New Jersey has enacted comprehensive pet insurance rules, giving producers less than a year to implement new requirements across sales, disclosure, and training.
The state's "Pet Insurance Act" was approved on January 12, 2026 as Public Law 2025, Chapter 224, following Senate amendments on December 18, 2025. Sponsored by Assemblywoman Carol A. Murphy, Assemblyman William B. Sampson, IV, Assemblywoman Rosaura "Rosy" Bagolie, Senator Vin Gopal, and Senator Joseph P. Cryan, with co-sponsorship from Assemblywomen Hall and Speight and Senator Mukherji, the legislation establishes a detailed regulatory framework for pet insurance in New Jersey. It applies to pet insurance policies issued to residents, sold, solicited, negotiated, or offered in the state, and to policies or certificates delivered or issued for delivery in the state.
A core requirement is the use of standardized definitions for key terms. If a policy uses terms such as "preexisting condition," "chronic condition," "hereditary disorder," or other defined concepts in the act, insurers must use the statutory definitions and include them in the policy, and also make them available through a clear and conspicuous link on their main website.
Preexisting conditions receive specific treatment. The law defines a preexisting condition as any condition for which, prior to the effective date of the policy or during any waiting period: a veterinarian provided medical advice; the pet received previous treatment; or, 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 that policy.
Other critical terms are likewise defined. A chronic condition is one that can be treated or managed but not cured. A hereditary disorder is an abnormality genetically transmitted from parent to offspring that may cause illness or disease. A congenital anomaly or disorder is a condition present from birth, whether inherited or caused by the environment, which may cause or contribute to illness or disease. The act also defines "orthopedic," "pet," "insured," "renewal," "veterinarian," "veterinary expenses," "waiting period," and "wellness program."
The law includes extensive disclosure obligations. Pet insurers must disclose whether the policy excludes coverage due to a preexisting condition, hereditary disorder, congenital anomaly or disorder, or chronic condition. If the policy includes any other exclusions, it must use the specific statement: “Other exclusions may apply. Please refer to the exclusions section of the policy for more information.” Insurers must also disclose any policy provisions that limit coverage through a waiting or affiliation period, a deductible, coinsurance, or annual or lifetime policy limits; whether they reduce coverage or increase premiums based on claim history, the age of the covered pet, or a change in the insured’s geographic location; and whether the underwriting company differs from the brand name used to market and sell the product.
The act mandates a 30-business-day free look period. Unless a claim has been filed, the insured may examine and return the policy, certificate, or rider within 30 business days of receipt and obtain a refund of the premium if not satisfied for any reason. Policies, certificates, and riders must include a prominently printed notice on the first page, or attached, with specific instructions for accomplishing a return and with the prescribed free look statement in capital letters.
On claim payments, the law requires insurers to clearly disclose a summary description of the basis or formula used to determine claim payments under the policy. This must appear in the policy, prior to policy issuance, and via a clear and conspicuous link on the insurer’s main website or its program administrator’s website. Insurers that use benefit schedules must clearly disclose the applicable schedule in the policy and make all benefit schedules used under their pet insurance policies available online. Insurers that base claim payments on usual and customary fees, or other reimbursement limitations tied to prevailing veterinary service provider charges, must include a provision describing the basis for determining such fees and how that basis is applied in calculating claim payments, and must disclose that basis on their website.
If a medical examination by a licensed veterinarian is required to effectuate coverage, the insurer must clearly and conspicuously disclose the required aspects of the examination prior to purchase and disclose that examination documentation may result in a preexisting condition exclusion. Waiting periods and their requirements must also be clearly and prominently disclosed to consumers before purchase. Insurers must provide a separate “Insurer Disclosure of Important Policy Provisions” document summarizing all required policy provisions, make it available through a clear and conspicuous website link, and provide a copy in at least 12‑point type when delivering a new policy. At issuance or delivery, they must also provide, in 12‑point boldface type, the Department of Banking and Insurance’s mailing address, toll-free number, and website address; the insurer’s or agent’s/broker’s address and customer service number; and, if applicable, a statement advising the policyholder to contact the broker or agent for assistance.
On preexisting conditions, the law permits exclusions but places the burden of proof on the insurer. A pet insurer may issue policies that exclude coverage on the basis of one or more preexisting conditions with appropriate disclosure, but the insurer must prove that the preexisting condition exclusion applies to the condition for which a claim is being made.
The statute allows waiting periods but limits them. Insurers may impose waiting periods of no more than 30 days for illnesses or orthopedic conditions not resulting from an accident. Waiting periods for accidents are prohibited. Coverage must be effective by 12:01 a.m. on the second calendar day after purchase, subject to specified exceptions: individualized underwriting (coverage effective by 12:01 a.m. on the second day after the insurer determines eligibility); delays to establish a premium payment method; alignment with an employer or organization’s benefit plan eligibility and effective date for group-related coverage; or, where a policy does not include a waiting period for illness or orthopedic conditions, a policy effectuation date up to 15 calendar days after purchase, if clearly disclosed and no premium is charged before the policy becomes effective.
The law further provides that a pet insurer shall not require a veterinary examination of the covered pet for renewal. If any prescriptive, wellness, or non-insurance benefits are included in the policy form, they must be made part of the policy contract and follow all applicable laws and regulations. An insured’s eligibility to purchase pet insurance may not be based on participation, or lack of participation, in a separate wellness program.
On wellness programs, the act states that pet insurers or insurance producers may not market a wellness program as pet insurance. Where a wellness program is sold by a pet insurer or insurance producer, the purchase of the program must not be a requirement for purchasing pet insurance; the costs must be separate and identifiable from any pet insurance policy; a payment transaction for pet insurance must be separate from a payment transaction for a wellness program; the terms and conditions for the wellness program must be separate from those of any pet insurance policy; products or coverages available through the wellness program must not duplicate those available through the pet insurance policy; and advertising of the wellness program must not be misleading and must comply with the statutory requirements. The law also requires clear disclosure, in 12‑point boldface type, that wellness programs are not insurance, along with the address and customer service telephone number of the insurer or insurance producer or broker of record, and the department’s mailing address, toll-free number, and website. At the same time, coverages included in a pet insurance policy contract and described as “wellness” benefits are deemed insurance.
Producers face explicit training and licensing requirements. An insurance producer may not sell, solicit, or negotiate a pet insurance product until appropriately licensed and after completing required training. Insurers must ensure their producers are trained on the coverages and conditions of their pet insurance products. The training must cover preexisting conditions and waiting periods; the differences between pet insurance and noninsurance wellness programs; hereditary disorders, congenital anomalies or disorders, and chronic conditions and how pet insurance policies interact with those conditions or disorders; and rating, underwriting, renewal, and related administrative topics. Training requirements of another state that are substantially similar will satisfy New Jersey’s training requirement. A producer may only be licensed to sell pet insurance if they hold an active life, health, personal lines, or property and casualty line of authority and are in good standing when they submit an application for licensure.
The commissioner of the Department of Banking and Insurance is authorized to establish and enforce penalties for violations of the act under existing statutory authority. The department may adopt rules and regulations pursuant to the Administrative Procedure Act to effectuate the purposes of the act.
By its terms, the act takes effect on the first day of the 12th month next following the date of enactment. With approval on January 12, 2026, that effective date is January 1, 2027, giving pet insurers and producers just under a year to bring policies, disclosures, systems, and training into line with the new requirements.
