My experience has for the most part been positive. I had one situation, and a very costly one, that I thought Trupanion could have stepped up to the plate. They are very tied to "a condition". ie - My pet needed to have a very boxer dental disease of a bleeding epulus and it was determined that she would need to ungergo a general anestetic to remove the oral masses. At the young age of 4, the vet detected a slight heart murmur and before he would proceed with the oral surgical work, which required, anasthesia, he prescibed the following diagnostics: complete blood panel, urinalysis, chest radiographs, ECG and an echocardiogram with a board certified cardiologist. Dr. Goldfarb stated to Trupanion that "The echocardiogram and cardiac work up was performed by Kristen McDonald at the Animal Care Center on 8/16/13. The ECG, chest radiographs and echocardiogram are considered diagnostic tests for the purpose of Lilly going under anesthesia and removing the oral masses. The cardiology report clearly states that "Lilly presents for aneststhesia clearance". Trupanion denied the singular claim and concluded that the ECG was a separate condition and applied the separeate deductible to the ECG even tho our vet wrote and said that it was a diagnostic test required for the anastesia. The cardiology report also stated that "Lilly presents for anastesia clearance", which is was the diagnostic procedure requied. Trupanion did not live up to their claim that "diagnostics" would be considered one claim. I was very disappointed that they considered this another "condition" rather than a diastonic test for a prescribed procedure. The deductible tab was over $500. for a "new condition". Otherwise, we have been pleased with their prompt response for other "conditions", but be careful how you "present" as they can worm around.