Horrible. 0 if possible.We have had Trupanion insurance for over 3 years now and Trupanion has not paid a single claim. Each claim submitted has taken over a month to finalize and each time they come back and deny the claim.
If a vet wrote down that your dog fell down, Trupanion equates that to your dog having a history of seizures. They find something in your pets medical history that they can stretch into being something else to deny your claim. This has happened 3-4 times to us in 3 years.
When we originally signed up, we had a ~$20 premium with zero deductible. 3 years later with zero claims paid to us, our premium is nearly $45 with a $250 deductible.
I cannot stress enough what an absolute scam this company is. Horrible product, horrible service. Steer clear.