I have had this insurance for almost 5 years. My yorkie had a end of a chew stick stuck in his throat he had to have surgery to remove the total cost incurred $4300. I comtacted trupanion and was totally impressed. They emailed me the claim form immediately and also faxed each vet a copy so that claim could be submitted. My claim was paid within a week and I received the cheques shortly after. I was surprised and very happy with the entire process. They were so accessible. The only surprise was that they did not cover taxes charged on the invoice i don"t recall seeing this as an exclusion. Anyways i would highly recommend Trupanion and did my friend bought the next day. Very happy pet owner.