I have Trupanion (Canada) for Enzo - So far, we have not had to use it.
I look at it this way...Just like house, car, life etc. insurance - You pay your premiums hoping you never have to use it, but if your house burns down, your car is in a crash or you can't work due to illness, then you have it to help.
Same with Pet Insurance - I will gladly pay, and hope I never need it, but sleep better at night knowing I do