If your dog any any kind of medical history or if you reported any incidents of vomiting or diarrhea to your vet, then I do not recommend purchasing any plans from Trupanion. You will be sorely disappointed. Even if your dog has never been diagnosed with any kind of illness by your vet such as stomach related illnesses, Trupanion will quote you on those reports recorded by your vet and will deem them as pre-existing symptoms to deny your claims. If your dog has a pre-existing illness and contracts a completely different illness while you're on Trupanion's plan, they will deny your claim and say that it's relayed to the pre-existing condition even when it's not. I am rating them 3 because they're quick to respond to claims. They're also only worth the investment if you purchase it for a dog that has never been to the vet.