We have had such a wonderful experience with Trupanion thus far. The monthly fees for our cat have seemed reasonable. And they've more than paid for themselves. Our cat required several expensive procedures to remove almost half of her teeth due to resorption issues. That itself was stressful, as was the fear over whether we'd have a good experience with the insurance. We needn't have worried about that. Trupanion was very fast in responding to our pre-authorization requests (responding within the same day) when we explained the time-sensitive nature of our requests. And after submitting our claim forms, they indeed covered 90% of eligible expenses after the deductible. We received payment within a week or two of claim submission, as well.
On top of that, every interaction I had with them over the phone was quite pleasant. In addition to discussing the details of the work our cat needed, they showed concern and always wished us and our cat well. That was a nice touch, on top of the already great service.
This has been our only interaction with Trupanion over the 2 years or so we've had coverage, but based on this experience, we'd absolutely recommend them.