Great Customer Service. Representatives are very clear, helpful and consistent. The annual increase based on the area of residence was a surprise. I got Trupanion when my dog was less than a year old thinking there would be premium savings if we kept the insurance throughout the life span of our dog. By the time our dog is 10, our premiums will be so high, it will not have made a difference that we subscribed to Turpanion so early on.