19 MAC Pt. 5, R. 6.02
Definitions
Cite as 19 Miss. Admin. Code Pt. 5, R. 6.02
Definitions.
If a pet insurer uses any of the terms in this Regulation in a policy of pet insurance, the pet
insurer shall use the definition of each of those terms as set forth herein and include the
definition of the term(s) in the policy. The pet insurer shall also make the definition available
through a clear and conspicuous link on the main page of the pet insurer or pet insurer’s program
administrator’s website.
Nothing in this Regulation shall in any way prohibit or limit the types of exclusions pet insurers
may use in their policies or require pet insurers to have any of the limitations or exclusions
defined below.
A.
“Chronic condition” means a condition that can be treated or managed, but not
cured.
B.
“Congenital anomaly or disorder” means a condition that is present from birth,
whether inherited or caused by the environment, which may cause or contribute
to illness or disease.
C.
“Hereditary disorder” means an abnormality that is genetically transmitted from
parent to offspring and may cause illness or disease.
D.
“Orthopedic” refers to conditions affecting the bones, skeletal muscle, cartilage,
tendons, ligaments, and joints. It includes, but is not limited to, elbow dysplasia,
hip dysplasia, intervertebral disc degeneration, patellar luxation, and ruptured
cranial cruciate ligaments. It does not include cancers or metabolic, hemopoietic,
or autoimmune diseases.
E.
“Pet insurance” means a property insurance policy that provides coverage for
accidents and illnesses of pets.
F.
“Pet Insurance Producer” means a person licensed in a major line of authority
and appointed by a pet insurer may be authorized to sell, solicit or negotiate a pet
insurance product.
G.
“Preexisting condition” means any condition for which any of the following are
true prior to the effective date of a pet insurance policy or during any waiting
period:
(1)
A veterinarian provided medical advice;
(2)
The pet received previous treatment; or
(3)
Based on information from verifiable sources, the pet had signs or
symptoms directly related to the condition for which a claim is being
made.
A condition for which coverage is afforded on a policy cannot be considered a preexisting
condition on any renewal of the policy.
H.
“Renewal” means to issue and deliver at the end of an insurance policy period a
policy that supersedes a policy previously issued and delivered by the same pet
insurer or affiliated pet insurer and which provides types and limits of coverage
substantially similar to those contained in the policy being superseded.
I.
“Veterinarian” means an individual who holds a valid license to practice
veterinary medicine from the appropriate licensing entity in the jurisdiction in
which he or she practices.
J.
“Veterinary expenses” means the costs associated with medical advice,
diagnosis, care, or treatment provided by a veterinarian, including, but not
limited to, the cost of drugs prescribed by a veterinarian.
K.
“Waiting period” means the period of time specified in a pet insurance policy
that is required to transpire before some or all of the coverage in the policy can
begin. Waiting periods may not be applied to renewals of existing coverage.
L.
“Wellness program” means a subscription or reimbursement-based program that
is separate from an insurance policy that provides goods and services to promote
the general health, safety, or wellbeing of the pet. Any wellness program that
meets the definition of insurance as provided in Miss. Code Ann. § 83-5-5 (Rev.
2022), shall be considered insurance and shall be subject to the insurance code.
This definition is not intended to classify a contract directly between a service
provider and a pet owner that only involves the two parties as being “the
business of insurance,” unless other indications of insurance also exist.