The literal WORST insurance to have. A friend spoke highly of them so I decided to give them a try for one of my pets even though I was satisfied with my other pet insurance I have had for my other cat. In the 2 years that I paid almost $80 a month I had one claim with them and they refused to pay it. My cat went to the vet for unknown medical reason showing a symptom of vomitting. They checked him out and could not find a cause nor a diagnosis and he basically just got over it. But Trupanion took a good and thorough amount of time scouring his historical medical records looking for a REASON NOT TO PAY. They justified a denial because my cat had historically had an issue with vomitting from a hairball. SERIOUSLY! History of vomitting was their reason of denial. So I got stuck with the $300 vet bill. Effectively they have made that money from me in 4 months of those 2 years that I have paid $80 per month and he has literally been to the vet ONCE because he is healthy, They are useless and NOT to be trusted. I'm sure they spent more money on staffing salary to scour the medical record and find a reason not to pay me than they would have if they sent me a check for $200. And frankly the reason is not a good one. I would completely agree if it was an actual diagnosed preexisting condition, but frankly I consider this borderline theft. Which BTW...does anyone know a cat that has not vomitted from a hairball? Just curious! I would say who my other insurance is that has treated me really well but I don't want to discredit my very well earned and deserved review.