When your pet needs treatment, the last thing most owners expect is to find themselves arguing with an insurance company about something buried in an old veterinary record.

Yet one of the most common sources of pet-insurance disputes arises when an insurer refuses to pay because it says the illness or injury being treated is a pre-existing condition — or is connected to something that happened before the policy started.

That decision can be particularly difficult to understand when the pet had never been diagnosed with the condition before, appeared healthy when the insurance was purchased, or the earlier veterinary history seems only loosely connected with the problem now being treated.

The Financial Ombudsman Service recorded 2,065 pet-insurance complaints in 2025/26, with a reported 41% uphold rate for that product category.^[1]

Those complaints cover several different issues, but the figures demonstrate that disagreements about pet insurance are far from unusual.

The more useful question is not simply whether the insurer has found something in the veterinary history which predates the policy.

It is whether the earlier problem is genuinely the same as, related to, or causative of the condition now being claimed for — and what the owner reasonably knew when the policy was taken out.

Why pet insurers look through veterinary records

Pet insurance is generally intended to provide cover for unforeseen illness or injury, subject to the terms and exclusions of the individual policy.

Most pet-insurance policies therefore restrict or exclude conditions which already existed before cover began, or conditions which first appeared during an initial waiting period.

That principle is understandable. The difficulty often lies in deciding what actually counts as pre-existing.

Animals can visit a vet with symptoms which are temporary, vague or unrelated to a later diagnosis.

A dog might once have been lame. A cat may have suffered vomiting. A vet may have recorded stiffness, itching, an ear infection, weight change or a minor lump.

Years later, a different diagnosis may be made.

When a substantial claim is then submitted, the insurer may obtain the full clinical history and argue that the current problem can be traced back to the earlier entry.

Sometimes that connection will be medically justified.

Sometimes it deserves much closer examination.

A previous symptom is not necessarily the same as a previous diagnosis

This is one of the most important distinctions in a disputed pet-insurance claim.

Suppose a dog was taken to a vet two years before the insurance policy began because it was temporarily limping.

No significant diagnosis was made. The dog recovered. There was no continuing treatment.

Two years after the policy begins, the dog develops a serious orthopaedic problem requiring surgery.

If the insurer finds the historic reference to lameness, it may investigate whether that earlier episode was the first sign of the condition now requiring treatment.

But the existence of an old symptom does not automatically answer the question.

The Financial Ombudsman Service says that, where an insurer relies on a pre-existing condition, two of the central issues it considers are whether the current condition is the same as or related to the earlier problem and what the customer knew about it.^[2]

Where signs existed before the policy but the later condition was not diagnosed until afterwards, the insurer may need to show that the two are the same, related or have the same underlying cause.^[2]

What did you actually know when you bought the policy?

There is another important distinction between what can retrospectively be found in a clinical record and what the owner reasonably understood at the time.

Imagine a vet examined a lump and reassured the owner that it was nothing to worry about.

Years later, another lump develops and is diagnosed as something more serious.

With hindsight, an insurer might identify similarities between the two episodes.

But that does not necessarily mean the owner knew when the policy was purchased that their pet had the condition later diagnosed.

The Ombudsman says it considers what the customer knew or should reasonably have known when taking out the policy, alongside the medical history and the policy wording.^[3]

What does the policy actually define as a pre-existing condition?

Do not stop at the phrase “pre-existing condition”.

Read the definition in the policy.

Pet-insurance wording can contain separate definitions for:

• condition;
• clinical signs;
• illness;
• injury;
• symptoms;
• treatment;
• related conditions;
• bilateral conditions; and
• pre-existing conditions.

Those definitions can make a substantial difference to the outcome.

The Ombudsman notes that most pet policies do not cover pre-existing conditions or a condition which appears during an initial period after the policy begins, often around 14 days, although the actual wording of the policy is what matters.^[2]

An insurer's explanation should therefore be capable of answering more than:

Ask the insurer to identify the connection

A useful starting point is to ask the insurer to set out its reasoning clearly.

The veterinary notes can be more important than the rejection letter

Pet-insurance disputes are frequently evidence disputes.

An insurer considering a substantial claim may review several years of clinical notes.

You should obtain those records yourself and look at what was actually recorded at the earlier appointment.

• Was there a diagnosis?
• Was treatment prescribed?
• Was further investigation recommended?
• Did the symptoms resolve?
• Was the animal examined again without abnormal findings?
• How much time passed before the current condition appeared?
• Does the treating vet believe the two episodes are medically connected?

The Ombudsman says that it considers medical evidence from vets, including clinical notes and written submissions, when assessing pet-insurance complaints.^[3]

That can make a properly explained veterinary opinion considerably more useful than simply arguing that the insurer is wrong.

Related and bilateral conditions can become particularly contentious

Another recurring dispute involves conditions affecting both sides of an animal's body.

A dog might develop a problem with one knee and later suffer a similar problem in the other knee.

The insurer may argue that this is a bilateral condition and treat both events as part of the same underlying condition.

That can affect whether the second claim is covered, particularly under a time-limited policy or where the first problem existed before the present policy started.

The Ombudsman says it will consider the available evidence, including the vet's opinion and the animal's medical history, when deciding whether the two events are directly connected. It may also consider how much time passed and what the customer was told at the time.^[2]

Again, chronology and veterinary evidence matter.

What if the insurer adds an exclusion after seeing the veterinary history?

Sometimes the dispute goes further than a single claim.

An insurer may obtain the medical history after cover has begun and decide that an exclusion should have applied from the start.

That can raise questions about what the owner was actually asked when the policy was purchased.

Under the Consumer Insurance (Disclosure and Representations) Act 2012, a consumer has a duty to take reasonable care not to make a misrepresentation. Whether reasonable care was taken can depend on matters including how clear and specific the insurer's questions were.^[4]

The Act also provides that an insurer has a remedy for a qualifying misrepresentation only where the relevant statutory requirements are met, including the insurer showing that it would not have entered the contract at all, or would have done so on different terms, without the misrepresentation.^[4]

If an insurer says the policy should retrospectively contain an exclusion, obtain the application questions and answers as well as the veterinary history.

“The vet mentioned it before” is not always enough

This is where pet-insurance decisions can become overly simplistic.

Imagine an old clinical note says:

That entry might become relevant if a later claim concerns a serious joint condition.

But it still leaves questions.

• Was the animal examined?
• What did the vet find?
• Was a diagnosis made?
• Was the symptom transient?
• Did it resolve without treatment?
• Was there a long symptom-free period afterwards?
• Does the treating vet consider the episodes medically related?
• Could the owner reasonably have understood that the later condition already existed?

A single line in a veterinary history needs to be read in context.

The important question is not simply whether an historic entry exists.

It is what that entry proves.

Pet-insurance disputes can involve substantial veterinary bills

Pet-insurance disputes are not necessarily arguments over minor sums.

ABI members paid a record £1.23 billion in pet-insurance claims during 2024, following around 1.8 million notified claims.^[5]

Individual veterinary treatment can run into thousands of pounds, leaving an owner facing a significant unexpected bill while also dealing with a sick or injured animal.

That is precisely when it can be tempting to accept an insurer's explanation without examining it.

Before doing so, understand whether the rejection actually stands up.

Seven things to check after a pet-insurance claim is rejected

1. The full policy wording. Look particularly at the definitions of pre-existing, related and bilateral conditions.
2. The rejection letter. Identify exactly which clause the insurer says applies.
3. The complete veterinary history. Do not rely only on the extracts selected by the insurer.
4. The current diagnosis. What condition is actually being treated now?
5. The earlier symptom or condition. What exactly does the insurer say pre-dates the policy?
6. Your vet's view. Does the treating vet consider the earlier and current problems to be medically connected?
7. The application questions and answers. What were you actually asked when the insurance was purchased?

Do not assume the insurer's interpretation is necessarily the only possible interpretation.

Equally, do not assume every rejection is wrong.

The purpose of reviewing the evidence is to establish which it is.

What if the insurer says you failed to disclose the condition?

Ask for the proposal, online application or other record of the questions you answered when cover was arranged.

What exactly were you asked?

What did you answer?

What did you actually know at that point?

The FCA's claims-handling rules require insurers to handle claims promptly and fairly and not unreasonably reject a claim. The rules also address when an insurer can rely on a qualifying consumer misrepresentation.^[6]

A historic clinical note is therefore not automatically the same thing as proving that the owner made a qualifying misrepresentation.

What should you do before escalating the dispute?

Do not begin with the destination.

Begin with the claim.

A well-prepared challenge should identify the policy wording, the insurer's reasoning, the relevant veterinary history and the medical evidence concerning whether the conditions are genuinely connected.

Only then does it make sense to decide how the dispute should be pursued.

That may involve further representations to the insurer, additional veterinary evidence, a formal complaint, the Financial Ombudsman Service where appropriate, or another route depending on the circumstances.

Insurance Dispute Service can review the rejection

If your pet-insurance claim has been rejected because the insurer says the treatment relates to a pre-existing, related or bilateral condition, Insurance Dispute Service can review the position.

We can examine the insurer's decision against the policy wording, veterinary records and the evidence being relied upon.

In particular, we can look at:

• what the insurer says was pre-existing;
• what the veterinary records actually show;
• whether the old and current conditions appear to be the same or related;
• what you reasonably knew when the cover was arranged;
• what questions you were asked when taking out the policy;
• whether the exclusion has been applied in accordance with the policy wording; and
• what realistic options are available if the insurer maintains its position.

Frequently asked questions

Sources and further reading

1. Financial Ombudsman Service — Annual complaints data and insight 2025/26
2. Financial Ombudsman Service — Pet insurance: guidance for businesses
3. Financial Ombudsman Service — Pet insurance: consumer guidance
4. Consumer Insurance (Disclosure and Representations) Act 2012
5. Association of British Insurers — Pet insurance claims data for 2024
6. FCA Handbook — ICOBS 8.1: Insurers — general claims handling

This article provides general information about pet-insurance disputes and does not constitute legal advice, veterinary advice or a prediction of claim success. The appropriate position depends on the individual policy wording, veterinary evidence, application information and circumstances of the claim.