Our 6 month old shih tzu, Sassy, was in for spaying and umbelical hernia repair. Our vet found she also had decidious teeth that was not loose and interfering with the formation and placement of permanent teeth. With our permission, she pulled these teeth while having her under anesthetic for the other things. While Trupanion does not cover spaying or the umbilical hernia (pre-existing), they promptly paid for the teeth removal and part of the anesthetic. The claim was handled promptly and completely to my satisfaction. Best decision I made was to get Trupanion. I have peace of mind.