We got off to a rocky start with Trupanion, who claimed that my cat's illnesses were pre-existing conditions. I spent some time on the phone until I finally talked to Kristy and everything changed. She agreed that his conditions were new and that they would cover them in full - and they have done so ever since. Our large bill for surgery ($5,300) was processed on receipt and we had the check in a week. He is now doing very well and we are very happy with the service that we are getting. My advice to others is to question denials of claims, and to push for reviews of any negative decisions.