I have had Trupanion for my dog for 7 years, unfortunately my dog has had some health problems. Trupanion has been wonderful. Pays claims fast. Customer service is excellent, friendly caring people when you call. Trupanion will pay directly to your veterinarian if you choose and your vet agrees. (paper work involved for the vet, many can't do insurance paperwork due to staffing) They will make an emergency approval if needed, for me it was just a few hours to let me know that my claim was covered. I would definitely recommend Trupanion.