Exactly one year of having Trupanion was noticed that there would be a 267% increase in premium rate, which could be reduced by taking increased deductible. During the year they did pay claims timely as promised and were responsive. HOWEVER, personally feel victim of a bait-and-switch leaving me scrambling for another insurance carrier. Premium went from about $40/month to $109/month for similar coverage with an added California Amendatory Endorsement, which ironically changes that originally noted when policy was in conflict with Calif laws, the provisions are amended to conform to such statues -- amended to state that if the provisions of the contract conflict with Calif laws the policy is canceled (at least that is how it reads). Rating based on their unbelievable actuarial stats from year to year costs.