This is my 2nd claim in a couple of months. A couple of months ago she needed mouth surgery and 6 teeth removed along with other tests. The bill came to $1300 but I only had to pay about $256.00. My vet's office uses express claims and I did not have to lay out all that money and wait for a refund. I only paid my portion. This time around my cat was vomiting quite a bit and tests were taken. Her bill came to about $286.00 and with express claims I only had to lay out $78.00. I've had VPI in the past for several dogs and did not get much money back, but did pay more for the monthly premium as well. I'm thrilled with Trupanion so far and hope they continue to take care of us the way they are now.