Last updated: September 2026
Quick answer: If your pet insurance claim is rejected, ask the insurer for the reason in writing, check it against your policy wording and your pet’s vet notes, and make a formal complaint if you disagree. The insurer has eight weeks to send a final response. If you’re still unhappy, or it doesn’t respond in time, you can take the complaint to the Financial Ombudsman Service for free, usually within six months of the final response. The Ombudsman regularly overturns decisions where the vet evidence doesn’t support the insurer’s reasons.
A rejected claim can leave you facing a large vet bill. This guide explains why claims are turned down, how to check whether the decision is right and how to challenge it.
The most common reasons claims are rejected
| Reason | What it means | Can you challenge it? |
|---|---|---|
| Pre-existing condition | The insurer says signs appeared before cover started | Often, if the vet notes are vague or the new problem is unrelated |
| Not covered by the policy | For example routine care, dental work or an excluded condition | Rarely, unless the wording is unclear |
| Waiting period | Signs first appeared in the first days of the policy | Sometimes, if the timing in the notes is wrong |
| Limit reached | The time or cash limit for that condition has run out | Rarely; this is how time-limited and maximum benefit policies work |
| Bilateral condition | The insurer links a problem in one leg or eye to an earlier one on the other side | Often, if the two problems aren’t clinically connected |
| Non-disclosure | Information given when you bought the policy was wrong or incomplete | Depends on whether the missing information mattered |
ManyPets lists claiming for something the policy doesn’t cover and claiming outside the policy’s time or vet fee limit among the most common reasons for refusal. That’s why the type of policy matters so much; see lifetime vs time-limited vs maximum benefit cover.
Step 1: Find out exactly why
Ask the insurer to explain the decision in writing, quoting:
- The policy clause it is relying on.
- The vet notes or dates it used, for example a consultation where a symptom was recorded.
You’re entitled to a clear explanation. A vague answer such as “pre-existing” is not enough on its own.
Step 2: Check the evidence yourself
- Get your pet’s full clinical history from your vet practice.
- Compare it with the insurer’s reasons. Does the note really describe the same condition? Is the date before cover started or inside the waiting period?
- Read the policy wording, especially the definitions of “pre-existing condition”, “bilateral condition” and the exclusions.
- Ask your vet for a written opinion if you think the insurer has linked two unrelated problems. A vet’s letter explaining that a new condition has a different cause is often the strongest evidence you can provide.
Our guide to pre-existing conditions explains how insurers use vet notes.
Step 3: Make a formal complaint
Write to the insurer’s complaints team. Include:
- Your policy number, your pet’s name and the claim reference.
- Why you think the decision is wrong, point by point.
- The evidence: vet notes, your vet’s letter, relevant policy wording.
- The outcome you want, such as payment of the claim in full.
The insurer then has up to eight weeks to send its final response.
Step 4: Go to the Financial Ombudsman Service
If you’re not happy with the final response, or eight weeks have passed without one, you can refer the complaint to the Financial Ombudsman Service. It is free, and you should normally do it within six months of the insurer’s final response.
The Ombudsman looks at whether the insurer acted fairly, not only at the strict policy wording. Two published decisions show how this works:
- Bilateral cruciate disease. An insurer refused a claim for a dog’s right knee because the left knee had been treated for the same disease about 18 months earlier. The Ombudsman’s investigator upheld the owner’s complaint.
- Linking unrelated problems. In another case, the ombudsman said treating a later problem in a different leg as the same condition would only be fair if the underlying issue was the same, not if it had an independent cause such as an injury.
Our guides to cruciate ligament surgery costs and luxating patella surgery costs cover these cases in more detail.
How to avoid a rejected claim
- Insure early, before any symptoms appear in the vet notes.
- Declare everything when you buy.
- Read the exclusions and limits before you buy, not after your pet falls ill.
- Get pre-approval for planned treatment by sending the vet’s estimate to your insurer first.
- Keep cover continuous. Don’t let a policy lapse, and think carefully before switching; see switching pet insurance.
If you still have to pay the bill
If you can’t cover the bill while the complaint is ongoing, talk to your practice about a payment plan. See what happens if you can’t pay the vet.
Frequently asked questions
How long does the insurer have to respond to a complaint?
Up to eight weeks to send a final response.
Does it cost anything to use the Financial Ombudsman?
No. It is free for consumers.
Can I complain if my claim was only partly paid?
Yes. The same process applies if you think the insurer paid too little, for example by applying the wrong excess or limit. See excess and co-payment explained.
Will complaining affect my policy?
Making a complaint should not affect how your insurer treats your policy.
Can my vet help?
Yes. A letter from your vet explaining the clinical history is often the most important piece of evidence.
Key takeaways
- Always get the reason for a rejection in writing, with the clause and vet notes it relies on.
- Check the vet notes and policy wording yourself, and ask your vet for a written opinion.
- Complain formally; the insurer has eight weeks to give a final response.
- The Financial Ombudsman Service is free and regularly overturns decisions the evidence doesn’t support.
New to the basics? Start with how pet insurance works.
This guide is general information, not legal or financial advice.