On the topic of pet insurance, we maintain an emergency savings fund. So rather than paying out to a third party group, we pay into our own fund. That way we use it if we need to, and if we don't need it, we still have the money for other tasks once the pet passes away naturally.
I suppose the fund wouldn't cover incredibly expensive things like chemotherapy, but I also don't like the thought of putting one of our pets through something like that. We all draw different lines when it comes to pet care. For me, I would certainly treat a UTI because that is a treatment that is not painful, and the cat quickly goes back to being healthy and "fully active" again. But if my cat needed months of agonizing chemical / radiation treatment, for the chance of living a few more months in an in-pain state, that would be where I felt it was kinder to let her go.
But again I know we are all different in that regard, and that is fine.