A Vet's Review of Figo Pet Insurance
2024

• To get exam fee coverage, you must remember to purchase the add on
• Figo's Bilateral conditions exclusion policy is not clear at the time of this writing
• According to their sample policy: "If a Pet had Undiagnosed masses prior to the end of the Waiting Period, any mass, or condition where a mass is a Clinical Sign, is not covered, including those caused by cancer. If the cause of the mass that occurred prior to the end of the Waiting Period can be diagnostically narrowed down via cytology, unrelated conditions may be covered"
  
  Potential buyers of this policy need to understand that if their pet has a mass (tumor) anywhere in/on the body that is pre-existing or appears during the waiting period, they will need to get a diagnosis of that mass (paid for out of their own pocket) in order for unrelated tumors to possibly be covered after the waiting period. This information was deep within the sample policy. Also, not all masses can be diagnosed with cytology alone. Sometimes histopathology is needed which may be more expensive.
• 6 months waiting period for orthopedic conditions. According their sample policy, this waiting period for orthopedic conditions may apply only to dogs. (Contact Figo to confirm) (May vary by state)
  
  While the orthopedic waiting period can be waived with a healthy orthopedic exam completed within the first 30 days of policy period, please note that a Vet may want additional diagnostics (e.g. x-rays, ultrasound, etc) before they will feel comfortable certifying this. The cost of this will be out of your own pocket.
• Dental coverage for accidents and illness is limited

• Strong underwriter
• Has an unlimited maximum annual payout option
• You may visit any licensed veterinarian in the world.
• You can request a medical review to get an idea of what your pet's pre-existing exclusions will be (Only available with policies that have been active for at least 30 days). (See Concerns Below)
• Provides comprehensive coverage in the 5 important areas as part of the base plan:
  1. Chronic disease
  2. Continual coverage for chronic disease
  3. Hereditary/congenital conditions
  4. Cancer
  5. Breed specific conditions

• According to their sample policy: "If a Pet had Undiagnosed masses prior to the end of the Waiting Period, any mass, or condition where a mass is a Clinical Sign, is not covered, including those caused by cancer. If the cause of the mass that occurred prior to the end of the Waiting Period can be diagnostically narrowed down via cytology, unrelated conditions may be covered"
  
  Potential buyers of this policy need to understand that if their pet has a mass (tumor) anywhere in/on the body that is pre-existing or appears during the waiting period, they will need to get a diagnosis of that mass (paid for out of their own pocket) in order for unrelated tumors to possibly be covered after the waiting period. This information was deep within the sample policy. Also, not all masses can be diagnosed with cytology alone. Sometimes histopathology is needed which may be more expensive
  
  Masses are very common in veterinary medicine. If a potential buyer misses this information and/or can't afford to get a diagnosis, they may end up with a policy that doesn't cover any malignant or non-malignant masses (tumors) after the waiting period.
• In Figo's sample policy it states, "...we may only cancel for one or more of the following reasons:...c. We have agreed to issue a new policy with the same or an affiliated company."
  
  Contact the company for clarity on what this means and whether your terms, conditions, and rates will stay the same as your original policy if they institute this reason for canceling your policy.
• While they define what Bilateral Conditions are, it is not clear if any body systems will become pre-existing Bilateral Condition exclusions.
• Based on their pre-existing conditions policy, signs and symptoms can be used to denote something as pre-existing. As with all pet insurance companies that use this wording, I have concerns that this can be used to deny claims even when these previous signs/symptoms are not directly related to the disease or condition currently in question.
• Reimbursements are calculated by applying your reimbursement percentage first, then your deductible. This can lead to being reimbursed less than companies that subtract the deductible BEFORE applying the reimbursement percentage.
• You can request a medical review to get an idea of what your pet's pre-existing exclusions will be, but it is only available with policies that have been active for at least 30 days. It appears to only be available after the money back guarantee has expired.

• Make sure you research what customers are saying about the company. A company may have the 5 components that should be part of a pet insurance plan, but the company may not be a hit with customers. Sites to check include but are not limited to BBB.org, Yelp.com and PetInsuranceReview.com. Things to look for include but are not limited to: How fast are payments paid?, What are customers saying about the pre-existing conditions policy?, How often are claims denied and for what reason?, What is the customer service experience like?, Are there issues with premium increases?
• Check with your state's Department of Insurance to see if any complaints have been filed for the company you are interested in.
• Make sure you understand what the waiting periods are.
• Make sure you understand their bilateral conditions policy.
• Make sure you understand any requirements that you must adhere to to maintain coverage.
• Make sure you read the terms and conditions to get a thorough understanding of all exclusions.
• Make sure you understand when and by how much your premium can increase.
• If you change plan levels, there is a possibility that all medical conditions present under the old plan will be considered pre-existing in the new plan. Make sure you ask the company if this is the case.
• For some companies, pre-existing conditions can be based on signs and symptoms alone, a diagnosis is not needed. For example, if your pet had a cough before you applied for pet insurance and this cough was discussed and written in the pet's medical record, there is the possibility that all future cough conditions, no matter what the cause, would be considered pre-existing - even if there was no treatment given. Make sure you ask the company if this is the case.
• Pet insurance companies are businesses. The top priority of any business is to make a profit for their stakeholders. Pet insurance companies can and may change your rates and terms to meet that top priority. A change of business ownership or underwriters can also be a catalyst for changes in your rates and terms.
  
  When you purchase pet insurance make sure you have a realistic understanding of this and how it can affect you.

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