Thanks for a thought-provoking and informative thread.
I think it is always important to remember that the idea of having insurance is
peace of mind and ability to cover all needed care -- and one should not consider it a waste if (with luck!) you never have to claim back what you put in.
People can be funny about pet insurance -- no one insures their house and then feels indignant if the house doesn't burn down or get turned inside out by thieves so they can claim back what they have put in. But some feel pet insurance isn't worth it unless they know they will be likely to claim. Insurance is security and as so many say, a comfort if and when the worst happens. With insurance, as Nicki and others say, you do not have to question whether you can give a pet needed care.
My own perspective is a bit of a mix IF there are large numbers of pets: for up to three animals I would definitely go for insurance.
Once you are paying for three or more animals, I think it becomes a matter of weighing up the risks versus benefits versus likely costs and one's own comfort zone and willingness to make sure their dog gets adequate care as needed out of pocket if not by insurance. Maybe given rising costs the issue would be more like four or more animals... though there is a discount generally with most policies if you have three or more covered.
I think for some -- willing to accept possible large out of pocket payments -- there is an argument for taking what would be the annual premium cost for all the dogs combined and putting it into a savings account as an alternative BUT if you face an up front early problem there could be a huge cost for a single dog that would more than wipe out a treatment kitty.
Some have told of exactly such an experience.
I actually only have insurance on two of my five -- mainly because they had it from the start. None of the other three has needed treatment that would not have been covered by the deductible or the vast majority of it and Lucy is now old enough that I'd be paying 50% of her costs anyway. Jaspar has had two procedures now and his accumulated lifetime premium is I think still well in excess of what the insurance paid out for (a minor surgery on his foot and a myringotomy). Leo has SM but his costs are medications rather than MRI/surgery (it was cheaper to do the MRIs thru research programmes in the UK and insurance would not have covered those -- they are out of pocket donations towards research, from my point of view, scan costs plus travel and hotel).
With four cats it has/had been more cost effective to have savings towards any problems. I have had very few costs with the cats; Quincy's recent illness cost little more than a single year's premium would have cost me. I have a theoretical kitty of close to five thousand euro for the cats based on what I would have paid in premiums over all their lives.
For me, the cost of paying 5 dog and 4 cat premiums every year would be approaching €2000. Saving that money towards health issues has made more sense. But unlike most, I have a lot of furries -- I would definitely pay for insurance on a smaller number of dogs or cats, and am aware I am taking the risk of having a really enormous upfront cost at some point, but will cover that if it arises.