So far, so good. My 13 year old cat is having some serious bowel issues, and thus far, the bills have totaled close to 3,000 for very expensive tests (rare and sophisticared blood tests/colonoscopy/endoscopy) etc. Trupanion has covered everything they said they would. Because I insure 5 cats with them, I opted for a 250 deductible per incident per cat to keep the premiums lower. As their policy states, after the 250 deductible in my case, 90% of everything has been covered. What a relief, I don't know what I would do without this insurance. The cat is still having issues, and I don't know what else will come out of it, but I have peace of mind knowing I can get her the help she needs without fretting over the money part of it.