I do rather resent paying £54 a month for pet insurance. However, about four years ago our dog needed investigations and surgery and the final bill was around £7,000. I was very relieved then that we had pet insurance.
What irritated me, was that, having purchased a "for life" insurance (whereby your pet is theoretically covered in subsequent years, and indefinitely, for a recurrence of a particular condition or injury), we were then informed that the underwriters to the scheme had pulled out of the UK. This, we were told, meant that, although the company had been able to arrange cover "for life" for everything else, our dog would not be covered for a recurrence of the condition which had required surgery. It had not occurred to me that the company we insured with was, in effect, just a middle man and that if the underwriters were changed this could affect the policy.
On balance, though, I would always get pet insurance if I could possibly afford it. As whitewave said, it has to be borne in mind that the premium goes up each year, more as a pet gets older.
I believe that if people are in receipt of certain benefits they may be able to get help with treatment from Blue Cross and, I think, the PDSA.