My 9 month old puppy was diagnosed with hip dysplasia several months after my coverage began and they pre-approved all the expenses for his x-rays and surgery. I went ahead and paid for thousands of dollars worth of treatment, only to get the payment DENIED by the insurance company. They are now saying that it was a pre-existing condition, even though they had pre-approved it before. They're unethical and will screw you over if they can.