They will do everything in their power to not pay. Apparently a 2 year old dog has a history of osteoarthritis. All their proof comes from treatments that occurred AFTER we started the insurance plan. We tried some chiropractic treatments which I paid out of pocket rather than get the rider in order to reduce some stiffness in her shoulder. The only way to challenge a claim is for your vet to write a clarification letter. My vet doesn't feel comfortable writing such a letter as she has endured harassing calls from insurance companies when she has done it, including Trupanion apparently and has her business to consider.I believe it. When I called to get clarification on what would be covered they tried to use fear to keep me from cancelling.