We submitter 3 clames with our French Bulldog and so far, didn't run into any problems. Its just as advertised. We pay exam fee, one time deductible per condition, and everything else was covered by Trupanion (90%). Vaccinations and any preventatives are not covered.
All in all, great service, fast response, pleasant over the phone - great pet insurance.
Wish there was a place to upload your pets pics so that they could be featured on your profile and on the website. (current photo feature is not working).