VPI pays based on its reimbursement schedule, which does not even remotely reflect real life Vet costs. Also, many things are not covered at all. Of course you don't know this when you buy the policy. With cancer, they reimburse about 20 - 25% of actual out-of-pocket costs. When you do file a claim, the Explaination of Benefits they send is often vague and confusing so that you don't understand why things aren't covered, or that they might reimburse more if they had more information from your vet. The customer service people are very very nice, but are often unequipped to answer simple reimbursement questions in plain English. In general, if you NEED INSURANCE to care for a sick pet - you are not going to get a lot of help from VPI.