Within 24 hour, of the vet and the ER vet faxing the insurance forms to Trupanion, we received confirmation, payment and condolonces as our pet eventually died after surgery. In addition, within the same week a notification that Trupanion cancelled our policy and monthly premium and even refunded us the remainder of the month. Since our dog died they had these records and took the initiative. Incredible. We also received an authentic heartfelt condolence note. We had never used Trupanion before, and wasn't sure animal insurance was "worth" the premium but in one tragic emergency they were there emotionally and financially. Truly a customer focused insurance company.