POLICY EXCLUSIONS & TERMS & CONDITIONS

1. PRODUCT OVERVIEW

This BetterPet Pet Insurance Policy provides financial protection against Vet expenses incurred for the treatment of your Pet as a result of injury, illness, or accident.

All limits reflect a combined accident and illness limit. Benefits are paid according to the Standard Rates and annual limits, less any Excess or levy shown on your Schedule of Insurance and Benefits.

2. REGULATORY & INTERMEDIARY DISCLOSURES

3. POLICY EXCLUSIONS

OMART Insure will not be obliged to make payment in respect of any condition or event arising directly or indirectly from or traceable to:

• Any Pre-existing condition, Excluded conditions, or Pandemic diseases.
• Claims arising from, or treatment rendered, outside the borders of South Africa.
• Elective Treatments and Procedures: Any treatments you choose to have carried out that are not directly related to a covered illness or injury. Cost of voluntary euthanasia, autopsy, disposal, cremation or burial of the Pet. Voluntary cosmetic procedures and surgeries such as tail docking, dewclaw removal, and skin fold resection.
• Claims arising from, or as a result of, any excluded condition, Pre-existing condition, or Pandemic Disease.
• Claims not received within sixty (60) days of treatment.
• Treatment of conditions or diseases relating to congenital or hereditary defects, or conditions directly caused by such defects.
• The cost of organ transplant surgery, artificial limbs, prosthetics, cruciate surgery implants, pacemakers, and any associated costs.
• For any one Condition, costs of medicines and injectable drugs will only be reimbursed for a maximum of 12 (twelve) consecutive months.
• Expenses related to prescription and special diets, pet food, nail clipping, grooming, and bathing.

4. WAITING PERIODS

From the commencement date of this policy, the following respective waiting periods apply.
*Note: Where a policy is reinstated, a new waiting period will start from the reinstatement date of cover.

5. PERSONAL INFORMATION

By accepting the terms and conditions, you consent to BetterPet receiving and storing your personal information. We will keep this data secure and confidential and will only share it with third parties to manage your policy better or if required to do so by law.

6. AGE LIMITS

Pets must be older than 8 weeks and younger than the limits below when taking out the policy. Your pet will continue to enjoy cover beyond these age limits, but pets cannot be newly insured if they exceed these limits at entry:

• Small dogs & cats: Must be under 9 years
• Medium size dogs: Must be under 9 years
• Large & giant size dogs: Must be under 9 years

7. DUTY TO DISCLOSE

We rely upon the information you and your Vet provide to us in order to decide whether to insure your Pet and under what terms. You are legally required to tell us about certain matters that enable us to make that decision.

To comply with your Duty of Disclosure, when first entering into an insurance contract with us (and whenever you renew, extend, reinstate, or change your Policy), you must tell us everything that a reasonable person under the circumstances could be expected to tell us regarding your Pet and relevant to our decision whether to insure (or continue to insure) your Pet and on what terms.

If we become aware of any relevant information which was not disclosed (intentionally or unintentionally), we reserve the right to apply underwriting restrictions or changes to your Policy retrospectively, including temporary exclusions, total exclusions, or cancellation of your Policy.

8. PREMIUMS & PAYMENT TERMS

The premium is payable in advance and must be paid on the selected due date.

If we do not receive your premium by the due date, there is a fifteen (15) day grace period following the due date. After a 15-day grace period, if no payment has been received, we will automatically deduct from the same account to ensure continuous cover.

If this premium is also not paid, you will have no cover for the period for which you did not pay, and any claim made after the grace period will not be valid. We will cancel your Policy, and the End Date will be the end of the month for which we last received premiums.

If this is a new Policy and we fail to collect the first premium, your Policy will automatically lapse, and no benefits will be payable.

9. CLAIMS PROCESS

Required documentation for claim submission:

• A completed claim form (unless completed via the digital claim journey).
• A detailed invoice on the Vet's official letterhead.
• Proof of payment (e.g., credit card slip, bank statement, or receipt from the Vet).

A copy of your Pet's Vet History is required at the time of joining. If it is not received, it will be requested when you submit your first claim for each Pet, which may cause processing delays. A vaccination card is not sufficient.

We deal directly with you regarding settlement of the claim. In the event of a valid claim, we reimburse you, not the Vet, within 14 working days upon receipt of all required documentation.

10. IMPORTANT POLICY INFORMATION

• • Claims are processed based on the overall annual maximum limit selected, subject to specific category treatment limits outlined in your policy schedule.
• • If anyone completes or submits any transaction requirement on your behalf, you must satisfy yourself of the accuracy and completeness of the information provided.
• • You have the right to request a copy of any transaction requirement submitted, as well as recordings of telephonic disclosures (if available).
• • You have a 14-day cooling-off period (for policies with a term longer than 31 days). You must email us to exercise this right.
• • You are entitled to a 15-day grace period upon taking up this insurance product.

11. CONTACT & COMPLAINTS PROCEDURES