E&L take an age to pay out. My dog developed diabetes and a few month later he was totally blind. Cataract surgery was arranged at a private vet. I had to take the insurance policy to the consultation the consultant wasn't familiar with E&l but thankfully when he checked the policy he agreed to a direct to vet payment. I had to sign forms to agree I was responsible for Payment if insurance didn't pay out within 90 Days. Thankfully they, did any claim direct to the vet is paid out quite quickly. Any treatment from his regular vet I have to pay up front then wait an age for payment. I received an email on 12/12/17 from claims department the had received my claim form after phone calls to them I am still awaiting payment over 8 weeks later. If people are on a tight budget I could imagine how much stress this would cause.