When my fiance and I decided to bring Rosie, our golden retriever puppy, into our family I was very concerned about our vastly different ideas of how much we would/could pay out of pocket if she was seriously ill or injured. Although skeptical of pet insurance we decided to cover Rosie so we wouldn't have to make that impossible decision. We have had VPI Major Medical coverage for 7 months and have submitted 4 claims. One of the 4 claims and a portion of 2 others was denied because the charges were to rule out GI parasites which is excluded from coverage (stated in plan). Our largest bill from an overnight ER stay we received 80% reimbursement. The other reimbursements were less due to high exam fees and parasite tests which are excluded. We haven't had any surprises, since we carefully read the plan and were aware of all exclusions. We chose VPI due to the low yearly deductible and high annual and per incident maximums compared to other insurance companies. We have been very happy with VPI so far and I would recommend them, as I said we've had it for less than a year so I may have a new opinion if our premium is hiked up ;) I would also like to mention the customer service has been amazing, everyone I have spoken to on the phone is professional, kind, and very helpful.