Weeks of exploration, false diagnoses (just a difficult thing to find) and finally an MRI and neurological consult, and a herniated disc was found and removed. Trupanion employees were quick, caring, and over the course of a month managed to keep me calm and pre-approve various procedures and then the surgery so we could deal with the considerable pain my poor Jake was in. I dealt with them over the phone, by e-mail, and through my vet and the surgeon, and in every situation, Trupanion was professional, quick, and reassuring to me. The follow up was terrific, and I couldn't be happier. Not sure why others have such an increase, but when our premiums were announced to increase, we were given the option to increase our deductible instead. $150 and 10% was completely reasonable as far as I'm concerned, since the total bill was almost $10,000! We pay less than $50 per month, and our pug is alive thanks to our decision to have a Trupanion policy.