I've had insurance with them for 13 YEARS straight, since my dog was a puppy. I've been paying $30-$40 per month in premiums for 13 YEARS and only submitted 3 or 4 times - only ONE of which was approved. I just submitted a claim for preapproval for $2200 and was approved for a measly $150. Ridiculous considering I’ve put in far more than that in premiums. DO NOT GET TRUPANION - they are a sham “insurance” that will never pay out.