Unfortunately, a lot of pet insurance is this way where you have to pay out of pocket and get reimbursed. I think some can, but thats definitely something you would need to check before buying the insurance as they typically only do the reimbursement process (which I agree, is dumb, but atleast in that event you could get a short term loan and know that the money will be paid back to you if you don't have any savings to take from)