Doggy had a sudden swelling bulge under his tongue. It didn't seem to bother him much, but it was abnormal. No apparent cause was identified and exploratory surgery was recommended. This is the first claim I have sought coverage with Trupanion. After the required deductible was met, coverage was at 90%. At the time of paying for treatment, most providers will likely require payment be received prior to returning the pet to the owner. Simply ask the office to complete the Claim form that can be easily prepared from the web ahead of time, or provide a blank form for future use with the office. The information will be reviewed by the underwriting agency, and payment remitted. Some aspects to be aware of for first claims, Trupanion will want to receive copies of medical records to verify pre-existing conditions prior to pet being insured. In my case, I insured my pet the first evening in my home. The responsiveness of the particular vet's office will determine when this request is fulfilled. Delay will result in claim remaining pending, but I do not consider that to be problematic.