I have had VPI for about 19 years. Have no experience with other companies so can't compare. My vet's office pushes Trupanion and I did get a quote. They may reimburse more but their premiums seemed high. Was very happy recently when out of the blue my 2-year-old Scottie got very ill. After the $500 deductible, I was reimbursed the rest, so was very happy. Also, last year my elderly Scottie had surgery for liver cancer. Unfortunately, she did not survive, but VPI was a godsend with helping to pay those bills at a time when we were grieving. I am hoping the premiums do not go up too much because I have made these claims. I would be happy never to have to claim again though.