I adopted two feral kittens two years ago and signed up for the free 30-day Sheltercare policy from 24 PetWatch. Then I continued the policy. Kittens get sick a lot, after all. Mine turned out to have infections, calicivirus, several kinds of worms diagnosed at different times, and, to our horror, RINGWORM. It was a tough time; months of nursing, etc.. Ringworm treatment is expensive, and we were reimbursed hundreds of dollars with only minor runaround. For example, they needed medicinal dips every week for months, and the vet billed them as "grooming," so I had to clarify that one several times before I got reimbursed.
I got the hang of filling out the paperwork and dealing with issues on the phone pretty quickly. I thought the people I dealt with were friendly and helpful overall, and even sympathetic. So, that was 2 years ago. I haven't had dealings with them since and my cats are now big and healthy. Not sure I want to continue paying $32/month to insure them at this point when they will likely need only preventive care, which isn't covered, for at least a few years... on the other hand, as soon as I cancel, I'm sure one or both will develop a serious illness!
I believe it's worth it to insure a stray or feral kitten because they all have worms or some kind of issues and the costs add up. I'd recommend this company for that, but I have no experience with them in other situations, say, with older animals and chronic conditions.