I don't think you can beat trupanions turn around time on claims. The really do pay you back really fast. When there is any problem with a claim they are eager to sort the problems out.
To date I have only had one issue with them. My pet had diahrrhea once when he was a pup before I had insurance. My dog is now 7 months old. Recently he has been diagnosed with elbow dysplasia. The Vet prescribed him Rimadyl which has a know side effect of causing diahrrhea and potential death. Trupanion deemed this a pre-existing condition even though my vet specifically wrote them a letter stating his diarrhea was caused from the rimadyl and he had no diahrrea before his treatment. So while they are good at paying expect them to act like any other insurance company and look for ways not to pay.
They also wont pay for things such as adequan injections it's deemed a supplement and not covered.
My best review will be comming soon. My dog has gone to see a specialist for his elbow dysplasia and the estimated bill is $2.7k-3.3k.