My dog ate part of a toy chew rope, It was lodged in his intestines. He was very sick, x-rays could not see it. He become so sick they had to do exporitory surgery to find the rope. I received a call from the vet that not only had they found the rope his intestines had burst. He had a very slim chance of making it though the surgery and then the recovery of the poison in his system. Plus it would be costly for the recovery and surgery. The question was do you want to put in down! No, was the answer right away, do what every you can to save him. I got on the phone with the Trupanion and made sure all was covered and the folks on the phone was so nice and understanding as to the stress I had on me that day. They covered everything except my deductible and 10%. I had to pay up front to all the vets and ER but I received checks from Trupanion in a weeks time. I could not have asked for better service than that! FYI my dog is doing great and made a full recovery.