PetFirst was our first pet insurance experience. We read all exclusions which are many. During pre-op knee surgery (which we knew was not covered) our surgeon discovered a small tumor attached to the anal gland and removed it. It was later diagnosed as cancer. Our surgeon was careful to separate the cost of the tumor removal and was told in a phone call to PetFirst that the cancer was likely covered. We turned in the claim with 15 pages of surgeon's notes explaining and separating both surgeries. PetFirst then asked for 12 months of our regular vet's health records. When we finally received their determination, Pet First called the cancer pre-existing and denied the claim. Since there had never been cancer ever mentioned in any of our boy's vet reports in his 11 years, I called PetFirst. At first I was told the vet's exam for the torn ligament the week before surgery made the cancer a pre-existing condition. When I argued that no logic like that made sense since there had been no mention or awareness of cancer in any report let alone that one, I was told that anything related to the anal gland was not covered anyway. I have to say the coverage offered by this company is not worth the premium.