Our dog was admitted to a pet emergency room the vet took an X-ray and said they had to perform emergency surgery if we wanted our dog to live. My wife and I were not worried because we had go pet insurance through Trupanion. We have now waited two months and gone through multiple appeals we even have a letter (that we had to go get) from the vet that completed the surgery which states that this surgery had to be completed to keep the dog alive. do not waste your money on Trupanion search for them on Yelp and other complaints about unpaid claims. This company is worse than any insurance company and just deny deny deny.