BRANDON BEDORE

1521 SIESTA KEY WAY, APT 380

ROCKVILLE, MD 20850

5/24/2019

Dear Brandon Bedore:

Congratulations and welcome to the PetFirst family! You, like so many other pet owners, enjoy the
companionship of having a pet. By activating this policy you have made Reese 's health and well-being a top priority.

Did you know- every six seconds a pet owner is faced with a vet bill of more than $1,000? Or, that dog and cat
owners are expected to spend more than $15 billion every year on veterinary care alone? Because you purchased a pet
insurance policy from PetFirst, you don’t have to worry about the financial aspects of taking care of your pet.

PetFirst is dedicated to providing great pet insurance coverage for dogs and cats of all ages and breeds, each and
every day. Please take a few minutes to look over the details of your policy. Let us know if you have any questions.

Our primary focus at PetFirst is you and your pet. If we can assist you in any way, please contact us at 1-866-937-
PETS (7387).

Thank you for choosing PetFirst to protect your pet.

Sincerely,

Chief Executive Officer

 NEW HAMPSHIRE INSURANCE COMPANY

175 Water Street

New York, NY 10038
(866) 937-7387

DECLARATIONS PAGE - PET INSURANCE

INSURED INFORMATION
Insured's Name: Brandon Bedore
Address: 1521 Siesta Key Way, apt 380
City, State and Zip: Rockville, MD 20850
Telephone: 518-354-2025
POLICY INFORMATION
Policy Number: PFH965553
Plan: Standard 30-Day
Policy Period: 05/24/2019 11:09:02 AM to 6/24/2019 Time: 12:01 A.M.
Covered Incident Limit: $500.00
Category: Pet Insurance
Aggregate Limit: $1,000.00
Deductible: Accident & Illness $50(Per Incident)
Co-Insurance: %
Waiting Period Per Pet: PET #1: Illness 0 days

DESCRIPTION OF COVERED PETS PET #1

Name of Pet(s): Reese
Species: Cat
Breed(s): Domestic Short Hair

Color(s):
Sex/Age: F/1
ENDORSEMENTS PER POLICY

121077 (03-18) MD State Amendatory

COMBINED TOTAL PREMIUM

Base Premium All Pets: $8.00

Total Cost of Policy: $8.00
Monthly Payment: $0.00

_________________________________
Authorized Signature

121052 (11/15)
 Claim Form
All claims must be submitted in writing within ninety (90) days of the treatment or receipt date.

1 Member Info
PFH965553
Policy Number: ___________________________________________________

My Vet Info
Reese
Pet Name:______________________________________-__________________
Brandon Bedore
Pet Parent Name: ________________________________________________
1521 Siesta Key Way, apt 380
Address: __________________________________________________________
Rockville
City: _____________________________________ MD
State: __________________
20850
Zip:________________________ 518-354-2025
Phone: _______________________________

2 Vet Visit Info

Please attach medical records (i.e. SOAP notes, vet notes, chart notes) from your veterinarian for the claimed incident.

Important Note: Medical records often differ from discharge instructions and invoices, so it is important to ask your vet specifically for
chart/SOAP/vet notes.

*Please note: if this is your first claim, please provide 12 months of medical records. If you have recently adopted your pet and don’t
have 12 months of medical records, all you will need to submit is your adoption contract and adoption medical records.

Attach invoices and/or itemized receipts along with this completed claim form.

3 Diagnosis and Invoice Info

/ / $
Treatment Date Medical Diagnoses or Routine Treatment Total Charges

/ / $
Treatment Date Medical Diagnoses or Routine Treatment Total Charges

/ / $
Treatment Date Medical Diagnoses or Routine Treatment Total Charges

4 Sign and Date

Incomplete forms will delay claims processing.

Signature: ________________________________________________________________________________________ Date: ________________________________________

Policyholder declaration: I declare my veterinarian recommended the treatment for which I am claiming. The particulars given are
correct to the best of my knowledge and belief. I authorize my veterinarian to release medical records and give consent to PetFirst
Pet Insurance to communicate with my veterinarian or veterinarian’s staff.

Any person who knowingly and with intent to defraud any insurance company or another person files an application for insurance
or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning
any fact material thereto, commits a fraudulent insurance act which is a crime and subjects the person to criminal and civil penalties.

All claims must be submitted in writing to PetFirst within ninety (90) days of the treatment or receipt date.
Please allow at least 10 business days for processing.

Submit Your Claim:

EMAIL TO: FAX TO: UPLOAD TO:

submitclaim@petfirst.com 877-281-3348 MyPets Online Account

866-937-7387 | petfirst.com | #LoveYourPetFirst

 Submitting a Claim Checklist
Before you leave the vet:

Gather all medical records from your vet including actual medical diagnosis and any notes associated
with the diagnosis. These notes have several different names (soap, vet or chart) but they are NOT the
same as your discharge instructions.

Make note of your vet contact information. You will need this on your claim form.

Get a copy of your invoice or itemized receipt at the end of your vet visit.

If this is your first claim with PetFirst, please read the following scenarios as you may require
additional paperwork.
• If your pet is less than 12 months of age, please include all vet visit medical records.
• If your pet is older than 12 months (not adopted) please include the past 12 months of medical
records (or as far back as you and your vet have access to).
• If you’ve recently adopted your pet, please include your adoption records.

Consolidate and gather your paperwork:

Complete the Claim Form (download from petfirst.com or sign into your MyPets online account
and select your pet for the pre-populated form).

Attach all medical records you received before you left the vet (medical diagnosis and any soap/
vet/chart notes).

Attach your invoice or itemized receipt from your vet visit.

Save a copy of all your paperwork for yourself.

Submit your claim by any of the following ways:

Online: MyPets Online Account

Email: submitclaim@petfirst.com

Fax: 877-281-3348

Mail: PetFirst– Claims Department, 400 Missouri Avenue Suite 105, Jeffersonville, IN 47130

All claims must be submitted in writing to PetFirst within ninety (90) days of the treatment or
receipt date. Please allow at least 10 business days for processing.

866-937-7387 | petfirst.com | #LoveYourPetFirst

 FRAUD WARNING NOTICE

THE UNDERSIGNED IS AN AUTHORIZED REPRESENTATIVE OF THE APPLICANT AND CERTIFIES THE INFORMATION PROVIDED TO OBTAIN THIS COVERAGE IS
ACCURATE TO THE BEST OF THEIR KNOWLEDGE, THIS INCLUDES ANY APPLICATIONS, LOCATIONS SCHEDULES, VALUATION STATEMENTS, LOSS
HISTORY INFORMATION AND ENGINEERING REPORTS.

THE FOLLOWING STATEMENT APPLIES IN ALL STATES EXCEPT THOSE NOTED BELOW:

ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR ANOTHER PERSON FILES AN APPLICATION FOR
INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING,
INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON
TO CRIMINAL AND CIVIL PENALTIES.

Arkansas Fraud Warning: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information on an
application for insurance is guilty of a crime and may be subject to fines and confinement in prison.

California Fraud Warning For your protection California law requires the following to appear on this form. Any person who knowingly presents false or fraudulent claim for the
payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.

Colorado Fraud Warning: It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or
attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance, and civil damages. Any insurance company or agent of an insurance
company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the
policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of
Regulatory Agencies.

District of Columbia: WARNING: It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person.
Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the
applicant.

Florida Fraud Warning: Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false,
incomplete, or misleading information is guilty of a felony of the third degree.

Kansas Fraud Warning: An act committed by any person who, knowingly and with intent to defraud, presents, causes to be presented or prepares with knowledge or belief
that it will be presented to or by an insurer, purported insurer, broker or agent, any written, electronic, electronic impulse, facsimile, magnetic, oral or telephone communication
or statement as part of, or in support of, an application for the issuance of, or the rating of an insurance policy for personal or commercial insurance, or a claim for payment or
other benefit pursuant to an insurance policy for commercial or personal insurance which such person knows to contain materially false information concerning any fact
material thereto; or conceals, for the purpose of misleading, information concerning any fact material thereto.

Kentucky Fraud Warning: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any
materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime.

Louisiana Fraud Warning: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an
application for insurance is guilty of a crime and may be subject to fines and confinement in prison.

Maine Fraud Warning: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company.
Penalties may include imprisonment, fines or a denial of insurance benefits.

Minnesota Fraud Warning: A person who files a claim with intent to defraud or helps commit a fraud against an insurer is guilty of a crime.

New Jersey Fraud Warning: Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties.

New Mexico Fraud Warning: ANY PERSON WHO KNOWINGLY PRESENTS A FALSE OR FRAUDULENT CLAIM FOR PAYMENT OF A LOSS OR BENEFIT OR
KNOWINGLY PRESENTS FALSE INFORMATION IN AN APPLICATION FOR INSURANCE IS GUILTY OF A CRIME AND MAY BE SUBJECT TO CIVIL FINES AND
CRIMINAL PENALTIES.

New York Fraud Warning: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of
claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance
act, which is a crime, and shall also be subject to a civil penalty not to exceed $5,000 and the stated value of the claim for each such violation.

Ohio Fraud Warning: Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a
false or deceptive statement is guilty of insurance fraud.

Oklahoma Fraud Warning: WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an
insurance policy containing any false, incomplete or misleading information is guilty of a felony.

Oregon Fraud Warning: Any person who knowingly and with intent to defraud or solicit another to defraud an insurer: (1) by submitting an application, or (2) by filing a claim
containing a false statement as to any material fact, may be violating state law.

Pennsylvania Fraud Warning: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of
claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act,
which is a crime and subjects such person to criminal and civil penalties.

Tennessee Fraud Warning: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the
company. Penalties include imprisonment, fines and denial of insurance benefits.

Virginia Fraud Warning: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company.
Penalties include imprisonment, fines, and denial of insurance benefits. READ YOUR POLICY. THE POLICY OF INSURANCE FOR WHICH APPLICATION IS BEING MADE,
IF ISSUED, MAY BE CANCELLED WITHOUT CAUSE AT THE OPTION OF THE INSURER AT ANY TIME IN THE FIRST 60 DAYS DURING WHICH IT IS IN EFFECT AND
AT ANY TIME THEREAFTER FOR REASONS STATED IN THE POLICY.

Washington Fraud Warning: It is a crime to knowingly provide false, incomplete, or misleading information to an insurance company for the purpose of defrauding the
company. Penalties include imprisonment, fines, and denial of insurance benefits.

Vermont Fraud Warning: Any person who knowingly presents a false statement in an application for insurance may be guilty of a criminal offense and subject to penalties
under state law.
Pet Insurance Policy
Standard Plan
TERMS AND CONDITIONS
American Alternative Insurance Corporation
ADMINISTRATIVE OFFICE
555 College Road East, Princeton, New Jersey 08543-5241
(800) 305-4954
INDEX OF POLICY PROVISIONS

121035 (03/18) Page 1 of 7

TABLE OF CONTENTS

INSURING AGREEMENT . . . . . . . . . . . . . . . . . 3
DEFINITIONS . . . . . . . . . . . . . . . . . . . . . . . . . . 3
EFFECTIVE DATE . . . . . . . . . . . . . . . . . . . . . . 4
BENEFIT PROVISIONS . . . . . . . . . . . . . . . . . . 4
DEDUCTIBLE . . . . . . . . . . . . . . . . . . . . . . . . . . 4
LIMITS OF LIABILITY . . . . . . . . . . . . . . . . . . . . . 4
GENERAL CONDITIONS . . . . . . . . . . . . . . . . . 4
ELECTRONIC DELIVERY . . . . . . . . . . . . . . . . 5
TERRITORY . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
OTHER INSURANCE . . . . . . . . . . . . . . . . . . . . 5
TERMINATION OF INSURANCE . . . . . . . . . . . 5
TRANSFER . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
EXCLUSIONS AND LIMITATIONS . . . . . . . . . . . 5
EXPANSION OF COVERAGE . . . . . . . . . . . . . 6
LOSS CONDITIONS AND
INSURED’S DUTIES . . . . . . . . . . . . . . . . . . . . . 6
DECLARATIONS . . . . . . . . . . . . . . . . . . . . . . . . 7

121035 (03/18) Page 2 of 7

INSURING AGREEMENT
A. Upon payment of the premium by the Insured when due and complying with the terms of this policy,
the Insurer agrees to reimburse the Insured for Covered Service(s) to the extent set forth in this policy.
We will pay only for Covered Services rendered during the Policy Period. Benefits are payable subject
to the applicable Co-Insurance, Deductible, Covered Incident Limit, Aggregate Limit and any and all
policy conditions and exclusions.
B. As various provisions in this policy restrict coverage, please read the entire policy carefully to
determine Your rights and what is and is not covered.
C. Words and phrases capitalized and in bold print have special meaning. They are defined in the
Definitions provision below.

DEFINITIONS
A. Aggregate Limit: The maximum amount We will pay for all Covered Incidents as shown on the
Declarations Page of this policy during the applicable Policy Period.
B. Application: Your statements and representations to Us provided by You in the enrollment process
in response to Our standard questions and data requests to You as comprising part of the enrollment
process whether such enrollment is done over the telephone, on paper, or via the Internet.
C. Chronic Conditions: Are injuries and/or illness that are likely to reappear and are unlikely to be
resolved. These conditions can be treated or managed, but not cured.
D. Co-Insurance: The percentage of the Covered Service for which You are responsible per Your Pet
and which is not reimbursable under this policy. Co-insurance shall be applied after any Deductible.
E. Congenital Defects or Diseases: A condition that is present from birth, whether inherited or caused
by the environment, which may cause or otherwise contribute to illness or disease.
F. Covered Incident: An occurrence wherein You had to make payment for a Covered Service under
this policy. A Covered Incident includes payments for all covered Veterinary Services resulting or
arising from the same accidental injury or illness, diagnosis, or disease process during the Policy Period
regardless of the number of covered Veterinary Services provided or areas of Your Pet’s body affected.
G. Covered Incident Limit: The maximum amount We will pay per Covered Incident, as shown on the
Declarations Page of this policy.
H. Covered Service: Expenses incurred from Veterinary Services provided to Your Pet that relate to or
arise from accidental injury or illness to Your Pet during the Policy Period. Covered Service includes
the costs associated with Your Pet’s cremation up to a maximum amount of $150.00 per any applicable
Policy Period.
I. Deductible: The specified amount of money You must pay per each Covered Incident before We will
pay a claim under this policy as shown on the Declarations Page.
J. Document of Insurance: Any document issued to You by Us in connection with this policy that
names You as the Insured, specifying Your Pet with respect to which coverage is being provided and
stating the effective date of the policy and/or Policy Period. This term shall include the Declarations
Page of this policy.
K. Hereditary Disorder: An abnormality that is genetically transmitted from parent to offspring and may
cause illness or disease.
L. Insured: You, the pet owner/Insured policyholder.
M. Insurer: The insurance carrier identified on the Declarations Page of this policy and other pertinent
Documents of Insurance.
N. Long-Term Conditions: Injuries and/or illness for which treatment continues or is likely to continue
for a period of six months or longer.
O. . Maintenance Plan Fees or Membership Fees: Periodic or annual fees paid to a Veterinarian or
other third-party to obtain certain Veterinary Services or incentives for Your Pet at a reduced cost or
discount or otherwise under special rates or terms or a set plan.
P. Policy Period: Twelve months from the effective date of this policy unless otherwise specified on the
Declarations Page of this policy.
Q. Pre-Existing Condition: Any illness, condition requiring medical treatment or injury affecting Your
Pet that manifests, whether diagnosed or treated, prior to the inception date of this policy.
R. Preventive Treatment: Any treatment, service, or procedure, including but not limited to physical
examinations, medications, surgeries, inoculations, or laboratory procedures, for the purpose of

121035 (03/18) Page 3 of 7

prevention of illness or injury or for the promotion of general health, where there is no related injury or
illness.
S. Reasonable & Customary: Published industry guidelines such as the American Animal Hospital
Association’s fee reference guide for Veterinarians.
T. Veterinarian: A properly licensed veterinarian.
U. Veterinary Services: Reasonable and Customary medical services rendered by a Veterinarian.
Veterinary Services do not include Maintenance Plan Fees and Membership Fees.
V. Waiting Period: An initial period of 14 days from the inception date of this policy, or as otherwise
shown on the Declarations Page.
W. We; Our; or Us: The Insurer.
X. You or Your: The Insured policyholder.
Y. Your Pet: The pet specified and described by You in the Application for this policy and other
Documents of Insurance pertaining to this policy.

EFFECTIVE DATE
Your coverage begins as of the effective date and time shown on the Documents of Insurance
(including the Declarations Page, which forms part of this policy as issued) provided to You upon
enrollment in this policy. We will not reimburse You for expenses arising from any incident pertaining to
Your Pet occurring within the initial Waiting Period commencing at policy inception. This Waiting
Period will not apply to accident expenses that are Covered Incidents or any subsequent Policy Period
representing a renewal of this policy, if continuous coverage is maintained.

BENEFIT PROVISIONS
A. During the Policy Period, We will reimburse You for Covered Service per Covered Incident, subject
to the Covered Incident Limit, the Aggregate Limit, the Co-Insurance shown on the Declarations
Page, and Your payment of any applicable Deductible.
B. Benefits are paid for Covered Service as set forth in this policy.

DEDUCTIBLE
The Deductible applies to each Covered Incident during the Policy Period as shown on the
Declarations Page.

LIMITS OF LIABILITY
Our limit of liability to You under this policy for each Covered Incident is the Covered Incident Limit as
set forth on the Declarations Page. Our total limit of liability to You under this policy for all Covered
Incidents in a single Policy Period is the Aggregate Limit as set forth on the Declarations Page.

GENERAL CONDITIONS
A. Our payments for Covered Service are limited to the Covered Incident Limit and the Aggregate
Limit as shown on the Declarations Page. The Covered Incident Limit and the Aggregate Limit for all
coverages provided by this policy for Covered Service is shown on the Declarations Page.
B. Expenses arising from Pre-Existing Conditions are not covered by this policy. In the original
Application for this insurance, You have either represented that Your Pet as specified and described in
the Application and/or Declarations Page was in good health and free of illness or injury as of the
effective date of this policy, or You have disclosed a specific Pre-Existing Condition(s). By accepting
this policy You have affirmed Your understanding that any expenses arising from treatment of such Pre-
Existing Condition(s) will not be covered under this policy.
C. In the event You opt to transfer, and We approve of such a transfer of, Your Pet to another policy with
Us with higher benefits, the maximum benefit payable with respect to a Covered Service will be
restricted to the maximum benefit payable under the policy that applied during the period in which such
illness(es) or injury was first noted, diagnosed, or treated. If the level of benefits is lowered, the lower
benefits shall apply. The addition of any new pet(s) or endorsements/riders to an active policy shall result
in a 14 day waiting period before that coverage becomes effective. This paragraph C does not apply to
expiring 30- or 60- day policies that are renewed or upgraded to a 12-month plan.

121035 (03/18) Page 4 of 7

D. Coverage for treatment of leukemia for cats may be made effective after You provide documentation
of a negative FeLV test and proper vaccination from a Veterinarian.
E. Conformity to State Statutes – When this policy’s provisions are in conflict with the statutes of the state
in which this policy is issued, the provisions are amended to conform to such statutes.

ELECTRONIC DELIVERY
By accepting the terms of this insurance as evidenced by the payment of premiums hereunder, it is
agreed that this policy and any endorsements may be delivered to You by electronic mail via the internet,
at Our option. If You choose not to accept electronic delivery of this policy, You must immediately notify
Us and arrange for the policy to be mailed or otherwise delivered.

TERRITORY
This coverage is valid and only applies to Covered Service rendered within the United States, its
territories and possessions while this policy is in effect.

OTHER INSURANCE
If at any time a claim is made under this policy for a Covered Incident, and there is other insurance
applicable, We will pay Our share of the benefits for covered expenses subject to the following
conditions:
1. If the policies are not simultaneous as to the order of policy dates, the second and subsequent policies
shall participate in the loss only to the extent that the coverage is excess over the amount of all previous
policies on the same interest.
2. If two or more policies bear the same date, they are considered to be simultaneous, and each insurer
shall contribute proportionately. If the other insurance does not have a per incident or aggregate limit, Our
share of the loss shall be no more than 50%.
The insolvency of the insurers does not affect the proportionate liability of the other insurers.

TERMINATION OF INSURANCE
A. General. This policy may be terminated by Us during the Policy Period by written notice to You for
reasons allowable by applicable state law and with such time period between the sending of such notice
and the effective date of cancellation as is allowable under state law. Reasons for cancellation may
include, but, subject to applicable state law, are not necessarily limited to, nonpayment of premium.
Specific terms and conditions with respect to termination, cancellation, and nonrenewal of this policy are
set forth in the attached Cancellation and Nonrenewal Endorsement, which is made a part of this policy.
B. Misrepresentation. The policy is terminable if You have willfully concealed or misrepresented any
material fact concerning this insurance or the subject thereof or committed any fraud or false swearing
relating thereto. Such cancellation will be effected pursuant to written notice to You with the minimum
advance notice period allowable under applicable state law for a cancellation due to fraud or material
misrepresentation.
C. Termination by Insured. You may terminate this policy at any time for any reason by mailing or
delivering written notice of cancellation to Us.

TRANSFER OF POLICY
This policy, while issued to You, provides coverage only with respect to Your Pet, the specific pet
designated and described in the Application for this policy and its Declarations set forth herein. If
ownership of Your Pet is transferred to another person during the Policy Period, continued coverage for
Your Pet is subject to a new Application and to applicable underwriting rules.

EXCLUSIONS AND LIMITATIONS

Beyond the exclusions and limitations pertaining to specific coverages under this policy that have thus far
been set forth above, this policy will not pay for costs nor reimburse You for expenses You incur for:
1. Injury or illness contracted, manifested or incurred prior to the policy effective date, unless such injury
or illness has been cured and there has not been a subsequent recurrence or manifestation of the injury

121035 (03/18) Page 5 of 7

or illness requiring treatment. Support documentation from a Veterinarian must be submitted to Us for
consideration of removal of any medical exclusion.
2. Elective procedures, cosmetic surgeries, including but not limited to tail docking, dewclaws, skin folds,
nail trims, and cropping of ears.
3. Expression or removal of anal glands or anal sacculitis.
4. Pregnancy, breeding, and conditions related to pregnancy or breeding.
5. Special diets, pet foods, vitamins, mineral supplements, grooming costs and bathing (including
medicated baths).
6. Treatment of external parasites such as fleas, lice and ticks and preventable internal parasites such as
heartworms, hookworms, roundworms, tapeworms and whipworms.
7. Reserved for future use.
8. Diagnostic test(s) and treatment(s) for conditions excluded or limited by this policy and complications
of conditions excluded or limited by this policy.
9. Time and travel expenses to the Veterinarian’s premises or hospital.
10. Illness or injury which arises out of racing, coursing, commercial guarding, or organized fighting of
Your Pet.
11. Congenital Defects or Diseases and Hereditary Disorders.
12. Continuous coverage of Chronic Conditions and Long-Term Conditions that manifested in a
previous pet insurance policy with Us.
13. Behavioral training.
14. Routine examinations, routine tests or screens, vaccines, teeth cleaning or polishing.
15. Preventive Treatments and diagnostics for, or conditions relating to, preventable parasites,
including heartworms.
16. Spaying/Neutering.
17. Diagnosis, medical management, or surgical correction of cruciate ligament damage or rupture to
include treatment for the anterior cruciate ligament (ACL), medial cruciate ligament (MCL), posterior
cruciate ligament (PCL), and cranial cruciate ligament (CCL).
18. Diagnosis, medical management, or surgical correction of interverterbal disc(s) regardless of the
procuring cause (unless otherwise agreed with You) during the first twelve (12) months of the Policy
Period. However, this exclusion does not apply if this policy is a renewal of a Pet Insurance Policy
issued by Us.
19. Treatment of periodontal disease.
20. Diagnosis, medical management, or surgical correction of patella luxation or hip dysplasia.
21. Treatment of foreign body ingestion, occurring more than once per Policy Period.
22. Payment of any treatment not performed by a Veterinarian.
23. Diagnosis or treatment for organ transplants.
24. Injury to or illness caused directly or indirectly by: an enemy attack by armed forces with or without a
state of war including actions taken in resisting that attack; insurrection, rebellion, revolution, invasion,
civil war, illegal acts, usurped power, or as a result of any: nuclear incident, or biological, chemical or
radiation contamination or exposure other than acts of terrorism.

EXPANSION OF COVERAGE
If We make changes to the policy form, the provisions exclusions and limitations conditions,
endorsements or rules whereby the insurance is expanded or broadened without any additional premium,
this policy will be so expanded.

LOSS CONDITIONS AND INSURED’S DUTIES

A. In cases of a Covered Incident giving rise to a claim under this policy, You agree to obtain or release
all medical records to support claims upon request. Furthermore, You authorize Us to obtain all records
to support the claim. Upon request, You will provide Us with proof of identity of Your Pet as We may
require.
B. A loss is payable within 60 days after We receive a fully completed claim form with the attached actual
itemized receipts that have been paid in full for Covered Service(s).
C. All claims must be submitted to Us in writing within 90 days of the treatment date or date of the receipt
furnished to You in connection with such Covered Service(s).

121035 (03/18) Page 6 of 7

DECLARATIONS
By accepting this policy, You agree that all the statements made by You to Us in the Application and/or
enrollment process, and any related declarations or representations by You are true and that You have
not withheld any information regarding Pre-Existing Condition(s) or any other material facts. You affirm
that the policy and the endorsements comprise the entire agreement between You and Us.

By signing below, the President and the Secretary of the Insurer agree on behalf of the Insurer to all the
terms of this Policy.

_________________________________ _________________________________
PRESIDENT SECRETARY

121035 (03/18) Page 7 of 7

 NEW HAMPSHIRE INSURANCE COMPANY
MARYLAND STATE AMENDATORY ENDORSEMENT

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

This endorsement contains Maryland specific language and amends the Policy to comply with the
requirements of Maryland law.

This endorsement modifies insurance provided under the following: PET INSURANCE POLICY
STANDARD PLAN (FORM #121035), PREMIER PLAN (FORM #121029) AND EMERGENCY PLAN
(FORM #121030)

DEFINITIONS
The following definition is added:

First Class Mail Tracking Method means a method that provides evidence of the date that a piece of
first-class mail was accepted for mailing by the United States Postal Service, including a certificate of mail
and an electronic mail tracking system used by the United States Postal Service.

First Class Mail Tracking Method does not include a certificate of bulk mailing.

GENERAL CONDITIONS section Paragraph C in the STANDARD PLAN and Paragraph D in the
PREMIER PLAN are deleted in their entirety and replaced with the following:

In the event of the insured opting to transfer the insured's pet to a program with differing benefits, the
maximum benefit payable with respect to an illness or injury will be restricted to the maximum benefit
payable under the policy that applied during the period in which such illness(es) or injury was first noted,
diagnosed, or treated. The addition of any new pet(s) or endorsements/riders to an active policy shall
result in a fourteen (14) day waiting period before that coverage becomes effective. This paragraph does
not apply to expiring 30- or 60- day policies that are renewed or upgraded to a 12-month plan.

TRANSFER OF POLICY section is deleted in its entirety and replaced with the following:

TRANSFER OF YOUR PET

This Policy, while issued to and held by You, provides coverage only with respect to the specific pet
(Your Pet) designated and described in the Application for this Policy and its Declarations Page. If
ownership of Your Pet is transferred to another person during the Policy Period, this Policy will be
cancelled and the new owner of Your Pet may apply for coverage by completing a new Application
which will be subject to applicable underwriting rules.

Paragraph B of the policy entitled LOSS CONDITIONS AND INSURED’S DUTIES is deleted in its
entirety and replaced with the following:

We shall acknowledge receipt of a notice of claim within fifteen (15) working days, unless payment is
made within that period of time.

We will affirm or deny coverage of a claim within fifteen (15) working days after receiving a properly
completed claim form or other proof of loss. If We have not completed Our investigation of the claim
within forty five (45) days of the notice of claim, We shall promptly notify You in writing of the actual

121077 (03/18) Page 1 of 2

reason that additional time is necessary to complete the investigation. We will send the notice to You
each additional forty five (45) day period until We either affirm or deny the coverage.

If there is a reasonable basis supported by specific information available for review by the Insurance
Commissioner that You fraudulently caused or contributed to the loss, We shall not be bound by the
preceding paragraph.

If a claim is affirmed, the benefits are payable within thirty (30) days after We receive a fully completed
claim form with the attached actual itemized receipts that have been paid in full for Covered Services.

TERMINATION OF INSURANCE, Subparagraph A. General, is deleted in its entirety and replaced with
the following:

NOTICE OF CANCELLATION OR NONRENEWAL

If Your policy has been in effect for more than forty five (45) days or is a renewal, We shall send You or
Your agent a written notice of Our intention to cancel Your policy. The notice shall be sent by certificate
of mailing at least forty five (45) days prior to the policy’s expiration date unless the cancellation is for
non-payment of premium. If the cancellation is for non-payment of premium, We will send You or Your
agent written notice of Our intention to cancel Your policy. The notice will be sent by a First-Class Mail
Tracking Method, at least ten (10) days prior to the effective date of cancellation. The notice of
cancellation or nonrenewal will provide the reason for Our proposed action. You may request additional
information regarding cancellation or nonrenewal. We will respond in writing to Your request within fifteen
(15) days from the date it is received.

However, if We have provided You with a renewal policy and a notice of premium due at least forty five
(45) days before the renewal date of the policy and You fail to make the required payment by the renewal
date, We may terminate the policy on the renewal date for nonpayment of premium.

At the time We issue Your policy or binder of insurance, We shall provide You with written notice of our
ability to cancel the policy or binder during the forty five (45) day underwriting period.

If Your policy is other than a renewal, has been in effect for less than forty five (45) days and is being
cancelled for other than nonpayment of premium, We may cancel it if You do not meet any of Our
underwriting standards. We will provide You with a written notice of cancellation sent by a First-Class
Mail Tracking Method. The notice shall be effective fifteen (15) days after its mailing. The notice will
clearly and specifically state Our reason for the cancellation.

If Your policy is other than a renewal, has been in effect for less than forty five (45) days and is being
cancelled for nonpayment of premium, We shall provide You with a written notice of cancellation stating
the reason for the action as nonpayment of premium. The notice of cancellation will be sent by a First-
Class Mail Tracking Method. It shall be effective ten (10) days after its mailing.

NOTICE OF CONDITIONAL RENEWAL

We will provide written notice to You upon renewal or by endorsement, of any proposed addition,
reduction, or elimination of coverage. If We intend to increase Your renewal premium by twenty percent
(20%) or more, We shall send You or Your agent a written notice of Our intention to increase Your
premium. The notice will be sent by first class mail. We are not required by Maryland law to send You a
notice if the increase in premium is due to an increase in exposure or if You have replaced the insurance.

All other terms and conditions of this policy shall remain unchanged.

121077 (03/18) Page 2 of 2

 POLICYHOLDER NOTICE

Thank you for purchasing insurance from a member company of American International
Group, Inc. (AIG). The AIG member companies generally pay compensation to brokers
and independent agents, and may have paid compensation in connection with your policy.
You can review and obtain information about the nature and range of compensation paid
by AIG member companies to brokers and independent agents in the United States by
visiting our website at www.aig.com/producer-compensation or by calling 1-800-706-
3102.

91222 (9/16)
 Rev 7/2016 

WHAT DOES AMERICAN INTERNATIONAL GROUP, INC. (AIG) DO WITH YOUR

PERSONAL INFORMATION?
FACTS
Financial companies choose how they share your personal information. Federal law
gives consumers the right to limit some but not all sharing. Federal law also requires
Why? us to tell you how we collect, share, and protect your personal information. Please
read this notice carefully to understand what we do.

The types of personal information we collect and share depend on the product or
service you have with us. This information can include:
What? • Social Security number and Medical Information
• Income and Credit History
• Payment History and Employment Information
When you are no longer our customer, we continue to share your information as
described in this notice.

All financial companies need to share customers' personal information to run

How? their everyday business. In the section below, we list the reasons financial
companies can share their customers' personal information; the reasons AIG
chooses to share; and whether you can limit this sharing.

Can you limit

Reasons we can share your personal information  Does AIG share?  this sharing?
 
 

For our everyday business purposes — such as to process your

transactions, maintain your account(s), respond to  court orders Yes No
and legal investigations, conduct research including data analytics,
or report to credit bureaus
For our marketing purposes — to offer our products Yes No
and services to you

For joint marketing with other financial companies Yes No

For our affiliates’ everyday business purposes —  

information about your transactions and experiences Yes No

For our affiliates’ everyday business purposes —  

No We don’t share
information about your creditworthiness

For nonaffiliates to market to you No We don’t share

For AIG Insurance Companies: Call 866-244-4786; Fax: 212-458-7081 or E-Mail:

Questions?  CIPrivacy@aig.com
For Pet insurance sold by AIG Insurance Companies: Call 800-937-7387 or E-Mail:
CIPrivacy@aig.com
For Morefar Marketing, Inc. (Non-Warranty):
For policies/services sold prior to 2015, call 866-244-4786 or E-Mail: CIPrivacy@aig.com
For policies/services sold in 2015 or later, call 800-982-5701 or E-Mail: CIPrivacy@aig.com
For Morefar Marketing, Inc. (Warranty): Call 800-982-5701 or E-Mail: CIPrivacy@aig.com
For Livetravel, Inc.: Call 866-244-4786 or E-Mail: CIPrivacy@aig.com

 
 Page 2    Rev 7/2016 
 
 

Who we are
 

Who is providing this notice?  The insurance company subsidiaries of American International Group, Inc. (AIG)
underwriting property-casualty, accident & health, life insurance and related
 
services and certain marketing subsidiaries of AIG listed below. 

 
What we do
How does AIG protect my To protect your personal information from unauthorized access and use, we use
personal information?  security measures that comply with federal law. These measures include
computer safeguards and secured files and buildings. We restrict access to
employees, representatives, agents, or selected third parties who have been
trained to handle nonpublic personal information.

How does AIG collect my
personal information?
We collect your personal information, for example, when you
• apply for insurance or pay insurance premiums
• file an insurance claim or give us your income information
• provide employment information
We also collect your personal information from others, such as credit bureaus,
affiliates, or other companies.

Why can’t I limit all sharing?
Federal law gives you the right to limit only
• sharing for affiliates’ everyday business purposes— information about your
creditworthiness
• affiliates from using your information to market to you
• sharing for nonaffiliates to market to you
State laws and individual companies may give you additional rights to limit sharing.
See below for more on your rights under state law.

 
Definitions
 

Affiliates  Companies related by common ownership or control. They can be financial and
nonfinancial companies.
•Our affiliates include the member companies of American International Group, Inc.
Nonaffiliates Companies not related by common ownership or control. They can be financial
and nonfinancial companies.
•AIG does not share with nonaffiliates so they can market to you.
Joint marketing A formal agreement between nonaffiliated financial companies that together
market financial products or services to you.
•Our joint marketing partners include companies with which we jointly offer
 
insurance products, such as a bank.
 

 
Other important information
This notice is provided by American Home Assurance Company; AIG Assurance Company; AIG Property Casualty Company; AIG Specialty
Insurance Company; Commerce and Industry Insurance Company; Granite State Insurance Company; Illinois National Insurance Co.; Lexington
Insurance Company; AIU Insurance Company; National Union Fire Insurance Company of Pittsburgh, Pa.; National Union Fire Insurance Company of
Vermont; New Hampshire Insurance Company; The Insurance Company of the State of Pennsylvania; (collectively the “AIG Insurance Companies”).
This notice is also provided by certain marketing subsidiaries of AIG, including Morefar Marketing, Inc., LLC, Travel Guard Group, Inc. and Livetravel,
Inc. who market insurance or non-insurance products and services to consumers.

For Vermont Residents only. We will not disclose information about your creditworthiness to our affiliates and will not disclose your personal
information, financial information, credit report, or health information to nonaffiliated third parties to market to you, other than as permitted by
Vermont law, unless you authorize us to make those disclosures. Additional information concerning our privacy policies can be found using the
contact information above for Questions.

For California Residents only. We will not share information we collect about you with nonaffiliated third parties, except as permitted by California law,
such as to process your transactions or to maintain your account.

For Nevada Residents Only. We are providing this notice pursuant to Nevada state law. You may elect to be placed on our internal Do Not Call list by
contacting us as listed above. Nevada law requires that we also provide you with the following contact information: Bureau of Consumer Protection,
Office of the Nevada Attorney General, 555 E. Washington Street, Suite 3900, Las Vegas, NV 89101; Phone number: 702-486-3132; email:
aginfo@ag.nv.gov. You may contact the applicable customer service department using the contact information above or by writing to us at Privacy
Officer, 175 Water Street, 18th Floor, New York, NY 10038.

You have the right to see and, if necessary, correct personal data. This requires a written request, both to see your personal data and to request
correction. We do not have to change our records if we do not agree with your correction, but we will place your statement in our file. If you would like a
more detailed description of our information practices and your rights, please write to us at: Privacy Officer, 175 Water Street, 18th Floor, New York, NY
10038.
CONSENT AND NOTICE REGARDING ELECTRONIC COMMUNICATIONS
FOR PET INSURANCE POLICY AND OTHER COMMUNICATIONS FROM PETFIRST
HEALTHCARE LLC

1. Electronic Signature Agreement.

By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your
electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting
"I Accept" you consent to be legally bound by this Agreement's terms and conditions. You further
agree that your use of a key pad, mouse, or other device to select an item, button, icon or similar
act/action, or to otherwise provide PetFirst Healthcare LLC via an Email notice, in P.E.T.S. online or
in accessing or making any transaction regarding any agreement, acknowledgement, consent terms,
disclosures or conditions constitutes your signature (hereafter referred to as "E-Signature"),
acceptance and agreement as if actually signed by you in writing. You also agree that no certification
authority or other third party verification is necessary to validate your E-Signature and that the lack
of such certification or third party verification will not in any way affect the enforceability of your E-
Signature or any resulting contract between you and PetFirst Healthcare LLC. You also represent that
you are authorized to enter this Agreement for all persons who own or are authorized to access any of
your accounts and that such persons will be bound by the terms of this Agreement. You further agree
that each use of your E-Signature in obtaining a Pet Insurance service constitutes your agreement to
be bound by the terms and conditions of the PetFirst Healthcare LLC disclosures and agreements as
they exist on the date of your E-Signature.

2. Consent to Electronic Delivery.

You specifically agree to receive and/or obtain any and all Pet Insurance related "Electronic
Communications" (defined below) via Email and/or in P.E.T.S. The term "Electronic
Communications" includes, but is not limited to, any and all current and future notices and/or
disclosures that various federal and/or state laws or regulations require that we provide to you, as
well as such other documents, statements, data, records, and any other communications regarding
your Pet Insurance relationship with PetFirst Healthcare LLC. You acknowledge that, for your
records, you are able to use Email or P.E.T.S. online to retain Electronic Communications by printing
and/or downloading and saving this Agreement and any other agreements and Electronic
Communications, documents, or records that you agree to using your E-Signature. You accept
Electronic Communications provided via Email or in P.E.T.S. as reasonable and proper notice, for
any and all laws, rules, and regulations, and agree that such electronic form fully satisfies any
requirement that such communications be provided to you in writing or in a form that you may keep.

3. Paper version of Electronic Communications.

You may request a paper version of an Electronic Communication. You acknowledge that Petfirst
Healthcare LLC reserves the right to charge you a reasonable fee for the production and mailing of
paper versions of Electronic Communications. To request a paper copy of an Electronic
Communication contact us at (866) 937-7387.
 4. Revocation of electronic delivery.
You have the right to withdraw your consent to receive/obtain communications via Email at any
time. If you wish to withdraw your consent, contact us at (812) 206-6928.

5. Valid and current email address, notification, and updates.

Your current valid email address is required in order for you to obtain Pet Insurance services if you
have consented as is noted above. You agree to keep PetFirst Healthcare LLC informed of any
changes in your email address. You may modify your email address by submitting a written request
to PetFirst Healthcare LLC or by speaking with a Customer Service Representative at (866) 937-
7387. PetFirst Healthcare LLC may notify you through email when an Electronic Communication or
updated information pertaining to P.E.T.S. is available. It is your responsibility regularly check your
email for Electronic Communications and to regularly review your P.E.T.S. account for updates.

6. Hardware, software, and operating system.

You are responsible for installation, maintenance, and operation of your computer, browser, and
software. PetFirst Healthcare LLC is not responsible for errors or failures from any malfunction of
your computer, browser, or software. PetFirst Healthcare LLC is also not responsible for computer
viruses or related problems associated with use of an online system. The following are the minimum
hardware, software, and operating system requirements necessary to use P.E.T.S. and receive
Electronic Communications:
Processor - IBM compatible Pentium PC running Windows 2000
Memory - 4MB RAM
Disc Space - 50 MB's Free Space
Monitor - 800 x 600 resolution
Browser - Microsoft Internet Explorer 8.0 or higher
Internet access - 28.8 modem or better

To obtain electronic services and communications, indicate your consent to the terms and
conditions of this Agreement by clicking on the "I Accept" button.

It is recommended that you print a copy of this Agreement for future reference.