I've worked with three different pet insurance companies and Trupanion is far and away the best. Claims were handled by my veterinarian, before I even paid. At other companies, I had to pay in full first, and then fill out a mountain of forms, and then wait for a reimbursement check to come in the mail, and that was usually a paltry sum, because there was so much they just didn't cover. With Trupanion, everything was covered 90%!! And because the service is so easy and efficient, I was able to focus on the well-being of my pets--not on the headache of insurance forms. They're compassionate, friendly, helpful, efficient--I'm a BIG fan of Trupanion.