Understanding the whole journey: how insurance can better support access to care

Every veterinary professional has experienced it. The insured client who suddenly discovers they’re not covered. The claims conversation that overtakes the clinical one. The welfare decision shaped by an insurance policy purchased years earlier.

The Pet and Equine Insurance Association (PEIA) is mapping the whole-life journey of companion animals, from the decision to bring an animal into the home through to end-of-life care, to understand where access to veterinary care and insurance breaks down, and why.

The work will feed into The Pet Pledge, PEIA’s developing framework for improving access to care, building trust and supporting the long-term sustainability of pet insurance. The journey will help identify the evidence, priorities and areas for collaboration The Pet Pledge will take forward. We’re asking veterinary professionals to help shape it from this early stage, alongside the other organisations and professions involved.

Why start here?

Earlier this year, through Vet Times, we asked veterinary professionals where interactions with insurance were creating friction for practice teams and clients. Their feedback highlighted a wide range of issues, often connected to decisions or expectations formed much earlier in the animal’s journey. It prompted us to step back and ask a different question: rather than tackling individual points of friction one by one, what happens if we look at the whole journey first and allow evidence to show us where the most significant issues lie?

An animal’s journey doesn’t begin in the consultation room. It begins when someone decides to bring an animal into their life, what they’re told about its likely health needs, whether they understand the lifetime cost of preventive care and treatment, and who influences that decision.

From there, it may include choosing and later changing a veterinary practice, microchipping, changing insurer, chronic illness, financial pressure, claims, complaints and end-of-life care. Every animal’s route is different, but each stage may shape what happens later, including whether insurance is purchased, understood, maintained and able to support access to care when it is needed.

We’re not assuming every stage needs fixing. We want to identify which interactions genuinely affect preparedness, access to care and welfare outcomes and which don’t.

Why veterinary insight is essential

Insurance data, complaints and consumer research can’t show the full picture on their own. Veterinary teams are the ones who see it directly: when someone is surprised by cost of care, when an animal’s health needs weren’t understood at acquisition, and the gap between having insurance and having insurance that responds as expected.

You also undertake much of the practical work involved in a claim, completing forms, supplying clinical histories and explaining why a condition was treated in a particular way, despite having no role in designing or selling the policy.

That doesn’t make the veterinary profession responsible for problems created elsewhere in the system. It’s exactly why veterinary insight is essential to understanding those problems accurately, and to telling isolated issues apart from systemic ones.

Two situations will be familiar to most practice teams. An owner arrives believing their pet is “fully insured”, only to discover partway through treatment for a cruciate injury that their policy carries a £1,000 per-condition limit, nowhere near enough for surgery and rehabilitation.

They hadn’t misunderstood their policy through carelessness; the limit simply wasn’t something they had registered as relevant until they needed it. The clinical conversation about treatment options then becomes, unavoidably, a conversation about what they can afford, at the worst possible moment.

The second is the policy-year problem. Depending on the type of cover purchased and the policy terms, a dog treated for a skin condition one year may find that a related or recurring issue, such as an ear infection, is not covered the following year or is treated as pre-existing.

The decision may be entirely reasonable under the policy wording, but rarely something the owner anticipated when renewing. The practice team is then left explaining a decision it didn’t make, using information the owner didn’t know they needed to ask about.

Important questions

Neither scenario reflects bad faith on anyone’s part: not the insurer applying the policy terms correctly, the owner who didn’t absorb every implication of the cover, or the practice team caught in the middle.

Both are the kind of interaction that only becomes visible when you look at the whole journey: a decision made at purchase may resurface months or years later as confusion and cost at the point of care. Rather than treating each case as an isolated misunderstanding, PEIA wants to understand whether these are symptoms of wider patterns across the journey.

That raises important questions. How many of the challenges experienced in practice begin long before a claim is ever submitted? Are moments we instinctively focus on really the ones shaping access to care, or are earlier interactions quietly setting expectations that only become visible when an animal needs treatment?

Looking across the whole journey gives us the opportunity to test those assumptions rather than simply repeat them and, where necessary, rethink where the real opportunities to improve access to care lie.

The whole picture

Each part of the system encounters only part of the issue. An insurer sees a claim outside policy terms, a regulator sees a confused consumer, a welfare organisation sees delayed treatment, a veterinary practice sees the effect on the clinical conversation, and the person caring for the animal may feel unprepared for cost or complexity.

Each perspective is valid, but incomplete. Looking at these issues in isolation is what makes conversations about access to care feel adversarial, with blame falling in turn on insurers, veterinary practices, people who have animals, breeders or rescue organisations, rather than helping us understand how the system is working.

Veterinary professionals will see things insurers can’t. Insurers will understand product design, underwriting and claims issues that aren’t visible in clinical practice, while welfare organisations may encounter cases where access to care has already broken down.

Breeders and rescue organisations may also shape expectations before either the insurer or veterinary practice becomes involved. The next stage of this work is to test the journey against all these perspectives, including yours.

One of the questions we’re particularly interested in is where those perspectives align and where they don’t. If insurers, veterinary teams, welfare organisations and pet owners describe the same interaction in fundamentally different ways, those differences may tell us something important.

They may reveal where expectations have diverged, where communication has broken down, or where we’ve simply been looking at the wrong part of the journey. Understanding those differences is essential if we want to identify where meaningful improvements to access to care can be made.

Where is the animal’s voice?

Insurers, veterinary practices and people who have animals can all describe this journey from their own vantage point.

The one perspective that can’t speak for itself is the animals, and it is often the easiest to lose when the conversation becomes centred on cost, cover or process. The policyholder is the keeper of a sentient animal. The customer experiences insurance, while the animal experiences many of its consequences.

An animal doesn’t experience a claims limit, policy exclusion or difficult renewal conversation directly. It experiences what follows: a delayed decision, fewer treatment options, a shorter course of treatment or a compromise reached for financial reasons rather than clinical ones.

That’s why animal welfare can’t be treated as something that follows naturally once the insurance and access questions have been resolved. It needs to be built deliberately into the journey at every stage by asking what a decision, product or interaction means not only for the people managing the process, but for the animal whose care may be affected.

Veterinary professionals are often the ones holding that question on the animal’s behalf. Their insight into welfare outcomes, not only cost and process, needs to be part of this work from the outset rather than added once the practical interactions have been mapped.

What happens next?

Once the initial journey map has been tested and challenged, we’ll examine evidence behind its most significant themes. Some findings will relate directly to insurance products and claims. Others will sit outside the insurance world, but still affect whether cover is understood, purchased, maintained or able to support timely access to care. We expect some long-held assumptions to be reinforced. Others may prove to be incomplete, or simply wrong. That’s why we’re deliberately testing the journey before deciding where attention should be focused.

This isn’t a set of answers PEIA has already written. Its value depends on whether it reflects evidence and experience of the people living it – veterinary teams, insurers, welfare organisations and pet owners.

Get involved

We want veterinary professionals to review the initial journey map and tell us where it does not reflect clinical reality. We want to know what is missing, which interactions help or hinder timely access to care, and where the consequences of earlier decisions become visible in practice.

We’re looking for examples of where insurance supports good clinical and welfare outcomes, recurring issues seen across multiple clients, moments where the customer’s understanding breaks down, and assumptions you believe insurers or other parts of the system may be making incorrectly.

At this stage, we’re not asking veterinary professionals to endorse a solution. We’re asking them to challenge the journey, contribute evidence and help us identify the questions that need deeper investigation.

To take part, contact PEIA at [email protected] or visit the website (www.peia.co.uk). The evidence and insight gathered will shape the next phase of the work and ultimately the recommendations that underpin The Pet Pledge.

The animal experiences one continuous journey. It’s the organisations and professions around it that divide that journey into separate interactions. Understanding access to care, and how insurance can support animal welfare, must start with seeing the whole journey.

Sharon Brown is is the founder and CEO of the Pet and Equine Insurance Association (PEIA), created to support a more sustainable future for pet and equine insurance. Through PEIA, Sharon brings together insurers, brokers, veterinary stakeholders, animal welfare organisations, regulators and service providers to tackle shared challenges around affordability, access, claims, fraud, regulation and animal welfare. She has worked in insurance for more than three decades and has held senior executive, non-executive and advisory roles across the market.