focus on caring for your pet during that time. For this reason, we request that you submit your claim within 180 days of the treatment date.
- How do I get paid once my claim has been approved?
Claims are reimbursed by ACH deposit to your bank account (quickest method) or via a paper check. You can set your preference in your Customer Portal. If selecting paper check, please make sure your mailing address is up to date to ensure a speedy return.
- How long will it take for my claim to be processed?
Claims are typically processed within 3-4 business days after we have received all of the necessary medical information from your veterinarian.
- Who is my claims administrator?
PetPartners, Inc. is the claims administrator.
Claims can be physically mailed to:
Pet Partners, Inc.
PO Box 37940
Raleigh, NC 27627
- What payment methods are available?
We accept payment by all major credit cards, electronic check, or paper check. Paper checks are only accepted for policies paid annually in full. Paying annually could help you save more money. Payments are set to automatically charge the credit card we have on file unless we hear from you. Please call our Toto Specialists at (888) 868-6738 to update your billing information.
- How do I update my payment or personal/address information?
To update your payment or personal/address information, please call our Toto Specialists at (888) 868-6738.
- How do I cancel my policy?
You can cancel your policy at any time by calling our Toto Specialists at (888) 868-6738, or by email us at firstname.lastname@example.org.
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