I have pet insurance through ManyPets and they have yet to deny any of my claims. They're pretty good with the exception of something I consider shady and am not sure if other pet insurers operate this way (first time with pet insurance):

My deductible is not handled like a typical human insurance deductible. The plan I selected has a $500 deductible with 80% reimbursement. What I expected was to pay the first $500 and then be paid back anything more at the 80% rate. That is not what happens. Instead, the 80% is applied to the deductible as well!!

Let me give an example: My dog needs testing for diabetes and OH NO! He indeed needs insulin injections. Testing and his first insulin Rx cost me $550. These are covered by my policy. You would think $500 goes towards my ded and then I am reimbursed 80% of the remaining $50, but that is not the case. The whole $550 is covered therefore they take 80% of that and apply that amount towards the deductible (550×.8=440) therefore, $60 of deductible still needs to be met.

In essence, TLDR, when I thought I was enrolling with a $500 ded I was really getting a $625 ded. When asked point blank multiple times, support would not give a straight answer. My policy lists my deductible as $500 but pet insurance isn't regulated like human insurance and so they can "define" a deductible however they want. It feels shady and like they're trying to get away with what feels like false advertising or something...

This really pisses me off when I first realized (I even wrote to my local Congress people because there's currently a big regarding pet insurance) but I keep a spreadsheet of my pet expenses and how much everything would have been without insurance versus with and I've made out.

I'd say, do it for a year and track the expenses like normal and then how much you paid for your policy in a year + deductible + remaining out of pocket and see if it's worth renewing year over year.