I have been using the services of this company for couple of years. Recently, there was an accident with my cat. The total bill for the surgery from the vet clinic was more than $700. Trupanion quickly confirmed the coverage, and at the check out of the cat (which was 3 hours after surgery) I was charged only the 10% of the accident related costs - the rest was paid by Trupanion. Although, I had to pay the initial check up costs.