My big dog Roman went down hard with a herniated disk in his neck. He was largely paralyzed and could not stand or walk. Fortunately I had taken the precaution of insuring him and I happen to live near one of the finest Veterinary Hospitals in the country. Within a week, he was walking again and Trupanion paid the bulk of the cost. My settlement required that I turn in a form to the hospital with my name, email address (which identified my account) and name of my pet and one month later I got the check.