If your dog is a member of your family like our Penny is in ours, VPI is well worth the investment to have the piece of mind. If humans should have health insurance, why shouldn't your furlings? We got money back towards her flea & tick, toward the shots, we got a significant amount of money back for the emergency visit when she had a boo boo. The VPI reps are super polite and helpful when you call in. They are also very communicative when emailing back and forth. I'm giving 8 of 10 because I think that the we should be able to submit through the vet's office, let VPI review, then pay the balance. Vet bills aren't always the cheapest!