We purchased our policy with Trupanion within the first year of owning our pet...a Maltipoo She was recently was diagnosed with a condition effecting both knees known as 'Luxating Patella'. We were shocked to learn that the surgery would run over $3,000. We called Trupanion and after a thorough review of our Veterinary Pet History, they pre-approved the claims. The surgery turned out to be $3,146 and Trupanion paid 90% of this cost!! We were very pleased with their professionalism and service. No bait and switch that you hear about with so many other companies. No debate. Their policy is well written and easy to understand. I highly recommend trupanion if you pet does not have any pre-existing conditions. For a new pet under 12 months..it's a no brainer...just do it!