We recently found out that our Brandi girl needed to have both her Knee's Replaced due to an injury. I submitted for a Pre-Approval with Trupanion for the first knee. They were so quick to get the pre-approval completed and Brandi was booked in for surgery just days after approval. She is now 3 weeks into healing and is doing so well. Trupanion had sent out payment before the weeks end after her surgery. I cannot say enough of how good Trupanion is. They truly care about your pets well being, they follow up and complete things on a very timley basis. If you don't already have pet insurance I highly recommend purchasing it and I recommend Trupanion 110%.