We sadly acquired a puppy that developed a severe deformity. To get a diagnosis it took multiple x-rays, ultrasounds and MRIs. Needless to say this was several thousand dollars of tests, and now ongoing treatment and rehab. Trupanion paid just as the contract we signed said they would. Everything has been reimbursed at 90 percent and in a timely manner. I wish my personal insurance paid this well ! I would highly recommend Trupanion to all pet owners. Best to buy when your puppy or kitten is young, then there is no question about a pre existing condition...really a fantastic company!