Most of the time they pay back ok for claims (but when it comes to any insurance I have come to not expect too much). They are very reasonable with paying back on the yearly maintenance check ups. My vet actually recommended this company to me when my Abby was just a 6 week old puppy and now she is 6 years old and my vet says that VPI is one of the easiest insurance companies to deal with - there are some companies out there that have massive amounts of paperwork to fill out and my vet says that she should get paid extra from the client when she has to take a lot of time filling out forms. Lucky for me that is not the case with VPI. I was denied payment for distichia cryotherapy a few years ago that one of my cocker spaniels (Sandy)had to get treated for - the excuse was that spaniels are pre-disposed to eye problems. But my vet says that is wrong that other breeds get it too - she mentioned a beagle that she had as a patient with this condition. So you can get just as frustrated with what seems like an unfair denial like with people insurance. So that was a big bundle of money that came out of my pocket, would have been nice to get a little compensation on that one. Overall though I am pleased, I think this is probably the best pet insurance out there.