My 13 year old cat was diagnosed with nasal lymphoma. Trupanion has been stellar. Not only did they give us a pre-approval within two hours, they have paid every claim promptly and correctly and even called me to ask if I would like the payments deposited directly into my account. The payments are deposited with lightening speed. I also appreciate the courteous 24 hour phone customer service and non-existent to short hold times.