My dog required surgery for an injured knee and Trupanion was excellent from the first day! First of all, I could call anytime (day or night) and a customer service rep was there to assist me. They suggested I fill out a pre-approval form to ensure the surgery would be covered. The process was simple and Trupanion provided me not only with an answer, but a break down of what they would cover and what my costs would be within 48 hours of my pre-approval submission. Once the surgery was complete and my claims form was submitted, Trupanion had a check in the mail; which I received about 6 days after the claim. So difficult to find great customer service and a notification system like Trupanion offers.