Md. Code Ann., Ins. § 19-1105
Preexisting conditions; waiting periods; filing of claim required; medical examinations for renewal; prescriptive, wellness, or noninsurance benefits; wellness programs not a condition of purchase
Effective Jan 1, 2025Added by Acts 2024, c. 740, § 1, eff. Jan. 1, 2025.State of Maryland
(a)
- (1) A pet insurer may issue policies that exclude coverage on the basis of one or more preexisting conditions with appropriate disclosure to the consumer.
- (2) The pet insurer has the burden of proving that the preexisting condition exclusion applies to the condition for which a claim is made.
(b)
(1)
- (i) Subject to subparagraphs (ii) and (iii) of this paragraph, a pet insurer may issue a policy that imposes a waiting period before coverage under the policy begins.
- (ii) A waiting period may not exceed 30 days for an illness or orthopedic condition that does not result from an accident.
- (iii) A pet insurer may not impose a waiting period for an illness or orthopedic condition that results from an accident.
(2)
- (i) A pet insurer that imposes a waiting period under paragraph (1) of this subsection shall include a provision in the pet insurance policy that allows for the waiving of waiting periods on completion of a medical examination.
(ii) 1. A pet insurer may require a medical examination under subparagraph (i) of this paragraph to be conducted by a veterinary practitioner after the purchase of the policy.
- 2. Unless the pet insurance policy specifies that the pet insurer will pay for a medical examination under subparagraph (i) of this paragraph, a policyholder shall pay for the medical examination.
3. A pet insurer may:
- A. specify elements to be included as part of a medical examination under subparagraph (i) of this paragraph; and
- B. if the specifications do not unreasonably restrict a policyholder's ability to waive the waiting period, require documentation of the medical examination.
- (3) A pet insurer shall clearly and prominently disclose requirements with respect to applicable waiting periods before purchase of the policy.
- (c) A pet insurer shall require that an insured submit a claim under the pet insurance policy after submitting payment to the veterinary practitioner for veterinary expenses.
- (d) A pet insurer may not require a medical examination of the covered pet as a condition for the renewal of a policy.
- (e) A prescriptive, wellness, or noninsurance benefit included in the policy form for a pet insurance policy is part of the policy and subject to this article and regulations adopted under this article.
- (f) A pet insurer may not condition an insured's eligibility to purchase a pet insurance policy on participation, or lack of participation, in a separate wellness program.
Added by Acts 2024, c. 740, § 1, eff. Jan. 1, 2025.