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Methodology

How PawClaim works and how we verify what we publish.

Every statistic, insurer data point, and coverage rule on this site is sourced from a primary document. We do not publish what we cannot substantiate.

Our core principle

PawClaim exists to give pet owners information that insurers have but do not share. For that to be useful, it has to be accurate. We apply one test to everything we publish: can we point to a primary source? If not, we do not publish it.

What this means in practice: When we say Healthy Paws excludes hip dysplasia for pets enrolled at age 6 or older, we have the policy document. When we say 1 in 3 claims are denied, we have the NAIC data. When we estimate vet costs, we cite the source. If something on this site does not have a source, tell us at hello@pawclaim.com and we will either add one or remove the claim.

Industry statistics

StatisticSourceNotes
1 in 3 pet insurance claims initially deniedNAIC 2023 Pet Insurance ReportBased on complaint ratio and loss ratio data across major US pet insurers
5.7 million pets insured in the USNAIC 2023 Pet Insurance ReportTotal policies in force, end of 2023
$4.2 billion in premiums collectedNAIC 2023 Pet Insurance ReportTotal direct premiums written, US market
60% rise in vet costs over the past decadeBLS Consumer Price Index, Veterinary ServicesCPI series CUSR0000SERA02, 2014-2024
91% of pet owners experience financial stress from vet billsAVMA Pet Ownership and Demographics Sourcebook 2023Survey-based, self-reported financial stress
NAIC 2023 Pet Insurance ReportBLS CPI DataAVMA 2023 Sourcebook

Insurer data — waiting periods and coverage rules

📄 Primary source: published policy documents

Every waiting period, age restriction, bilateral exclusion rule, and coverage definition in our pre-enrollment database is sourced from published policy documents. These are the sample policy PDFs that insurers are required to make available, plus state-specific endorsements filed with state insurance departments.

We review these documents when we build each insurer profile and update them when policies change. If an insurer changes a waiting period or coverage rule, our database reflects the change after the next review cycle.

State Insurance Department Filings

⚠ Limitation: policies vary by state

Pet insurance policies are regulated at the state level. Waiting periods, coverage exclusions, and even available plan options can differ between states. Our database reflects the most common policy terms; state-specific variations may not always be captured. Always confirm coverage details with your insurer before enrolling.

Pre-enrollment scan — how it works

🤖 AI analysis + policy cross-reference

When you paste your vet records into PawClaim, our system uses a large language model to read the text and identify conditions, symptoms, medications, and diagnostic findings. It then cross-references these findings against each insurer's published definition of pre-existing conditions.

The output is a list of conditions that each insurer would likely flag, based on their published underwriting criteria. This is not a guarantee of how any insurer would actually underwrite your pet. Underwriting decisions are made by licensed adjusters, not by PawClaim.

What "likely excluded" means: When our scan says a condition is "likely excluded," it means the published policy language and underwriting criteria for that insurer would typically apply to that condition. It does not mean the insurer will definitely exclude it. Insurers have discretion in underwriting, and outcomes vary.

Appeal letters — how we generate them

✎ State-specific legal references

Our appeal letter generator produces letters that cite your policy language, state consumer protection statutes, and applicable Department of Insurance regulations. State legal references are sourced from published state insurance codes and DOI guidance documents.

These letters are not legal advice. PawClaim is not a law firm. The letters are designed to be persuasive and factually accurate, not to constitute legal representation.

Appeal outcomes

📋 User-reported, not independently verified

Any appeal success stories or win rate figures on this site are reported by users who chose to share their outcomes. We do not independently verify individual outcomes. We do not publish aggregate win rate statistics without sufficient sample size to be statistically meaningful.

If you win an appeal using PawClaim tools, we would love to hear about it — and with your permission, may share your story (anonymously or with attribution, your choice).

Reporting an error

If you find an error in our insurer data, a statistic without a source, or a claim that does not match your own policy document, please tell us. We take accuracy seriously and will correct errors promptly.

Contact: hello@pawclaim.com