Our 2 1/2 year old lab began vomiting a large volume of bloody gelatinous goo which was...disturbing, to say the least. We took her to our vet who sent us to an emergency vet who kept her overnight while performing a multitude of tests. I picked her up the next day along with some medication and a $2400 bill. We submitted a claim to Trupanion the next day and found their customer service to be very responsive. They kept us updated on the claim status as they gathered the necessary information from the vets involved and 2 weeks after the incident we were notified that a check was in the mail. After removing the cost of the vet exams (not covered) and our deductible, Trupanion reimbursed us $2000. Very satisfied! The only caveat is that the vet bill must be paid in full by the pet owner who is then reimbursed by Trupanion instead of the vet billing Trupanion directly. Overall we were very satisfied by our experience. The knowledge that we can afford to provide medical treatment for our dog without having to skip a mortgage payment gives peace of mind. Well worth the monthly premium.