Claimants have lost a dispute over their dog’s medical costs after the industry complaints authority found PetSure correctly capped its payout at $2600.  

The pet ruptured a cranial cruciate ligament – part of the knee joint – when jumping on or off a bed last year. It needed about $6500 of vet care, including surgery.  

The owners’ claim was accepted but the payout was capped under the policy’s annual sublimit for cruciate ligament conditions.  

The claimants argued the claim should fall under a different accidental injury cover.

But Petsure said its policy stated that ligament injuries, and the associated sublimit, included those caused accidentally.  

The complainants said the policy definition did not explicitly refer to cruciate ligament injuries.

But in its ruling, the Australian Financial Complaints Authority said: “It is clear that a cruciate ligament condition includes injuries that were caused accidentally, such as through jumping.”

It added: “The intention of the policy is clear that where the traumatic injury is a tear to a cruciate ligament, the policy covers that injury as a cruciate ligament condition.”  

See the ruling here.