I'm a year late writing this review, but oh well. Last year, my then-4 yo chihuahua terrier completely tore his ACL and because of his breed and knee structure, the surgery was complicated and costly. My family did not have $5,000+ to pay for the surgery, and the vet doesn't do payment plans. Luckily, Lucas (the dog) had been serviced by Healthy Paws for over a year and we felt comfortable with the claim process. Usually these insurances are reimbursement based, but because it was such a large amount, I talked to a HPPI representative and was able to get them to pay their part up front (90%!) and I ended up paying only $500 for my dog's pre-surgery consult, surgery, and post-surgery check! And, because of their unlimited lifetime claims (unlike other providers) i have no worries that I am going to run out of insurance money as he ages (since he's just a pup). Overall wonderful service.