Practically every single insurance company asks you if you want them to pay the vet direct, and most use this as a selling point. But, as Susanne points out, it is at the vets discretion, neither mine nor the out of hours vet will allow that, and the rescues vet only do it very occasionally, and mainly for very well known customers with a lengthy illness. So, it should be your vet you ask about that, dont take the insurance companies word for it. Ela, for the vets who will allow direct payments, I think the cheque would be made out to them, so there is no chance of them not getting their money - the prob is the owner still has to pay the excess, and I know with PEbbles first claim, it took about 5 weeks to come through, and about 4 phone calls - I shouldn't expect my vets to have to wait/deal with that. Plus there are some claims that are refused.
Dawn - I thought mine would have gone up, as they paid out over £500 for PEbbles in the first year of claiming, but it actually went down, as I had insured her when their prices were quite high, and they had reviewed them since.