Why a cruciate ligament tear in one knee can limit cover for the other, and which providers publish their rule.
Drafted with AI tools from our own cost data and the sources linked on this page. A veterinarian has not reviewed this guide. See our editorial policy.
A bilateral exclusion treats paired body parts, such as two knees or two hips, as one condition. If one knee is claimed or excluded, the other can be excluded too. It matters most for cruciate ligament tears, which are among the most expensive claims. Few providers publish their rule, so ask before you buy.
Dogs have two of several things that tend to fail: knees, hips, elbows, eyes. Insurers know that a problem in one side is often followed by trouble on the other, and many policies are written to account for it. The clause is called a bilateral or paired-condition exclusion, and it is easy to miss.
In plain terms, the second side may be treated as the same condition as the first. If the first knee was claimed, or was excluded as pre-existing, the second knee can be excluded for the same reason. The wording varies, and so do the details of when the clock starts and whether the exclusion lasts for life.
Local currency, before tax. Figures are the typical range in our index on 2026-11-05, not a quote from any one clinic.
| Country | Typical range | Currency | Highest city | Lowest city |
|---|---|---|---|---|
| 🇨🇦 Canada | $4,500–$8,000 | CAD | Vancouver $7,190 | Regina $5,440 |
| 🇺🇸 United States | $3,825–$6,800 | USD | San Francisco $7,440 | San Antonio $4,675 |
| 🇬🇧 United Kingdom | £2,610–£4,640 | GBP | London £4,895 | Belfast £3,080 |
| 🇦🇺 Australia | A$4,275–A$7,600 | AUD | Sydney A$7,125 | Hobart A$5,460 |
| 🇮🇪 Ireland | €2,790–€4,960 | EUR | Dublin €4,845 | Waterford €3,490 |
| 🇳🇿 New Zealand | NZ$3,690–NZ$6,560 | NZD | Auckland NZ$5,740 | Invercargill NZ$4,610 |
Same procedure, same country, eight Canadian cities. Rent, wages and how many clinics compete locally do most of the work.
The cranial cruciate ligament is the dog's equivalent of the human ACL. A tear is typically repaired with a surgery called a TPLO or a similar procedure. In our national index a cruciate ligament repair runs from $4,500 to $8,000 in Canadian dollars (a modelled range, not a quote). Ligament trouble in one knee can be followed by trouble in the other, so the clause can sit on top of a second bill of the same size.
Most providers do not spell this out on their public pages. These are the ones that do.
Not verified for: Desjardins Insurance, Fetch Pet Insurance, Furkin, Pets Plus Us, Sonnet Insurance, Spot Pet Insurance Canada. Blank means we could not confirm it on their public pages, not that it is missing from the policy.
Cruciate claims also run into the orthopaedic waiting period, which is longer than the illness wait. Here is what each provider states.
Not verified for: Fetch Pet Insurance, Pets Plus Us, Spot Pet Insurance Canada. Blank means we could not confirm it on their public pages, not that it is missing from the policy.
Get the answers in writing, or find the clause in the policy document. Related reading: what a cruciate ligament surgery costs, and pre-existing conditions explained.
Insurer terms checked 2026-10-25 from each insurer's own public pages. Terms change: check the policy before buying.
We build a national typical range from published clinic price lists, veterinary association fee surveys and real bills owners submit to us, then apply a city multiplier for local rent, wages and clinic density. Non-Canadian markets scale the same base by national price level. Figures are estimates in local currency before tax, never quotes. Once three verified bills exist for a city and procedure, the real bills replace the estimate.
Full method and correction policy: our methodology page. Spotted a price that is wrong? Send us the invoice and we will fix it.
A clause that treats a condition affecting both sides of the body, such as two knees, as one condition, so a claim or exclusion on one side can limit cover on the other.
No. It is commonly applied to any paired body part, including hips, elbows and eyes. Check the policy wording for the list.
You can reduce it by buying cover while your dog is young and has no ligament history, and by choosing a provider that states a clear rule on paired conditions.
No. It means we could not verify it on the provider's public pages. Ask the provider and read the policy document.
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