US Vets Don’t Want Anything to Do With Pet Insurance. They’re Afraid of Becoming Human Health Insurance.

Steve Long has a PhD in nematology — microscopic worms, studied at Imperial College as part of research into environmentally friendly alternatives to pesticides — and got into insurance entirely by accident. After deciding academic research wasn’t for him, he moved to Dublin in 1999 during the city’s dot-com software export boom and joined a startup called Selectaquote as a temp office administrator. Three and a half years later he was running the business, a white-label B2B financial services comparison platform covering home, auto, and travel insurance alongside credit cards and utility switching.

After a detour running an oil and gas simulation consultancy and then five and a half years as CEO of a global leader in offender management software (his phrase: “I’ve been in prison and jail a lot — don’t recommend it”), he was introduced to Steven Mendel, CEO and co-founder of what became ManyPets. He joined when the company was 20 people in a small London office doing under a million in revenue. Over the following seven years: launched pet insurance in 2017, launched Sweden in 2019, raised $350 million in a Series D at a $2.2 billion valuation in 2021, launched the US in 2021 (during COVID lockdown, notably), acquired a US insurance carrier, and grew past 600 employees. He left ManyPets earlier in the year of this recording and moved to Vitesse, a treasury and claims payment platform for insurers, working on their US expansion.

In Episode 111 of InsurTechTalk, Steve and I covered what pet insurance actually covers versus wellness plans, why US veterinarians are structurally reluctant to engage with insurers, and why unlimited coverage limits turn out to cost less than the number suggests.

About Steve Long

Dr. Steve Long holds a PhD in nematology from Imperial College London. He led ManyPets’ international expansion from 2016 through early 2024, launching the company’s business in Sweden and the US, leading the acquisition of a US insurance carrier, and sitting on the company’s global executive team. He is now US Expansion Advisor at Vitesse, a treasury management and claims payment platform serving the global insurance market.

Insurance vs. Wellness: A Distinction Regulators Are Now Enforcing

The core product distinction, and a genuine source of consumer confusion Steve encountered directly in ManyPets’ US market research:

• Pet insurance covers unexpected events — illness and accidents
• Wellness plans cover preventative, predictable costs — annual checkups, vaccinations, flea/tick/worming treatment, periodic dental cleaning

The confusion is consequential: ManyPets’ pre-launch US research found many consumers believed they had pet insurance when they actually held a wellness product. When an actual accident or illness occurred, they’d file a claim expecting accident/illness coverage, get rejected because the wellness plan never covered that category, and conclude — reasonably — that they’d been misled.

Regulators have started addressing this directly. The Pet Insurance Model Act pushes wellness providers toward the same regulated product pathway as insurance: providers can’t sell wellness and insurance in the same sales process or advertise them together unless the wellness product has filed its own rates and forms, either as a genuine insurance add-on or as a standalone regulated product.

Regulatory Classification Chaos: Inland Marine, Livestock, or a Third Thing

One of the stranger structural quirks Steve described: in the US, pet insurance doesn’t have a single, consistent regulatory classification. Depending on the state, it might be filed under inland marine, animal/livestock classifications, or a third category he couldn’t recall by name. Steve’s blunt comparison, coming from a UK-based company launching into the US: dealing with 50 state regulators is genuinely like dealing with 50 different countries, each with its own nuanced interpretation of what class of insurance the product even is.

Unlimited Coverage Sounds Bigger Than It Actually Costs

A genuinely counterintuitive underwriting insight: the US market commonly offers unlimited vet fee coverage, which sounds dramatically more generous than a capped policy. But the actual claims data doesn’t support the intuition that this creates runaway cost exposure. Steve cited the two largest pet insurance claims in the US the prior year — both for dogs with pneumonia, both around $60,000 (the year before, the largest claim was $79,000). Those are large numbers, but nowhere near the “millions” the word “unlimited” implies. His conclusion: moving from a $15,000 coverage cap to unlimited coverage doesn’t meaningfully change underwriting cost, because genuinely catastrophic claims at the true tail remain rare.

Country-by-Country Product Differences

Having launched the same underlying product in the UK, Sweden, and the US, Steve highlighted real structural differences beyond just regulation:

• Germany makes liability coverage compulsory as part of a pet policy — not the case in the UK or Sweden, where it’s optional (available standalone or as an add-on)
• The US market leans toward unlimited vet fee coverage as a competitive feature; liability generally isn’t part of the product at all — US pet insurance is essentially health coverage, full stop

Why US Vets Actively Avoid Engaging With Pet Insurers

This was the most striking finding from ManyPets’ pre-launch US research, and a genuine structural headwind for the entire category.

• In Sweden, roughly 90% of claims are paid directly to the vet, not the pet owner — Swedish vets are comfortable partnering with insurers because they see it as enabling treatment, not interfering with it
• US vets, by sharp contrast, largely wanted nothing to do with pet insurers during ManyPets’ research interviews — their explicit fear was that pet insurance would eventually follow the same path as US human health insurance, with insurers dictating reimbursement caps for procedures (an MRI, a CT scan) and effectively setting the vet’s pricing for them
• The practical result: US veterinary claims processing remains startlingly manual in places — Steve noted ManyPets still received handwritten veterinary notes submitted by fax, which he found genuinely astonishing given the era

I noted from my own research that US clinics have had to create an entirely separate role — medical billing specialists, often certified through a three-month course — purely to manage the relationship and reimbursement flow with insurers, a level of administrative overhead that doesn’t exist in markets like Sweden where vets and insurers work cooperatively.

The Real Pain Point: Customers Going Out of Pocket

Trupanion holds the patent on direct integration with veterinary practice management systems (their product, Trupanion Express) — letting a clinic see instantly whether a pet is insured and, if so, submit and receive claim payment directly, without the pet owner ever paying out of pocket.

Steve considers this the single biggest unsolved pain point in the US pet insurance category. His supporting statistic: roughly 57% of Americans can’t access more than $500 in available credit. A pet owner might genuinely be able to afford a monthly insurance premium and still be unable to cover a $5,000 emergency vet bill upfront while waiting for reimbursement — meaning the insurance exists but doesn’t actually solve the acute cash-flow problem at the moment it matters most.

Low Penetration, High Growth: Why the US Market Is Genuinely Attractive

Despite the structural friction, Steve’s read on the US opportunity is bullish, grounded in comparative penetration data:

• US pet insurance penetration sits around 3% of cats and dogs
• The UK is around 28%; Sweden is around 50% overall, and roughly 90% for dogs specifically
• Per NAPHIA (North American Pet Health Insurance Association) statistics, gross written premium growth has exceeded 24% annually for at least four consecutive years, with insured pet counts growing over 20% year-over-year across the same period

His explanation for the underlying demand driver: millennials increasingly acquiring pets in place of, or well ahead of, having children, and treating those pets as genuine family members worth insuring properly — a cultural shift with real staying power rather than a temporary pandemic artifact. He noted COVID actually accelerated pet acquisition and insurance uptake (the opposite effect it had on many other industries), and the underlying NAPHIA growth trend predates COVID by several years, suggesting the growth trajectory is structural rather than a pandemic-driven blip.

Why Differentiation Is Hard, and Where It’s Actually Possible

The US regulatory environment structurally undermines product-based competitive advantage in a way UK and Swedish insurers don’t face:

• Rate filings are public, typically 90-page documents disclosing every base rating factor and multiplier by zip code and breed
• “Me-too” filings let a competitor go to a regulator, copy an existing insurer’s policy wording and rates nearly wholesale, and launch a near-identical product under their own brand
• This makes product and pricing innovation very difficult to defend, in sharp contrast to the UK and Sweden, where Steve described pricing as genuinely proprietary “secret sauce” competitors would try to reverse-engineer via scraping bots rather than simply copy from a public filing

Given that constraint, Steve identified two durable levers instead: brand, and claims experience — noting that companies with strong Trustpilot ratings consistently earn them through fast, well-handled claims, while companies with poor reviews consistently cite the opposite.

Customer Acquisition Costs Went Through the Roof

Steve shared concrete numbers on paid acquisition cost inflation that illustrate why distribution innovation matters as much as product differentiation. Pre-launch cost-per-click benchmarks in 2019: roughly $2.50 in Sweden, £1.44 in the UK, £1.50 in the US. Between 2021 and 2022, US costs rose roughly 50% on Google alone, driven by a wave of new entrants competing for the same paid search and affiliate traffic (including pet insurance comparison/review sites). His conclusion: by the following year, acquisition costs through Google and affiliates had become genuinely unsustainable for many players, making alternative distribution — SEO, content (aided by newer large language models), and embedding insurance directly where pet owners already transact — increasingly necessary rather than optional.

The Race to Own the Pet Ecosystem

Steve flagged a consolidation dynamic worth watching: JAB Holding has been acquiring multiple pet insurers (Figo, Pumpkin, PetsBest among them) alongside a veterinary clinic chain (VCA). He speculated, without claiming inside knowledge of their strategy, that this positions them to potentially move toward an in-network/out-of-network model resembling US human health insurance — full coverage within their own clinic chain, additional cost outside it. Mars, separately, already owns a wide swath of the pet ecosystem — food, grooming, and its own veterinary clinics — without yet holding an insurance arm. The pattern across multiple large players: converging toward vertical control of the entire pet ecosystem, not just the insurance slice of it.

Advice: Don’t Skimp on the Upfront Work

Asked for closing advice, Steve’s answer was consistent with the “50 different countries” lesson from his own international launches: invest heavily in research and planning before committing to a new market, product, or major project. His specific example: the UK and Sweden were both, pre-Brexit, under the same EU insurance directive — an assumption that they’d therefore have equivalent regulations turned out to be wrong. Both countries interpreted the directive differently, and without upfront research, ManyPets would have discovered the gap only after barreling in with UK-built systems and processes that didn’t fit. His broader framework: clear objectives, a documented strategy, aligned stakeholders, and — critically — metrics that surface when something is going off track early enough to course-correct.

Key Takeaways

• Pet insurance and pet wellness are legally and functionally distinct products, and consumer confusion between them is a real, regulator-recognized problem the Pet Insurance Model Act is actively addressing
• US regulatory classification of pet insurance varies meaningfully state by state, adding genuine complexity beyond what a UK-based entrant typically expects
• Unlimited vet fee coverage sounds far more expensive to underwrite than it actually is in practice — genuine catastrophic claims remain rare even without a cap
• US veterinarians’ reluctance to engage with pet insurers, rooted in fear of following the human health insurance reimbursement-dictation model, is a structural headwind unique to the US market
• The out-of-pocket cash-flow gap between an emergency vet bill and insurance reimbursement remains the single biggest unsolved friction point in US pet insurance
• US regulatory rate-filing transparency and “me-too” filings make product and pricing differentiation extremely difficult to defend, pushing competition toward brand and claims experience instead
• Consolidation by large players (JAB, Mars) toward vertically integrated pet ecosystems — insurance, clinics, food, and beyond — is an emerging structural trend worth watching for what it implies about future network-based coverage models