We rescued a 6 year old GSD in late 2010 and enrolled him in Trupanion shortly thereafter. A few months ago, we learned that he had a heartworm infection, and that his treatment would cost over $2000, an amount which would have been difficult for our family to afford. We went through the pre-approval process with Trupanion, and they approved our pre-approval request within 48 hours of receiving it. After the heartworm treatment, Trupanion reimbursed us for its cost about 3-4 days after we submitted the required paperwork. Thanks to Trupanion, we hope to enjoy many more healthy years with our beloved pet. Wish insurance companies for humans worked as fairly and efficiently as Trupanion!