Embrace Pet Health Insurance V5

This policy has been written in readable language to help you understand its terms.
For service, information or questions concerning this policy, please contact Embrace Pet Insurance at 1-800-511-9172.

PLEASE READ THIS POLICY CAREFULLY

American Modern Insurance Group

A stock insurance company

Main Office Mailing Address:

P.O. Box 5323

Cincinnati, Ohio 45201-5323

Your policy is underwritten by American Modern Home
Insurance Company, rated A+ by A.M. Best.

Embrace Pet Insurance Agency LLC

4530 Richmond Rd

Cleveland, Ohio 44128

Your policy is fully administered by Embrace Pet Insurance
Agency

This policy is a legal contract between the policy owner and the company.

READ YOUR POLICY CAREFULLY

This cover sheet provides only a brief outline of some of the important features of your policy. This is not the insurance contract and only the actual policy provisions will control. The policy itself sets forth, in detail, the rights and obligations of both you and your insurance company.

IT IS THEREFORE IMPORTANT THAT YOU READ YOUR POLICY.

INSURING AGREEMENT

We will provide the insurance described in this policy
in return for the premium and compliance with all
applicable provisions of this policy.

The Declarations and Schedule Pages show the
policy period, coverages, limits of liability and
premiums. This policy is not complete without the
Declarations and Schedule Pages.

PART I - DEFINITIONS

In this policy, "you" and "your" refer to the Named
Insured shown on the Declarations Page. "We",
"us" and "our" refer to the Company providing this
insurance. In addition, certain words and phrases
are defined as follows:

Accident(s) means an unexpected or unintended
event, which is specific as to place and time
causing Injury to your Pet
Aggression means an abnormal hostile response
to an otherwise normal situation.
Allowable Charge(s) means the costs of the
actual Treatment(s) provided by your Veterinary
Provider.
Alternative Treatment means a group of practices
that may diverge from veterinary medicine
routinely taught in North American veterinary
medical schools and/or differ from current
scientific knowledge. If a Treatment is not a
generally accepted practice for the condition and
type of Pet insured, it is also considered
Alternative Treatment.
Ambulance means a specialized land vehicle
used for the sole purpose of transporting sick or
injured Pets.
Annual Maximum is the maximum amount we
will reimburse you per Pet in a period of
insurance.
Behavioral Therapy includes diagnosis by a
Veterinarian, laboratory testing, FDA approved
Medications and specialized training sessions by
a Veterinarian.
Bilateral Condition is a condition or disease that
affects both sides of the body.
Chronic Condition is a detectable condition that,
once developed, is deemed incurable or likely to
continue for the remainder of a Pet’s life.
Claim means your request for reimbursement of
an amount under the terms of your policy for
Treatment by a Veterinary Provider of your Pet.
Clinical Signs means changes in a Pet’s normal
healthy state, bodily function or behavior
observed by you, a Veterinarian, or other
observer.
Complementary Therapies include acupuncture,
chiropractic Treatment, laser Treatment,
hydrotherapy and physiotherapy performed by a
Veterinarian or a veterinary staff member under
direct supervision of a Veterinarian.
Coverage is the insurance described in this
policy.
Deductible is the annual amount you pay per Pet
for Treatments covered by this policy before we
will begin to reimburse you.
Dental Illness is an Illness affecting the teeth
and/or gums including but not limited to
gingivitis, stomatitis, attrition, and gingival
hyperplasia. This does not include FORLs or
Illnesses manifesting as oral diseases such as
FELV gingivitis, feline bartonella infection, or
auto-immune (eosinophilic) stomatitis.
Dermatological Condition means an Illness
related to your Pet’s skin and is deemed to
include ear infections and skin lumps from skin
irritation or infection, such as interdigital cysts
from pododermatitis, but not conjunctivitis or
parasitic infestations.
Genetic Condition means an Illness whose
presence is determined by hereditary factors.
Illness means sickness, disease, or any change
in a Pet’s normal, healthy state, which is not
caused by Injury to the Pet.
Injury means physical harm or damage to your
Pet.
Medical Boarding is a hospital stay for the Pet
parent's convenience, or an abnormally
prolonged stay that is not Medically Necessary
hospitalization, where the therapy or
Treatments provided could be completed at
home by the Pet parent.
Medical Director means a Veterinarian who may
be assigned by us to monitor and review the
appropriateness of the services provided to the
Pet, the reasonableness of the fees, and the
relationship between conditions.
Medical History Review means a comprehensive
review of your Pet(s) full medical history for the
twelve (12) months before your Pet was insured
or the date of acquisition of your Pet, whichever
is later through the policy Waiting Periods.
Medically Necessary means directly and materially
related to a covered Illness or Injury, in our
reasonable judgment.
Medication means any veterinary recommended
items prescribed by your Veterinarian and
approved by the Food and Drug Administration
(FDA) of the United States or accepted for
inclusion in the Homeopathic Pharmacopoeia of
the United States for veterinary use.
FDA-approved or Homeopathic Pharmacopoeiaincluded
drugs available over the counter must
be dispensed directly by your Veterinarian or
compounded by a pharmacist under the
guidance of your Veterinarian. Medication
includes medical supplies required to administer
those Medications.
Orthopedic Illness means an Illness affecting or
manifesting from the musculoskeletal system,
which is made up of the body's bones (the
skeleton), muscles, cartilage, tendons,
ligaments, and joints, including, but not limited
to intervertebral spaces.
Pet is a cat or dog named and described in the
Schedule Page(s) and both owned by you and
residing with you.
Pet Original Start Date means the effective date
when that Pet was first covered by a policy
administered by Embrace Pet Insurance Agency,
LLC, unless otherwise stated on the Schedule
Page.
Physical Examination means an exam, check-up,
physical consultation, health inspection, office
visit, office call, after-hour fee, referral,
telemedicine consultation, telemedicine service
fee, or recheck for otherwise covered
conditions.
Policy Original Start Date means the effective
date when you were first continuously covered
by a policy administered by Embrace Pet
Insurance Agency, LLC, unless otherwise stated
on the Schedule Page.
Preventative Care means any Treatment, service
or procedure, routine exam, Physical
Examination, Medication, surgery, inoculations,
or laboratory procedures, for the purpose of
prevention of Injury or Illness or for the
promotion of general health, where there has
been no Injury or Illness.
Professional Services are diagnosing, treating,
operating, or prescribing for any cat or dog
Illness or Injury.
Pre-existing Condition(s) means
1. Chronic Condition observed by you or your Veterinary Provider prior to the end of
  the Waiting Period for your Pet(s) and any
  related conditions; or
2. An Illness or Injury that first occurred or
  showed Clinical Signs prior to the end of
  the Waiting Period for your Pet and any
  related conditions.
3. Undiagnosed conditions with the same
  Clinical Signs as those in a. or b. above are
  also considered pre-existing.
Reimbursement Percentage is the amount of the
covered Allowable Charge for which you may be
reimbursed.
Temporary Condition means an abnormal
Clinical Sign or diagnosis, which is likely to
resolve. A Temporary Condition may become a
Chronic Condition.
Treatment means any examination,
consultation, hospitalization, anesthesia,
surgery, X-rays, MRI or CT scans,
Complementary Therapies, laboratory tests,
nursing or other care provided and administered
by a Veterinary Provider.
Undiagnosed means the underlying or causative
condition has not yet been identified.
Veterinarian means a currently licensed Doctor
of Veterinary Medicine.
Veterinary Provider means a Veterinarian,
veterinary technician or veterinary nurse
currently licensed in the state in which
Treatment is performed.
Waiting Period means the time period where the
policy’s Coverage is restricted. For this policy,
the time period is two (2) days for Accidents
and fourteen (14) days for Illnesses, except for
Orthopedic conditions for dogs where the
Waiting Period is six (6) months.
The Waiting Period starts from the Pet Original
Start Date. Conditions that occur during the
Waiting Period will be excluded from your
policy’s Coverage as Pre-existing Conditions.
The Waiting Period also applies again when
there are Coverage increases but is waived for
policy renewals and optional Coverage
renewals.

PART II - CONDITIONS

Your Pet must have been examined by a
Veterinarian in the twelve (12) months prior to
the Pet Original Start Date as shown on the
Schedule Page(s) or within fourteen (14) days
after the Pet Original Start Date. Failure to do so will result in your policy defaulting to an Accident
only policy. Meaning you will have no Illness
Coverage and your Illness premium will be
refunded. You may add Illness Coverage back
onto your policy once a qualifying Veterinarian
has examined your Pet and detailed records for
the exam are available to us. This will result in
your Illness Waiting Period end date changing to
the date of the first exam. No Illness Coverage is
available until a qualifying Veterinarian has
examined your Pet, and Pre-existing Conditions, if
any, may be determined upon the date of the
qualifying Veterinarian's examination.
The examining Veterinarian for the purposes of
medical information or for an Orthopedic
examination cannot be you or be related to you.
All Treatment must be performed by a
Veterinary Provider that you may freely choose.
You must arrange for a Veterinarian to examine
and treat your Pet as soon as possible after it
shows Clinical Signs of Injury or Illness.
You are financially responsible to your
Veterinary Provider for payment of all
Treatment.
Your Pet(s) must reside with you and be under
your regular care and supervision at the physical
address and zip code listed on the Declarations
Page.
You must disclose all Veterinary Providers your
Pet has seen in the twelve (12) months prior to
the Policy Start Date through the end of the
Waiting Periods. Failure to disclose all
Veterinary Providers is considered concealment
(see 5. Misrepresentation, Concealment or
Fraud under PART VI - OTHER TERMS AND
CONDITIONS).
By purchasing a policy, you give us permission
to gather all medical history for your Pet(s) from
all your Veterinary Providers as we deem
necessary. The medical information must
contain detailed Veterinarian examination
findings and must be made available to us for
review to satisfy the examination requirement in
PART II. item 1.
We will attempt to collect your Pet(s) medical
history from all Veterinary Providers you inform
us of at the start of your policy; however, we will
not review the medical history until your Pet’s
first Illness Claim is submitted, or you request a
Medical History Review. This request may be
made any time after the policy fourteen
(14) day Illness Waiting Period is complete.
The standard Orthopedic condition Waiting
Period for dogs is six (6) months from the Pet
Original Start Date shown on the Schedule Page for that dog.
You may apply to reduce the
Orthopedic Waiting Period by having a
Veterinarian perform, at your own expense, an
Orthopedic examination on your dog and
submitting the results to us for review.

The Orthopedic examination must occur on or
after the Pet Original Start Date for that dog and the
Veterinarian must complete, sign and date
the “Canine Orthopedic Examination Report”
form based on that Orthopedic examination,
which we shall supply upon request. Upon
review of the results of the Orthopedic
examination, we may reduce the Orthopedic
Waiting Period for some or all Orthopedic
conditions to two (2) days for Accidents or
fourteen (14) days for Illnesses, or from the
Orthopedic examination date, whichever is later.

Our review of the Canine Orthopedic
Examination Report only addresses the length of
the Orthopedic Waiting Period. A comprehensive
review of your dog’s medical information to
determine Pre-existing Conditions is not
performed as part of this review and must be
requested separately. Regardless of when the
medical history is reviewed, any condition noted
in the medical history prior to the end of the
Orthopedic Waiting Period is a Pre-existing
Condition even if the condition is not noted on
the Canine Orthopedic Examination Report form.

PART III - COVERAGE

THE FOLLOWING COVERAGES APPLY
SEPARATELY TO EACH PET.

Coverage
We will reimburse you for Allowable Charges in
excess of the Deductible amount, subject to
Reimbursement Percentage amounts, for
Treatment(s) performed for conditions that
started after the Waiting Period and during the
policy period, which result from:
1. Accidents, including but not limited to an
  automobile Accident, ingestion of a foreign
  body, poisoning, animal bites, and gastric
  torsion, as well as Accidents resulting in
  dental trauma, burns, and fractures; (if
  shown as applicable on the Schedule
  Page(s)). Orthopedic Accidents are subject
  to the Orthopedic Waiting Period; or
2. Illnesses, including but not limited to
  Genetic Conditions, cancer, and Chronic
  Conditions (if shown as applicable on the
  Schedule Page(s)); or
3. Accidental Orthopedic or dental fractures
  that occur or first show signs after the end
  of the Accident Waiting Period.
4. We will reimburse you for the costs of
  Medications your Veterinarian prescribes as
  part of your Pet's Accident or Illness
  Treatment that started after the Waiting
  Period and during the policy period.
5. We will reimburse you for Pet Ambulance
  transport costs in the case of a medical
  emergency, by our best estimation.
6. We will reimburse you for eligible
  Veterinary Treatment expenses caused by
  Dental Illness, in excess of the Deductible
  amount, subject to Reimbursement
  Percentage requirements and a $1,000
  Annual Maximum sub-limit, for all
  Treatment(s) except dental prophylaxis, for
  conditions that started after the Waiting
  Period and during the policy period.
7. We will reimburse you for the cost of
  Treatment your Pet receives in the current
  period of insurance for an Illness or Injury
  that first showed Clinical Signs after the
  end of the Waiting Period. Coverage is up to the Annual Maximum as
  shown on the Schedule Page(s), subject to the
  Deductible and Reimbursement Percentage
  requirements.
Benefits
We will reimburse you for Medically Necessary
Treatment, including tax, for:
1. Physical Examination;
2. Surgery;
3. X-rays, ultrasounds, and other diagnostic
  tests;
4. Professional Services rendered by your
  Veterinary Provider;
5. Medical supplies required to perform
  covered procedures performed in the
  Veterinarian’s office and other medical
  supplies, where deemed Medically
  Necessary by the Veterinarian, such as an
  Elizabethan collar;
6. Laboratory tests required by your Veterinary
  Provider;
7. Hospitalization required in order for your
  Veterinary Provider to deliver Professional
  Services to your Pet and post procedure
  in-hospital care as is medically standard by
  our best estimation;
8. Medication that is prescribed by a Veterinary
  Provider;
9. Endodontic Treatment for dental Injuries,
  such as root canals and crowns, for all
  adult canine teeth, upper 4th premolar
  teeth, and 1st molar teeth;
10. Euthanasia where necessary for humane
  reasons due to a covered condition;
11. Medical waste disposal;
12. Complementary Therapy related to a
  covered surgical procedure or Illness which
  is not performed for maintenance,
  prevention, or is not the initial course of
  Treatment;
13. Examination, Medication and training
  performed by a Veterinarian for the
  Treatment of Behavioral Therapy.
Deductible and Reimbursement Percentage
Your Deductible is an annual amount. We will
apply the Deductible to your Allowable Charges
and then apply your Reimbursement Percentage
to the remainder to determine your Claim
reimbursement.

PART IV - EXCLUSIONS

Please read the following exclusions carefully. If an
exclusion applies, we will not provide Coverage
under this policy and you will not be reimbursed for
any cost of Treatment you have paid for. We do not
cover:

Pre-existing Conditions;
In addition, the following Illnesses or Injuries
shall be considered Pre-existing Conditions:
1. If your Pet has had Clinical Signs, prior to
  being insured, of a Bilateral Condition on
  one side of the body, she/he runs a higher
  risk of the same condition on the other side
  of the body and future occurrences of the
  same condition will not be covered. For
  example, but not limited to, if a dog has
  been diagnosed with a cruciate tear in his
  left leg before the end of the Waiting
  Period, a subsequent cruciate tear in his
  right leg shall be considered a Pre-existing
  Condition.
2. Any Pet diagnosed, treated or showing
  Clinical Signs of intervertebral disk disease
  (IVDD) prior to the end of the Waiting
  Period runs a higher risk of further episodes
  of IVDD and will not be covered for any
  future incidences of this condition.
3. If a Pet has 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, un-related conditions may be
  covered.
4. Orthopedic Accidents and Illnesses
  occurring or showing Clinical Signs during
  the Orthopedic Waiting Period, even if the
  Accident Waiting Period is complete.
5. If a Pet has been diagnosed, treated, or
  was showing Clinical Signs of renal disease
  prior to the end of the Waiting Period, any
  renal Treatments and Medications are not
  covered, as well as any related conditions
  that may develop. This includes but is not
  limited to: vomiting, diarrhea, dehydration,
  constipation, blood pressure or pH issues,
  and cardiac complications.
6. Osteosarcoma diagnosed or showing Clinical
  Signs within the Orthopedic Waiting Period.
  For the purposes of these exclusions,
  Temporary Conditions that started prior to the
  end of the Waiting Period that have not shown
  any Clinical Signs or received Treatment for a
  period of twelve (12) consecutive months shall
  not be considered Pre-existing Conditions.
  Specific situations include, but are not limited
  to
  1. If your Pet showed Clinical Signs of
    any Dermatological Condition prior to
    the end of the Waiting Period, your Pet
    must be free of any Dermatological
    Conditions for twelve (12) consecutive
    months before any Dermatological
    Conditions may be covered again.
  2. If your Pet has been treated for
    Undiagnosed vomiting and/or diarrhea
    prior to the end of your Pet’s Waiting
    Period, your Pet must be free of
    conditions with the same Clinical Signs
    for twelve (12) consecutive months
    before any conditions with the same
    Clinical Signs may be covered again.
Preventative Care including, but not limited to,
wellness exams or tests, preventative
Treatment, tests or diagnostic procedures,
vaccinations, flea and other parasite prevention,
spaying or castration (including preventative
sterilization surgery, such as for Treatment for
cryptorchidism, chimerism, or chromosomal
abnormalities), grooming and de-matting, and
dew claw removal;
Treatments for Accidents or Illnesses arising from
any Pre-existing behavioral problems. For
example, a dog that has persistently eaten rocks or
foreign objects prior to the Pet Original Start Date
shall not be covered for Treatment during
the policy period for similar episodes. A dog
who has shown any signs of Aggression prior to
the Pet Original Start Date shall not be covered
for Treatment for Aggression or dog fights;
Alternative Treatments;
Complementary Therapies performed as
maintenance, prevention or not as the initial
course of Treatment;
More than the first submitted anesthetic
removal of an ingested foreign body in one (1)
policy term of insurance;
Any Illness, as a result of a covered Accident,
that is not part of the initial course of Treatment
for that Injury. For example, future Treatment(s)
for liver damage from an accidental poisoning
incident. This exclusion does not apply to
policies with Illness Coverage;
The cost of boarding your Pet, including Medical
Boarding;
Costs of Treatments arising from your decision
to pursue a course of Treatment other than that
which was recommended to you by your
Veterinarian, unless specifically authorized by us
prior to Treatment. Examples include:
1. Cost of Treatments continued after a
  Veterinarian has recommended a Pet be
  euthanized for humane reasons
2. Ignoring a Veterinarian’s recommendation
  to amputate a leg, resulting in extra costs
  associated with Treatment of gangrene;
3. Ignoring a Veterinarian’s recommendation
  to remove an eye, resulting in extra costs
  associated with chronic eye issues;
Treatment for any Injury or Illness deliberately
caused by you, your family members, anyone
living with you, or any other persons who have
care, custody, or control of your Pet;
Treatment for Injury or Illness caused by
deliberate endangerment of your Pet, such as
organized fighting;
Treatment for Injury or Illness caused by
persistent neglect of your Pet;
Costs for Treatment of Injury or Illness that
arise out of racing, commercial guarding,
organized fighting or any other occupational,
professional or business use of your Pet unless
specifically authorized by us prior to the Pet
Original Start Date as shown on the Schedule
Page;
Cosmetic, aesthetic, or elective surgery
including tail docking, ear cropping, de-clawing
or any other surgical procedure not related to
Injury or Illness;
Natural supplements, vitamins, and all foods,
whether prescribed or not, including but not
limited to Denamarin, glucosamine, probiotics,
shampoo, conditioner, or ear cleaner. This
exclusion does not apply to Hill's y/d diet (or a
similar preparation by another manufacturer)
used in Treatment for feline hyperthyroidism;
Treatments for any Illness for which a vaccine is
available for your Pet to prevent such Illness and
for which vaccination is both recommended by
your Veterinary Provider and rejected by you.
For the purposes of this exclusion, such Illness
shall include but not be limited to “core
vaccinations” as stated by the American Animal
Hospital Association Canine Vaccine Guidelines
for your dog or “highly recommended
vaccinations” as stated by the American
Association of Feline Practitioners;
Any administration fees charged by a Veterinary
Provider or others, including chart set-up fees,
prescription dispensing fees, or for providing
information required by us;
Professional fees and services performed by a
Veterinary Provider for his/her own cat or dog;
Costs for any Treatment for:
1. Organ transplants;
2. Genetic/chromosome testing not used for
  diagnosis;
3. Procedures to determine the suitability or
  categorization of your Pet for breeding or
  genealogical purposes, including PennHIP
  and OFA evaluations, not used for
  diagnosis; or
4. Costs resulting from breeding, pregnancy,
  whelping or queening;
Costs for any Treatment arising from:
1. Avian, swine, or any other type of influenza
  or any mutant variation;
2. Intentional slaughter by, or under the order
  of, any government or public or local
  authority;
3. Epidemics or pandemics as declared by the
  U.S. Department of Agriculture;
Costs for any Treatment arising from a nuclear
reaction, radiation, radioactive contamination or
the discharge of a nuclear device, whether
controlled or uncontrolled, accidentally or
otherwise;
Costs for any Treatment arising from a
chemical, biological, bio-chemical or
electromagnetic weapon, device, agent or
material whether controlled or uncontrolled,
accidentally or otherwise;
Costs for any Treatment arising from war,
invasion, acts of foreign enemies, hostilities
(whether war be declared or not), civil war,
rebellion, revolution, insurrection, military or
usurped power, strikes, riots, or civil
commotion;
Reiki;
Magnet Therapy;
Prolotherapy;
Ozone;
Hyperbaric Oxygen;
Electroacupuncture;
Veterinary Orthopedic Manipulation;
Massage;
Bicom;
TENS;
Extracorporeal Shock Wave Therapy; or
Nutritional Counseling.

PART V – LIMITS OF INSURANCE

Regardless of the number of Claims made or covered
Injuries or Illnesses that occur during the period of
insurance, our total liability for each period of
insurance for all covered benefits shall not exceed
the amounts shown on the Schedule Page(s) under
Annual Maximum.

PART VI - OTHER TERMS AND CONDITIONS

Paying Your Premiums
Your policy does not become legally binding
until you have paid your premium. The premium
is payable when you take out a new policy and
when you renew an existing policy. Your policy
is an annual contract of insurance with the
option to pay annually or monthly.
You must pay your premiums in full and on time
to remain covered. Your policy will
automatically renew at the end of your policy
term unless you tell us otherwise or we
nonrenew under rare circumstances.
Upon payment of a Claim under this policy,
any premium that is due and unpaid may be
deducted from the Claim.
Cancellation
1. You may cancel this policy at any time by
  calling customer service and stating the
  future date that you wish the cancellation
  to be effective.
  
  We will not back date a cancellation for a
  period greater than sixty (60) days in the
  absence of proof that your Pet has died or is
  no longer in your possession.
2. We may cancel this policy at any time
  within the first sixty (60) days of the policy
  period.
  
  To cancel this policy, we will mail a notice
  of cancellation to the Named Insured
  shown on the Declarations Page at the last
  known address shown in our records.
  If we cancel this policy within the first sixty
  (60) days after the effective date, notice of
  cancellation will be mailed at least ten (10)
  days before the effective date of the
  cancellation.
3. If we cancel this policy at any time due to
  nonpayment of premium, notice of
  cancellation will be mailed at least ten (10)
  days before the effective date of the
  cancellation.
  
  If this policy is cancelled for nonpayment of
  premium, we may, at our option reinstate
  the policy. However, policies cancelled for
  nonpayment of premium are subject to
  underwriting review prior to reinstatement
  being offered or approved. A reinstatement
  fee may be charged.
4. After this policy has been in effect for more
  than sixty (60) days, notice of cancellation
  due to any reason other than nonpayment
  of premium will be mailed at least fifteen
  (15) days before the effective date of
  cancellation.
5. After this policy is in effect for more than
  sixty (60) days, or if this is a renewal or
  continuation policy, we may only cancel for
  one or more of the following reasons:
  1. You fail to pay your premium by the due
    date in accordance with the policy
    terms.
  2. The policy was obtained through fraud,
    misrepresentation or concealment in your
    application, the content of which is
    specifically incorporated into and as a
    material term of this policy.
  3. We have agreed to issue a new policy
    with the same or an affiliated
    company.
  4. The Department of Insurance of the
    state governing the policy determines
    that a continuation of the policy could
    place us in violation of that state's
    insurance laws.
  5. You fail to comply with the policy
    terms and conditions in a manner that
    prejudices or negatively impacts our
    ability to properly assess or evaluate the
    Claim or other material rights we have
    under the policy.
  6. Failure to provide us with information
    we have requested that is directly
    relevant to the Coverage provided
    under this policy or any Claims.
  7. The use or threat of violence or
    aggressive behavior against our staff,
    contractors or property.
  8. The use of foul or abusive language.
  9. A was made based on false Claim
    information with the purpose of
    defrauding us, including but not limited to
    submitting invoices that have been
    altered or concealing past medical
    records.
  10. With respect to cancellation, this policy is
    neither severable nor divisible. Any
    cancellation will be effective for all
    Coverage for all persons and all Pets. If
    this policy is canceled, Coverage will not
    be provided as of the effective date of the
    cancellation shown on the notice of
    cancellation.
Cancellation Refund
Upon cancellation, you may be entitled to a
premium refund. If you provide us notice of
cancellation within thirty (30) days of the
Policy Original Start Date and you have made
no Claim, we will refund the premium you paid
us and the policy will be canceled.

If you have made a Claim within thirty (30) days
of the effective date, the premiums paid for or
allocable to the first month of Coverage become
fully earned upon the submittal of the Claim,
and you will only receive a refund for any
premiums paid for periods beyond the first
month.

After the first thirty (30) days of the policy
period, we will compute any refund due on a
daily pro-rata basis based on the termination
date of the policy.
Nonrenewal
If we decide not to renew or continue this
policy, we will mail notice of nonrenewal to the
Named Insured shown on the Declarations
Page at the last known address appearing in our
records. Notice, including the reason for
nonrenewal, will be mailed at least sixty (60)
days before the end of the policy period.
Misrepresentation, Concealment or Fraud
This policy will be cancelled if, whether before
or after a Claim, you or any other insured has;
1. Misrepresented or failed to disclose any
  material fact or circumstance or made any
  false statement related to this insurance or
  your Pet; or
2. Engaged in fraudulent conduct.
  Moreover, if a person knowingly makes a Claim
  based on false information with the purposes of
  defrauding us, that person may be guilty of
  insurance fraud, which is a crime. We have a
  duty to seek out insurance fraud and report it to
  the appropriate authorities. We will then
  cooperate fully with authorities as required by
  laws.
Rights
In the event we reimburse a Claim contrary to
the policy terms and conditions, this payment
will not constitute a waiver of our rights to
apply the terms and conditions retrospectively
as they stand to any paid Claims or to any
future Claims for that or any related condition.
We reserve our right to recover from you any
Claim reimbursement paid in error.
Splitting of Charges
In the event an Allowable Charge is for both
covered and non-covered conditions, the
Allowable Charge may be split into a covered
and a non-covered Allowable Charge to
calculate your Claim reimbursement.
Increasing Coverage
In the event you choose to increase your Pet’s
Coverage after the Original Pet Start Date,
including lowering your Deductible, increasing
Coverage and/or Medication Coverage, or
increasing the Reimbursement Percentage, the
Waiting Period and the determination of Preexisting
Conditions reset as of the date of the
Coverage change. There is no reset for a decrease
in Coverage.
We will automatically renew your policy at
expiration unless you are otherwise notified of
nonrenewal. We may change the premium,
Reimbursement Percentage amounts, Deductible,
policy terms and conditions at renewal. You will
be notified of changes in writing.
Adding a Pet Mid-term
All Pets in the same household are on the same
policy. If you add a Pet to your policy mid-term,
all Waiting Periods will apply and the new Pet
will have the same policy term renewal as your
existing Pet. The Deductible you choose for the
new Pet will apply to the remainder of the policy
term, even though it is not twelve (12) full
months. The premium can change at renewal
regardless of how soon it occurs.
Allowable Charges Disputes
In the event that your Veterinary Provider
charges an amount for Treatments in excess of
those typically charged in your geographic area
for identical Treatments, Professional Services
or Treatments that are not Medically Necessary,
we reserve the right to dispute the amount of
the Allowable Charges to be reimbursed. Should
we fail to resolve such disputes to your
satisfaction, such disputes shall be resolved by
means of the procedures listed in PART VIII:
APPEALS AND COMPLAINTS of the policy.
Promotional Offers Insurance
Each Named Insured may occasionally receive
promotional offers, which include but are not
limited to gift cards, coupons, gift certificates,
and items of merchandise. The maximum value
of any promotional item will not exceed $25.
Other Insurance
This insurance is excess over any other
insurance covering your Pet that is provided by a
policy issued by any other insurance company,
whether collectable or not.

It is your responsibility to notify us in the event
that other insurance is in force. Failure to do so
may be considered concealment and may render
Coverage provided under this policy null and
void and all outstanding Claims shall be forfeited
and not paid.
Transfer of Rights of Recovery Against
Others to Us
If the insured has rights to recover all or part of
any payment we have made under this policy,
those rights are transferred to us. The insured
must do nothing after loss to impair them. At
our request, the insured will bring suit or
transfer those rights to us and help us enforce
them.
Joint and Individual Interests
If there is more than one Named Insured on this
policy, any Named Insured may cancel or
change this policy. The action of one Named
Insured shall be binding on all persons afforded
Coverage under this policy.
Transfer
This policy may not be transferred to another
person without our written consent.
This Coverage is not transferable to other Pets.
16. Period of Insurance and Territory
This policy applies only to Injuries and/or
Illnesses occurring during the policy period
shown on the Declarations Page and which
occur anywhere in the world.
Electronic Delivery
By accepting the terms of this insurance as
evidenced by the payment of premiums, it is
agreed that, unless otherwise notified by you,
all documents, notices and communications
regarding this policy, other than documents
required to be delivered by another method, may
be delivered to you by electronic mail using the
email associated with your account. It is your
responsibility to keep your contact details
including email address current and correct.
Conformity to State Statutes
When this policy’s provisions conflict with the
statutes of the state in which this policy is
issued, the terms and conditions are amended
to conform to such statutes.
Our Right to Recover Payment
If we make a payment under this policy and the
person to or for whom payment was made has a
right to recover damages from another, we shall
be subrogated to that right. That person shall;
1. Sign and deliver to us any legal papers
  relating to that recovery;
2. Do whatever is necessary to enable us to
  exercise our rights; and
3. Do nothing after loss to prejudice them.
  
  If we make a payment under this policy and the
  person to or for whom payment is made recovers
  damages from another, that person shall:
  1. Hold in trust for us the proceeds of the
    recovery; and
  2. Reimburse us to the extent of our payment.

PART VII – HOW TO FILE A CLAIM

For fastest claim processing:
1. Upload on your MyEmbrace customer portal
  at: my.embracepetinsurance.com
2. Email: claims@embracepetinsurance.com
3. Fax: (800) 238-1042
Another option that may result in slower claim
processing time:
1. Mail:
  
  Embrace Pet Insurance Claims Department
  P.O. Box 22188
  Beachwood, OH 44122-0188

Claim Procedure

Any Claim you make will be assessed fairly,
reasonably and promptly against the information you
provide and the terms of the policy.

All Claims must be submitted during the policy
term or within sixty (60) days of the end of that
term. You must send us a Claim form that has
been properly completed. We will post our
decision on your MyEmbrace customer portal.
We will not guarantee on the phone if we cover
a Claim.
All Claims must be submitted on the Claims
form that we email you with your policy
documents. You may also request a Claim form
be mailed or emailed to you.
You must provide all itemized invoices from your
Veterinary Provider, along with your completed
Claim form, before we will reimburse you. Save
the originals in case we require them from you.
You must cooperate with us in the investigation
or settlement of the Claim.
An Explanation of Benefits form will be available to
you on your MyEmbrace customer portal that shows
how we determined the amount to reimburse you for
your Claim. If you disagree with the outcome of your
Claim, you may dispute it as described in the
following section.

PART VIII - APPEALS AND COMPLAINTS

Upload your appeal letter on your MyEmbrace
customer portal at:
my.embracepetinsurance.com

Contact Information

Email: claims@embracepetinsurance.com
Fax: (800) 238-1042
Mail:

Embrace Claim Appeal Department P.O. Box 22188
Beachwood, OH 44122-0188

The following describes the appeal process in the
event you are not satisfied with the way we have
handled your Claim, or you are not happy with your
policy. All requests for an appeal must be submitted
to us within sixty (60) days of the renewal of your
policy. You may contact us using the information
above.

Procedure

First Appeal
Once we receive your formal appeal or
complaint, we will contact you within five (5)
working days to confirm receipt of your appeal.
We will answer you within fifteen (15) business
days with our decision. If it takes us longer than
fifteen (15) business days to complete our
review, we will notify you.
Second Appeal
If you disagree with our decision in the first
appeal, you may request a second appeal via an
external review. A request for a Second Appeal
must be made within thirty (30) days of the
date of issuance of our First Appeal decision to
you. An impartial Veterinarian selected by
Embrace, who is independent of Embrace and
the Named Insured, who is not controlled by us,
and who has not been a part of your Pet’s
veterinary team previously, will conduct an
external review. Embrace will provide the
decision to the Named Insured within three (3)
business days of receiving the independent
Veterinarian’s report.
Complaints
If you disagree with the decision made at any
time during the appeal process, you have the
right to file a complaint with your State's
Department of Insurance. Please refer to your
individual state’s department of insurance for
details, applicable rules and laws.