Trupanion is a pleasure to work with. My questions are always answered, and I was paid the benefits (after meeting the deductible) in a timely manner. They are very clear what is covered and what is not, since there are always exclusions. I had a complex issue after a rare leg fracture that required both my vet and a specialist surgeon (thank goodness surgery was not required). Each doctor had to sign the claim forms (each with a different diagnosis), and Trupanion handled it properly and promptly. One interesting note: After learning the surgeon prescribed physical therapy, Trupanion added a physical therapy rider on the policy "after" the accident without any question. My young Labrador now receives $130 physical therapy treatments (using an underwater treadmill) that only cost me $13. He loves the treatment (and the therapists) which I believe helped him recover 100%. No sign of lameness, and return to symmetrical muscle tone, which makes us both extremely happy. Didn't think I would need to use this insurance, but an accident can unexpectedly happen at any time.