2025 -- S 0649
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LC000616
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S T A T E O F R H O D E I S L A N D
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2025
____________
A N A C T
RELATING TO INSURANCE -- PET INSURANCE ACT
Introduced By: Senators Bissaillon, Raptakis, Britto, and Dimitri
Date Introduced: March 07, 2025
Referred To: Senate Environment & Agriculture
It is enacted by the General Assembly as follows:
SECTION 1. Title 27 of the General Laws entitled "INSURANCE" is hereby amended by 1
adding thereto the following chapter: 2
CHAPTER 83 3
PET INSURANCE ACT 4
27-83-1. Scope and purpose. 5
(a) The purpose of this chapter is to promote the public welfare by creating a 6
comprehensive legal framework within which pet insurance may be sold in this state. 7
(b) The requirements of this chapter shall apply to pet insurance policies that are issued to 8
any resident of this state and are sold, solicited, negotiated, or offered in this state, and policies or 9
certificates that are delivered or issued for delivery in this state. 10
(c) All other applicable provisions of this state’s insurance laws shall continue to apply to 11
pet insurance except that the specific provisions of this chapter shall supersede any general 12
provisions of law that would otherwise be applicable to pet insurance. 13
27-83-2. Definitions. 14
(a) If a pet insurer uses any of the terms in this chapter in a policy of pet insurance, the pet 15
insurer shall use the definition of each of those terms as set forth herein and include the definition 16
of the term(s) in the policy. The pet insurer shall also make the definition available through a clear 17
and conspicuous link on the main page of the pet insurer or pet insurer’s program administrator’s 18
website. 19
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(b) Nothing in this chapter shall in any way prohibit or limit the types of exclusions pet 1
insurers may use in their policies or require pet insurers to have any of the limitations or exclusions 2
defined below. 3
(c) For purposes of this chapter: 4
(1) “Chronic condition” means a condition that can be treated or managed, but not cured. 5
(2) “Congenital anomaly or disorder” means a condition that is present from birth, whether 6
inherited or caused by the environment, which may cause or contribute to illness or disease. 7
(3) “Hereditary disorder” means an abnormality that is genetically transmitted from parent 8
to offspring and may cause illness or disease. 9
(4) “Orthopedic” refers to conditions affecting the bones, skeletal muscle, cartilage, 10
tendons, ligaments, and joints. It includes, but is not limited to, elbow dysplasia, hip dysplasia, 11
intervertebral disc degeneration, patellar luxation, and ruptured cranial cruciate ligaments. It does 12
not include cancers or metabolic, hemopoietic, or autoimmune diseases. 13
(5) “Pet insurance” means a property insurance policy that provides coverage for accidents 14
and illnesses of pets. 15
(6) “Preexisting condition” means any condition for which any of the following are true 16
prior to the effective date of a pet insurance policy or during any waiting period: 17
(i) A veterinarian provided medical advice; 18
(ii) The pet received previous treatment; or 19
(iii) Based on information from verifiable sources, the pet had signs or symptoms directly 20
related to the condition for which a claim is being made. 21
(iv) A condition for which coverage is afforded on a policy cannot be considered a 22
preexisting condition on any renewal of the policy. 23
(7) “Renewal” means to issue and deliver at the end of an insurance policy period a policy 24
which supersedes a policy previously issued and delivered by the same pet insurer or affiliated pet 25
insurer and which provides types and limits of coverage substantially similar to those contained in 26
the policy being superseded. 27
(8) “Veterinarian” means an individual who holds a valid license to practice veterinary 28
medicine from the appropriate licensing entity in the jurisdiction in which the individual practices. 29
(9) “Veterinary expenses” means the costs associated with medical advice, diagnosis, care, 30
or treatment provided by a veterinarian, including, but not limited to, the cost of drugs prescribed 31
by a veterinarian. 32
(10) “Waiting period” means the period of time specified in a pet insurance policy that is 33
required to transpire before some or all of the coverage in the policy can begin. Waiting periods 34
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may not be applied to renewals of existing coverage. 1
(11) “Wellness program” means a subscription or reimbursement-based program that is 2
separate from an insurance policy that provides goods and services to promote the general health, 3
safety, or wellbeing of the pet. If any wellness program 4
(i) Pays or indemnifies another as to loss from certain contingencies called "risks," 5
including through reinsurance; 6
(ii) Pays or grants a specified amount or determinable benefit to another in connection with 7
ascertainable risk contingencies; or 8
(iii) Acts as a surety, it is transacting in the business of insurance and is subject to the 9
insurance code, as defined in § 27-54.1-1. This definition is not intended to classify a contract 10
directly between a service provider and a pet owner that only involves the two (2) parties as being 11
“the business of insurance,” unless other indications of insurance also exist. 12
27-83-4. Disclosures. 13
(a) A pet insurer transacting pet insurance shall disclose the following to consumers: 14
(1) If the policy excludes coverage due to any of the following: 15
(i) A preexisting condition; 16
(ii) A hereditary disorder; 17
(iii) A congenital anomaly or disorder; or 18
(iv) A chronic condition; 19
(2) If the policy includes any other exclusions, the following statement: “Other exclusions 20
may apply. Please refer to the exclusions section of the policy for more information.”; 21
(3) Any policy provision that limits coverage through a waiting or affiliation period, a 22
deductible, coinsurance, or an annual or lifetime policy limit; 23
(4) Whether the pet insurer reduces coverage or increases premiums based on the insured’s 24
claim history, the age of the covered pet or a change in the geographic location of the insured; and 25
(5) If the underwriting company differs from the brand name used to market and sell the 26
product. 27
(b) Right to examine and return the policy. 28
(1) Unless the insured has filed a claim under the pet insurance policy, pet insurance 29
applicants shall have the right to examine and return the policy, certificate or rider to the company 30
or an agent/insurance producer of the company within thirty (30) days of its receipt and to have the 31
premium refunded if, after examination of the policy, certificate or rider, the applicant is not 32
satisfied for any reason. 33
(2) Pet insurance policies, certificates and riders shall have a notice prominently printed on 34
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the first page or attached thereto including specific instructions to accomplish a return. The 1
following free look statement or language substantially similar shall be included: 2
“You have thirty (30) days from the day you receive this policy, certificate, or rider to 3
review it, and return it to the company if you decide not to keep it. You do not have to tell the 4
company why you are returning it. If you decide not to keep it, simply return it to the company at 5
its administrative office, or you may return it to the agent/insurance producer that you bought it 6
from as long as you have not filed a claim. You must return it within thirty (30) days of the day 7
you first received it. The company will refund the full amount of any premium paid within thirty 8
(30) days after it receives the returned policy, certificate, or rider. The premium refund will be sent 9
directly to the person who paid it. The policy, certificate, or rider will be void as if it had never 10
been issued.” 11
(c) A pet insurer shall clearly disclose a summary description of the basis or formula on 12
which the pet insurer determines claim payments under a pet insurance policy within the policy, 13
prior to policy issuance, and through a clear and conspicuous link on the main page of the pet 14
insurer’s or pet insurer’s program administrator’s website. 15
(d) A pet insurer that uses a benefit schedule to determine claim payment under a pet 16
insurance policy shall do both of the following: 17
(1) Clearly disclose the applicable benefit schedule in the policy; and 18
(2) Disclose all benefit schedules used by the pet insurer under its pet insurance policies 19
through a clear and conspicuous link on the main page of the pet insurer’s or pet insurer’s program 20
administrator’s website. 21
(e) A pet insurer that determines claim payments under a pet insurance policy based on 22
usual and customary fees, or any other reimbursement limitation based on prevailing veterinary 23
service provider charges, shall do both of the following: 24
(1) Include a usual and customary fee limitation provision in the policy that clearly 25
describes the pet insurer’s basis for determining usual and customary fees and how that basis is 26
applied in calculating claim payments; and 27
(2) Disclose the pet insurer’s basis for determining usual and customary fees through a 28
clear and conspicuous link on the main page of the pet insurer’s or pet insurer’s program 29
administrator’s website. 30
(f) If any medical examination by a licensed veterinarian is required to effectuate coverage, 31
the pet insurer shall clearly and conspicuously disclose the required aspects of the examination 32
prior to purchase and disclose that examination documentation may result in a preexisting condition 33
exclusion. 34
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(g) Waiting periods and the requirements applicable to them, shall be clearly and 1
prominently disclosed to consumers prior to the policy purchase. 2
(h) The pet insurer shall include a summary of all policy provisions required in subsections 3
(a) through (g) of this section, inclusive, in a separate document titled “Insurer Disclosure of 4
Important Policy Provisions.” 5
(i) The pet insurer shall post the “Insurer Disclosure of Important Policy Provisions” 6
document required in subsection (h) of this section through a clear and conspicuous link on the 7
main page of the pet insurer’s or pet insurer’s program administrator’s website. 8
(j) In connection with the issuance of a new pet insurance policy, the pet insurer shall 9
provide the consumer with a copy of the “Insurer Disclosure of Important Policy Provisions” 10
document required pursuant to subsection (h) of this section in at least twelve-point (12) type when 11
the policy is delivered. 12
(k) At the time a pet insurance policy is issued or delivered to a policyholder, the pet insurer 13
shall include a written disclosure with the following information, printed in twelve-point (12) 14
boldface type: 15
(1) The address and customer service telephone number of the pet insurer or the agent or 16
broker of record. 17
(2) If the policy was issued or delivered by an agent or broker, a statement advising the 18
policyholder to contact the broker or agent for assistance. 19
(l) The disclosures required in this section shall be in addition to any other disclosures 20
required by law or regulation. 21
27-83-5. Policy conditions. 22
(a) A pet insurer may issue policies that exclude coverage on the basis of one or more 23
preexisting conditions with appropriate disclosure to the consumer. The pet insurer has the burden 24
of proving that the preexisting condition exclusion applies to the condition for which a claim is 25
being made. 26
(b) A pet insurer may issue policies that impose waiting periods upon effectuation of the 27
policy that do not exceed thirty (30) days for illnesses or orthopedic conditions not resulting from 28
an accident. Waiting periods for accidents are prohibited; provided, however, an insurer shall issue 29
coverage to be effective at 12:01 a.m. on the second calendar day after the purchase, subject only 30
to the following exceptions: 31
(1) If an insurer elects to conduct individualized underwriting on a specific pet, then 32
coverage shall be effective by 12:01 a.m. on the second calendar day after the insurer has 33
determined such pet is eligible for coverage; 34
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(2) An insurer may delay coverage from becoming effective to establish a method for the 1
consumer or group administrator to pay the premium; 2
(3) For pet insurance coverage acquired by an individual through an employer or 3
organization, the coverage effective date of such pet insurance may be delayed to align with the 4
eligibility and effective date requirements of the employer's organization's benefit plan; or 5
(4) If a policy does not include a waiting period for an illness or orthopedic condition, an 6
insurer may set a policy effectuation date that is up to fifteen (15) calendar days after purchase, as 7
long as such policy effectuation date is clearly disclosed and no premium is charged before the 8
policy becomes effective. 9
(c)(1) A pet insurer utilizing a waiting period permitted in subsection (b) of this section 10
shall include a provision in its contract that allows the waiting periods to be waived upon 11
completion of a medical examination. Pet insurers may require the examination to be conducted by 12
a licensed veterinarian after the purchase of the policy. 13
(i) A medical examination under this subsection shall be paid for by the policyholder, 14
unless the policy specifies that the pet insurer will pay for the examination. 15
(ii) A pet insurer can specify elements to be included as part of the examination and require 16
documentation thereof; provided that, the specifications do not unreasonably restrict a consumer’s 17
ability to waive the waiting periods in subsection (b) of this section. 18
(2) Waiting periods, and the requirements applicable to them, shall be clearly and 19
prominently disclosed to consumers prior to the policy purchase. 20
(3) If a policy does not include a waiting period for an illness or orthopedic condition, an 21
insurer may set a policy effectuation date that is up to fifteen (15) days after purchase, as long as 22
such policy effectuation date is clearly disclosed and no premium is earned before the policy 23
becomes effective. 24
(d) A pet insurer shall not require a veterinary examination of the covered pet for the 25
insured to have their policy renewed. 26
(e) If a pet insurer includes any prescriptive, wellness, or non-insurance benefits in the 27
policy form, then it is made part of the policy contract and shall follow all applicable laws and 28
regulations in the insurance code. 29
(f) An insured’s eligibility to purchase a pet insurance policy shall not be based on 30
participation, or lack of participation, in a separate wellness program. 31
27-83-6. Sales practices for wellness programs. 32
(a) A pet insurer and/or producer shall not do the following: 33
(1) Market a wellness program as pet insurance; or 34
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(2) Market a wellness program during the sale, solicitation, or negotiation of pet insurance. 1
(b) If a wellness program is sold by a pet insurer and/or producer: 2
(1) The purchase of the wellness program shall not be a requirement to the purchase of pet 3
insurance; 4
(2) The costs of the wellness program shall be separate and identifiable from any pet 5
insurance policy sold by a pet insurer and/or producer; 6
(3) The terms and conditions for the wellness program shall be separate from any pet 7
insurance policy sold by a pet insurer and/or producer; 8
(4) The products or coverages available through the wellness program shall not duplicate 9
products or coverages available through the pet insurance policy; 10
(5) The advertising of the wellness program shall not be misleading and shall be in 11
accordance with subsection (b) of this section; and 12
(6) A pet insurer and/or producer shall clearly disclose the following to consumers, printed 13
in twelve-point (12) boldface type: 14
(i) That wellness programs are not insurance. 15
(ii) The address and customer service telephone number of the pet insurer or producer or 16
broker of record. 17
(c) Coverages included in the pet insurance policy contract described as “wellness” benefits 18
are insurance. 19
27-83-7. Insurance producer training. 20
(a) An insurance producer shall not sell, solicit, or negotiate a pet insurance product until 21
after the producer is appropriately licensed and has completed the required training identified in 22
subsection (c) of this section. 23
(b) Insurers shall ensure that its producers are trained under subsection (c) of this section 24
and that its producers have been appropriately trained on the coverages and conditions of its pet 25
insurance products. 26
(c) The training required under this subsection shall include information on the following 27
topics: 28
(1) Preexisting conditions and waiting periods; 29
(2) The differences between pet insurance and noninsurance wellness programs; 30
(3) Hereditary disorders, congenital anomalies or disorders and chronic conditions and how 31
pet insurance policies interact with those conditions or disorders; and 32
(4) Rating, underwriting, renewal, and other related administrative topics. 33
(d) The satisfaction of the training requirements of another state that are substantially 34
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similar to the provisions of subsection (c) of this section shall be deemed to satisfy the training 1
requirements in this state. 2
27-83-8. Violations. 3
Violations of this chapter shall be subject to penalties pursuant to § 42-14-16. 4
SECTION 2. This act shall take effect on January 1, 2026. 5
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO INSURANCE -- PET INSURANCE ACT
***
This act would provide for the sale and regulation of pet insurance policies and their 1
contents and provisions. 2
This act would take effect on January 1, 2026. 3
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LC000616
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