How Claims Are Calculated

The way we calculate your claim reimbursement is defined in your policy. The steps below summarize how your claim is processed, and you can always review the exact policy language by visiting our Sample Policies page.

Step 1: Start With the Invoice
We begin with the total amount listed on your veterinarian’s invoice for covered services.

Step 2: Apply Coinsurance
Coinsurance is the portion of each covered invoice that you are responsible for.
For example, with 10% coinsurance, you pay 10% and we cover 90%.

Your coinsurance amount is subtracted first, before the deductible.

Step 3: Apply the Deductible
Your remaining deductible is applied after coinsurance.

Your deductible only needs to be met once per annual policy term.

If any deductible remains for the year, we subtract it from the amount left after coinsurance.

Step 4: Calculate Your Reimbursement
The remaining amount—after coinsurance and any remaining deductible—is your reimbursement for that claim.
These steps reflect the official calculation process as outlined in your policy. For full details, you may review the policy forms available on our Sample Policies page.

1. Invoice Amount: $1,000

2. Apply Coinsurance First: 10% of $1,000 = $100 (your coinsurance)
 Remaining after coinsurance = $900

3. Apply Deductible Next: Annual deductible remaining: $500
 $900 − $500 = $400

4. Reimbursement to You: We reimburse you $400.

Once your deductible has been met for the policy year, future eligible claims will only have your coinsurance applied. No additional deductible is taken until the next annual term.