My dog suffered a soft tissue injury. We brought him to the vet, they examined him, took x-rays and diagnosed him, sending us home with pain meds. Our vet submitted to Trupanion and we recieved our reimbursement,EXACTLY as described in the insurance information. Even better: Now that we have had our first claim processed, our vet trusts Trupanion enough to submit claims directly and only bill us the difference! No up front costs at all. It gives me peace of mind to know that my Veterinary clinic trusts the company that much. We are all very happy campers with a very healthy puppy!