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Trupanion claim form 2017-2025 free printable template

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Questions? Claims@Trupanion.com Phone: 855.266.2151CLAIM FORM Policyholder name:Preferred phone:Your pets name (please complete one form per pet): Your policy number (if known):Reason for treatment
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Trupanion claim form Form Versions

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Who needs the Companion Claim Form?

Companion provides pet insurance. Companion provides insurance coverage to cats and dogs between 8 weeks to 14 years of age in the US, Canada and Puerto Rico. If the covered pet is sick or injured, the owner must file the Claim Form in order to receive the reimbursement of the expenses for treatment.

What is the Companion Claim form for?

The form must be submitted to record the insured event and to give all important information. Therefore, the owner must fill out the claim form together with the veterinarian in charge.

When is the Pet Insurance Claim form due?

The owner must submit the filled out form within 90 days after the date of the treatment to be granted the reimbursement.

Is the Companion Claim Form accompanied by any other forms?

If the claim is being filed for the first time, it is necessary to provide the pet’s complete medical records form current and prior veterinary and emergency hospitals.

And regardless of the time the claim is being submitted, it is always mandatory to attach a copy of the pet’s veterinarian’s itemized invoice.

How to fill out the Companion Insurance Claim Form?

The form requires providing the following details in part A:

  • The pet’s owner’s name, address, phone number, email, amount of claim;
  • The pet’s name, species;
  • Insurance policy number;
  • Whether the pet is spayed or neuter;
  • List of all the hospitals visited 2 years before the enrollment.
  • Part B is meant for the vet’s completion:
  • Reason of the treatment;
  • Date of injury or illness;
  • Diagnosis or type of illness or injury;
  • Whether the attending vet’s recommendations were followed;
  • Stamp of the clinic
  • Name and signature of the veterinarian.

Where to send the completed Claim Form?

It is to be directed to Companion by mail or fax. The details are indicated at the bottom of the one-page form.

 
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