A Vet's Review of Toto Pet Insurance
2024

• 180 day waiting period for Cruciate Ligament related conditions and Intervertebral Disc Disease. It is unclear whether or not this waiting period applies to all orthopedic conditions.
• 30 day waiting period for Alternative Therapy and Behavioral Conditions. May vary by state.
• The waiting period for Hereditary and Congenital Conditions is unclear.
• Whether or not an add-on is required for Hereditary and Congenital coverage is unclear.
• Dental coverage for accidents and illnesses is limited.

• Strong underwriter
• Coverage when travel out of state, to US territories and possessions and to Canada
• In some states. some pre-existing conditions may be deemed curable (and therefore will be covered) if there has been no symptoms or treatments for 365 days.
• Provides continual coverage for chronic diseases

• If a bilateral condition happens on one side before they policy starts or during the waiting period, that condition will not be covered if it happens on the other side. Even if it happens after the waiting period. Their Bilateral Conditions policy doesn't clearly list the medical conditions that fall under this exclusion.
  
  There are so many body systems that inhabit both sides of the body (e.g. eyes, ears, knees, hips, front paws, elbows, toenails, kidneys, lungs, femur, etc). Not clearly defining which systems they are referring to leaves a big door open that could allow them to deem something as a bilateral exclusion whenever they see fit.
  
  Letting customers know what specific conditions and/or systems fall under this exclusion would be much more transparent. Even if they want the definition to include all body systems that inhabit both sides of the body, it is important that they clearly let the customer know this.
• Based on their pre-existing conditions policy, 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 symptoms are not directly related to the disease or condition currently in question.
• Information about coverage and waiting periods is confusing. For example, at the time of this writing, the home page states there is a 365 day waiting period for hereditary conditions, but it states 30 days in sample policy and in FAQ section of the website. The home page also states a 180 day waiting period for all orthopedic issues, whereas the sample policy & FAQ section of the website states 180 days for cruciate and IVDD only. Make sure you contact Toto about these and other discrepancies before buying.

• 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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