The reason I brought my small young dog to the ER was reduced to the word "tremor" on the Trupanion claim form. She had become unsteady and was unable to stand or walk. That is significantly more serious than tremor. Regarding Conditions Not Covered - The claim report states: We do not cover examination fees. Has any one of you ever had the dire need to visit an ER for a medical issue? What is the most critical action the attending medical staff must take? He or she must EXAMINE the patient. Had I been advised that Trupanion Insurance would not cover any examination fees, I might have suggested that the doctor theorize, speculate or make a good guess regarding my dog's medical condition - and save $142.00. Trupanion criteria for coverage is inequitable, irrational and unacceptable.