I would rate ASPCA higher if they reimbursed a greater percentage of the bill. I have two vets who charge at or below competitive standard rates in a tri-county area and ASPCA claimed that their charges were high in comparison to other vets. Therefore, I did not get a full reimbursement. My past pet insurance company never questioned the bill and paid 100% - but, my premium was substantially higher. And, I have encouraged ASPCA to consider chiropractic adjustments as it has been proven this treatment is a viable precursor to invasive and expensive surgery. I do have concerns after reading other reviews about pre-existing conditions. With that said, I have found that ASPCA has excellent customer service, they are open to suggestions and take the time to answer my questions. I will do a comparative study of other pet insurance companies when I am up for renewal (as I always do, regardless of insurance companies) and if some of these issues are addressed, I will stay with ASPCA.