I have Trupanion as well and have been happy. I have the $1000 deductible to keep costs down as we have it on all 4 dogs. I truly only have it in case of a catastrophic event (knee surgery, cancer, etc). My premiums have only gone down in cost over the years. I haven’t had any claims denied, but they are kind of picky about what things are covered and what isn’t. So for example I submitted a $90 claim for Enzo’s appointment for a back injury. The exam was covered but the medications and some of the extraneous fees were not (I think around $55 was covered?). Now to me it’s not big deal as I only even submitted it in case it becomes more serious (I pray it doesn’t) but wanted to say that in case you expect them to always pay out penny for penny.