You've been comparing pet insurance policies. You've spotted a number — 80%, maybe 90% — and you're not quite sure what it means in practice.
You're not alone. Benefit percentage is one of the most misunderstood parts of pet insurance, and it's the main reason some pet parents are surprised when a claim comes back lower than they expected.
Here's everything you need to know, in plain English.
Your benefit percentage is the share of eligible vet costs we work out first, before your excess is deducted.
So, if your benefit percentage is 80% and you have an eligible vet bill of $800, with a $100 excess, here's how it works: we calculate 80% of the $800 bill = $640. Then we deduct your $100 excess = $540 back to you. Simple.
Where people get confused is the order of operations — your benefit percentage is applied to the vet bill first, then your excess comes off the result. We'll walk through that in a moment.
These three things work together to determine how much you get back on a claim. They're not the same thing, but they're often muddled together.
Benefit percentage is the portion we pay for approved vet costs (minus any excess). Think of it as your insurer's portion of the bill.
Excess is the amount you contribute towards claims each policy period. Once you've reached your chosen excess, no further excess applies for the rest of that year. A higher excess can lower your premium, but increase out-of-pocket costs when you claim.
Annual limit is the maximum you may be able to claim in a policy year — your overall cap. Think of it as the ceiling.
Your benefit percentage applies to the eligible vet costs first. Your excess then comes off whatever is left.
Here's a worked example using a $1,000 vet bill, a $200 excess, and three different benefit percentages:
Vet bill: $1,000 | Excess: $200 |
Notice how the same vet bill produces a meaningfully different out-of-pocket result depending on the benefit percentage you've chosen. On a $1,000 bill, the difference between 70% and 90% is $200.
On a larger bill, that gap grows significantly.
|
Benefit percentage: |
Reimbursement: |
You pay: |
|
70% |
$500 |
$500 |
|
80% |
$600 |
$400 |
|
90% |
$700 |
$300 |
Yes — especially on the big claims. And those are the ones that really count.
Here's the same comparison applied to an $8,000 eligible claim after excess:
|
Benefit percentage |
Reimbursement on $8,000 |
You pay |
|
70% |
$5,400 |
$2,600 |
|
80% |
$6,200 |
$1,800 |
|
90% |
$7,000 |
$1,000 |
That's a $1,600 difference between 70% and 90% on a single claim. For treatments like cruciate surgery, foreign body removal, cancer treatment, or fracture repair — which can run into thousands of dollars — your benefit percentage makes a real financial difference.
With petinsurance.com.au, you choose your own benefit percentage. You're not locked into a single rate:
You can always lead with the ceiling: up to 90% back on eligible vet costs.
As a general rule, choosing a higher benefit percentage may affect your premium. So, if keeping monthly costs down is the priority, a lower benefit percentage with a higher excess can help. If you want maximum benefit on a big claim, 90% is available on every tier.
This is the question underneath most of the confusion and it's worth being honest about. A few things can affect what you actually receive on a claim:
Your benefit percentage is applied first. Your excess is then deducted from that amount, not before it.
So, on a $500 bill with an 80% benefit rate and a $200 excess: we work out 80% of the $500 bill = $400. Then we deduct your $200 excess = $200 back to you. Note that:
None of this is designed to catch you out. But understanding how these three things interact means you'll never be surprised by a claim outcome.
It depends on what matters most to you:
There's no wrong answer; it's about matching your policy to your budget and your risk appetite. That's exactly why we let you choose.
What is benefit percentage in pet insurance?
Benefit percentage is the share of eligible vet costs we may reimburse before your excess is deducted. For example, a 90% benefit percentage means we calculate 90% of your eligible costs first, then deduct your annual excess from that amount.
Is benefit percentage applied before or after excess?
Excess is applied after we've worked out your benefit — not before. Your annual excess is deducted from your calculated claim benefit, after we've applied the benefit limit (where applicable), the Booster Care limit (where applicable) and your benefit percentage to the claimed amount. It's the amount you contribute per policy period, and it applies to each claim within that period until it's fully paid — once met, no further excess applies for the rest of that period. It resets when you renew your policy. Note: the annual excess doesn't apply to Routine Care items.
Does a higher benefit percentage mean a higher premium?
Generally, yes — choosing a higher benefit percentage may result in a higher premium. The trade-off is lower out-of-pocket costs when you do claim.
What benefit percentages are available with petinsurance.com.au?
Depending on your tier, you can choose 70%, 80%, or 90%. The Low tier offers 80% or 90%. The Mid and High tiers offer 70%, 80%, or 90%.
What is the difference between benefit percentage and annual limit?
Benefit percentage is the share of each eligible claim that may be reimbursed. Annual limit is the maximum total you may be able to claim across the whole policy year. Both affect what you receive on a claim, but in different ways.
Why was my pet insurance reimbursement lower than I expected?
The most common reasons are: your excess was deducted , reducing the eligible claim amount; some vet costs weren't eligible under your policy; . Your policy's PDS explains exactly how claims are calculated.