Trupanion answered the phone when I called them from the emergency hospital. They were in contact with the emergency hospital very soon. It took 25 minutes before the hospital got the OK from Trupanion that they would cover the claim. I don’t know what the hospital would’ve done in that one hour if my dog had needed intervention other than giving him fluids and comforting medications. I guess they would’ve told me I would have to pay everything upfront until they heard from Trupanion. After the incident was approved by Trupanion, everything went smoothly. My dog got the life-saving surgery he needed and Trupanion paid their part directly to the hospital. I paid my part directly to the hospital upfront. It was a smooth deal other than one email that said the claim was not approved but that turned out to be in case they needed to take out his spleen which Trupanion thought would be a separate event not related to the GDV. The GDV was caught early enough that the spleen did not need to be removed, but had it needed to be removed it would have been covered. Thank goodness.